Eating Disorder Recovery: Is Your Daughter or Son Ready for University?

One of the biggest transitions for any teenager is the move from high school to college or university. If your daughter or son is also in recovery from an eating disorder, it can be frightening to let them go. 

What if they aren’t ready? What if they relapse?

It’s scary as a parent, right? Especially after seeing them struggle so much when they were at their worst.

Part of recovery from an eating disorder – when its onset is during adolescence – is catching your child up on things that were halted developmentally. These might include: 

• Food logistics: Grocery shopping, meal planning and basic cooking.

• Portioning and Balanced Meals: Learning appropriate meal portions, understanding how to create a balanced meal and how often to eat.

• Independence: Practicing cooking meals independently, having go-to dishes they can cook confidently and eating without parental or therapeutic support.

• Social eating: Navigating meals with friends, especially spontaneous outings. 

• Autonomy: General decision-making and navigating adult relationships without constant parental support (especially if relationships have been disrupted or never started because of the eating disorder).

Assessing Readiness for the University Transition

There are many things to consider in the lead up to the university transition. Below are some of the main areas that I work with my clients on and how I can tell if they’re ready to go.

Medical, physical, mental and emotional stability. This is a catch-all category that I monitor in the lead-up months to see whether they are managing their daily lives well.

Medical stability: Recent bloodwork should come back with no red flags, vitamin deficiencies are managed with supplements if they’re not getting them through their diet, and any medical conditions are well managed.  

Physical stability: Weight should be stable for about 6 months. I do not usually have my clients weigh themselves regularly at this point in recovery, but checking in every 3-6 months can be enough to monitor whether there has been any fluctuations. Movement should have been reintroduced in a reasonable manner and is not being used to compensate after meals. Before and after exercising, they are (re)fueling their bodies appropriately and resting.  

Mental stability: Food and exercise rules should not be dictating their food choices, and they are honest with themselves and others about what and how much they’re eating. They’re able to eat balanced meals and try new foods, especially when eating out.

Emotional stability: Emotions are being regulated by non-food and exercise strategies, and a toolkit for managing emotions has been developed and become mostly habitual. This includes stress management and confidence about managing stress and overwhelm during the school year.

Triggers have been explored: The client has identified past and potential triggers that might set them back. As well, they have practiced strategies to navigate these if they arise. In other words, they are feeling confident that when triggers or difficulties come up, they know what to do and have a backup plan if they feel they cannot cope. 

They are independently plating meals: While most of my clients go on a dining hall meal plan for their first year at university, they should still be able to appropriately portion and plate their own meals and snacks, as well as have enough go-to recipes they can make on their own. 

The meal plans can be a great step to having mealtimes in a new environment but they will need to independently be able to serve themselves soon enough. When they are home for the holidays, this is a great time to reinforce and practice these skills.  

A relapse prevention plan is in place: This plan covers triggers and strategies to deal with triggers, red flags to watch out for, and what to do and who to reach out to if these flags are noticed (including family and/or friends). This is developed during sessions and is usually shared with their support network. 

Individual therapy is usually continued regularly leading up to and as they settle into university life, and for as long as is necessary to help them feel supported.

Realistic conversations: There is always the potential that a client might need to take a break and defer classes if they relapse. Having conversations about this beforehand can go a long way to helping them know that postponing or deferring their studies is an option, not a failure. 

If this isn’t discussed, the student may hide a relapse out of fear of disappointing their family. Knowing they have permission to prioritize their health over their program helps them feel supported rather than pressured.

Get Help 

If you would like help supporting your child in their transition to university, contact me to set up a free 15-minute intro call. I would be happy to answer any questions and talk more about how to approach this transition.