It is the natural progression within many families: growing up and going away to college. The expectation that a young person will be ready for higher education around the time they are a legal adult, is so common in our modern culture that we think of it almost as a rite of passage. But what about young people who have struggled with an eating disorder? Does this change the expectations? Parents around the world face this issue every day and there is no one answer, just as every family and every individual student is unique.
Are they ready?
The first question to ask is whether the young person is ready for college. This is not just a matter of being at a certain weight or being medically stable. This is a question of not just medical health but emotional wellness. College is a place where a student has to be fully well, even more than their peers – as the challenges of staying well add to the skills necessary for independence. Students will need to be able to maintain health during a new and sometimes stressful transition. In addition, eating disorders often leave intellectual abilities unscathed but dramatically delay emotional development and maturity. The time spent on recovery may delay any number of independence skills and the ability to self-regulate in a new environment.
The stress of change
Most young people have not lived on their own before college. Managing one’s possessions, schedule, money, relationships – not to mention laundry – for the first time are a significant shift from living at home. Change and uncertainty are a challenge for many eating disorder patients not just during the active eating disorder but also throughout their lives – making the transition to college living more risky.
Monitoring at school
Most students going off to college do not have to monitor a health condition as well, especially a life-threatening one. Those with a predisposition toward eating disorders can’t afford to go without careful and well-informed monitoring of medical and mental health. Many families require their college age children to have a local medical and psychological team for regular check-ins and sign disclosure forms so health information can be shared with parents. College students can be expected to resist such measures, but the risk of unmonitored relapse is too great and too dangerous to ignore.
Relapse prevention, and contracts for withdrawal
Students need a plan, preferably written and agreed upon by the family and the school, that describes exactly what symptoms or behaviors would trigger a leave of absence. Having a plan can even mean avoiding carrying it out: when a student knows the expectation, they can be more proactive about avoiding relapse.
Contracts are tools that treatment providers and families can utilize to help prevent relapse. These documents establish goals, measures, and resources as the student moves forward toward independence. Contracts can be an important tool for all parties involved, offering structure and safeguards to keep recovery on track.
An eating disorder can derail not only one’s education, but also one’s life. It is important for parents and treatment providers to work together to ensure that those struggling with an eating disorder receive the best treatment available.