We get a lot of questions about how to handle college for an eating disordered young adult.  There is no one right way to handle all situations, but I will list a few of our ideas here.

#1:   Make a plan!  Do not just cross your fingers and hope that things will go well for your child. Wishful thinking is not your friend.

#2:   If  your college-bound child is currently active in their eating disorder, for example bingeing or purging at any frequency, losing weight, restricting their food intake out of proportion to their activity level, etc  don't send them!  It would be worse to leave for college and then have to drop out because of becoming overwhelmed by their symptoms than to have waited to go until those symptoms were under control.  At any given time, we have young people in our college-age DTU  at Kartini Clinic who have had to leave college because they left home in unstable or marginal shape.  As tough as it is to change plans about which your child is excited and for which they have worked hard, think what it would be like if they had to drop out.  First get the eating disorder under control and then go to school.

#3:   Speak compassionately and openly with your young adult child.  Make a family decision about what point tuition will not be paid by parents or grandparents if follow-through with a safety plan is not adhered to.  

#4    Buy tuition insurance

What would such a safety plan look like?  Assuming your child is medically stable and weight restored, the first thing you will need is a signed release from them so that their college’s health center (or outside agency) can share information with you.  Then make firm arrangements for a bi-weekly or weekly weigh-in (depending on where your child is in treatment).  We strongly recommend you NOT share weight information with your child. All you are trying to do is hold the weight steady, not manage gain; weight restoration should have already taken place before they left for college.

Keep in mind, though, such an arrangement will not be enough on its own to ensure safety.  You will have to agree on a cut-off point.  For graduates of our program we have used a “lose five pounds, withdraw from school” cut-off to underscore how serious we are about not losing weight.  You may have your own level of comfort to address, but remember, if your child has an eating disorder, weight loss is the beginning of a very slippery slope.  Best not to “go there” at all.  Further, you will need to have an agreement in place with the college doctor, nurse practitioner or nurse that you are to be notified if your child does not show up for the weigh-in.  Some schools will need a lot of encouragement to allow you to be involved to this extent.  That has been the subject of another blog posting.

While you are struggling to create this safety net, try and be clear that, apart from assuring compliance with a family plan around the eating disorder, you are not trying to control or micromanage their entire college experience.  And then make sure you don’t!

Even if your child’s college is a long way away, it will be worth the money to have them come home for Thanksgiving.  You need to have a visual check as well as a psychological one.  College is fun and exciting but can also be unsettling, stressful and lonely.  There are many triggers, chief among them an eating disordered roommate!

Trying to put this kind of system of planning in place after the fact—after they have done poorly or experienced a relapse—will cause more resistance and pain than if you had done so as a matter-of-fact part of college planning from the beginning.