Eating disorders frequently show up during college - what a parent can do to help

What to do when your child is at college and tells you they have an eating disorder

The majority of eating disorders present themselves during adolescence, which extends through the college years. The disruption of going to college may be the impetus for a latent eating disorder to go full-force. Or it may be the very first time your child experiences the symptoms of an eating disorder. Parents can help their college-age children recover from an eating disorder, even from afar. Here are some recommendations:

1. Don’t rush in unless it is a medical emergency

If your child is facing anorexia and is in a medical crisis, then definitely rush in and physically take over. In this situation, your child needs need immediate medical care and possibly hospitalization and/or inpatient treatment for the eating disorder. But such situations are exceedingly rare compared to the more common eating disorders, which include excessive dieting, food avoidance, purging, and binge eating.

These more typical cases are still serious, dangerous, and demand treatment, but parents may be just as helpful working remotely rather than rushing to their child’s side. The fact is that we cannot fix our kids’ mental disorders, but we can certainly support their healing process.

Imagine you booked a flight and flew to your child’s college town. What are you going to do? Beat the eating disorder with a stick? Tell your child to “get over it” and stop the disordered eating patterns? Please understand that this is neither helpful nor effective eating disorder treatment.

Eating disorders are maladaptive coping mechanisms that we employ to help us process uncomfortable emotional states. This means they have a reason and a purpose. We must allow the time and energy required for our child to find out what the purpose of the eating disorder behavior is, and then treat that purpose. If we focus only on “stopping” the behavior, we do not heal the underlying problem.

2. Help your child receive counseling services

The following are ideas, not medical recommendations. Please consult a professional to address your child’s individual recovery needs.

All colleges and universities have student counseling services. These services are typically free or provided at very low cost. One drawback to these services is that the people providing the therapy typically do not have decades of experience treating people who have eating disorders. In fact, they may have very little or no experience with eating disorders.

However, with the increasing prevalence of eating disorders on college campuses, many offer eating disorder services and clinics. A relatively inexperienced therapist can still be very helpful as long as they have mentors who can help them navigate the unique elements eating disorder treatment.

The school counselors should be able to assess your child and help them identify whether specialized outpatient or inpatient treatment is necessary.  The initial goal is to help your child achieve remission from eating disorder behaviors and address the underlying mentality. Ongoing treatment may be required to address the conditions that typically underlie eating disorders (depression and anxiety).

3. Set up a formal daily phone call

You probably text each other randomly and keep in touch generally. But when your child presents the problem of an eating disorder, it’s time to step up your parenting game from afar.

A key element of eating disorder recovery is that the person must develop a sense of belonging and emotional safety. Parents are in the perfect position to do this, even from afar. One of the easiest things to do in this situation is set up a set time to talk on the phone every day. This does not need to be a long call, but you need to physically get on the phone together and hear each other’s voices every day at least during the initial stages of eating disorder treatment.

Setting a formal call time does many things on a subconscious level to let your child know that they are not alone in their recovery. Even if you are not a formal person, and even if your child says they don’t need you to call, push yourself to do this for the sake of your child’s recovery.

Pick a time that works for both of you and commit to a daily phone call as long as your child is experiencing eating disorder symptoms. Your goal is to provide your child with a daily reminder of love and acceptance. Set aside everything else, and make sure that when you talk on the phone you are not lecturing, criticizing or fixing. Instead, use open-ended comments designed to let your child know that you accept them exactly as they are right now, and forever.

Instead of saying: I just don’t get the problem!

Say: Please help me understand your eating disorder. I’d like to know more.

Instead of saying: you need to get over this!

Say: I know this is hard right now. Tell me what’s working – what makes you feel better when you feel bad?

Instead of saying: you need to stop with the binges!

Say: what’s going on for you when you eat? What are you thinking and feeling? I want to understand.

Instead of saying: you’re going to have to figure this out!

Say: I know you are going to figure this out, but it takes time. It’s OK to be patient with yourself.

Instead of saying: it’s going to be fine!

Say: I know how hard this is for you right now. I’m here for you.

Once your child achieves symptom remission and is well along the path to recovery, you can reduce call frequency to every other day and, eventually, every week. But as long as your child is in college, try to maintain the once per week scheduled call to keep your connection strong and remind your child that you are available to discuss the eating disorder, or anything else.

4. Encourage organized social activities and group participation

Loneliness and social isolation are significant problems for all people, and they underlie many mental and physical health complications, including eating disorders. Going to college is a major social transition, and our kids may need help navigating the social systems on campus.

Your child may or may not like their roommates. Your child may have found a few friends, or even many friends. But if your child is suffering from an eating disorder, then you should consider encouraging them to join some formal social activities to help them build deeper interpersonal connections and a stronger sense of belonging and purpose.

Talk to your child about options, which range from on-campus clubs, teams and programs, to off-campus volunteer opportunities. Even a low-stress job can be grounding and provide a sense of social connection and purpose for a child.

Your child may push back, and say that’s a stupid idea. It’s OK, just keep talking about it, and encourage your child to talk to their therapist about it, specifically in the context of loneliness and its impact on health and wellness. Remind your child that you’re not looking for a long-term commitment, but joining a group or club can be a great way to start the process of building connections and reducing loneliness.

It can feel very hard for parents to support their college-age kids, especially in light of the challenge of an eating disorder, but these tips can help you support your child’s full recovery from an eating disorder.

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