If your college student has an eating disorder it can be disorienting and terrifying. Eating disorders are most often diagnosed between the ages of 18 and 21 years of age. So it’s not uncommon to find out about them in college.
One of the biggest challenges with college-onset eating disorders is that your child is now a young adult. They often don’t live with you anymore, and even if they do, you cannot force them into medical treatment. Nor can you access their medical records without their written consent.
Some college students will gladly sign paperwork. They will allow their parents to help them with an eating disorder. But others will resist. Either way, parents often feel left out, confused, and frustrated. So what can parents do?
The first thing is to recognize that your child’s eating disorder is serious. It’s not a passing trend or something to be taken lightly. At the same time, recovery will require your child to be engaged and determined in the process. This is when things can get hard.
Often people who are inside of an eating disorder aren’t convinced that they want to recover. It’s quite normal to feel unsure about whether recovery is necessary or worth it. And even if they do want to recover, college activities can compete with recovery. Social and school activities often feel more urgent and important than dealing with an eating disorder.
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When you find out your college student has an eating disorder
How you find out that your college student has an eating disorder can make a difference in how you proceed.
If your child has come to you with news that they have an eating disorder, ask about their diagnosis. Congratulate and thank them for being proactive about seeking support, and assure them that you are proud of their bravery. Avoid throwing doubt on the diagnosis or questioning the person who made the diagnosis. For right now, try to keep communication open by asking questions in a positive, respectful tone.
If your child has not been formally diagnosed but has shared that they believe they may have a problem, then support them in seeking help. Let them know that it is courageous to seek help for mental health, and ask how you can support them. In a perfect world, it would be best to seek a diagnosis from a trained eating disorder professional. However, if that’s not an option, the campus health center should be able to help. Most colleges provide both physical and mental healthcare services. Encourage your child to seek care as soon as possible.
If your child has not spoken to you about having an eating disorder but you are seeing signs or have suspicions, you need to tread very carefully. Begin by opening conversations about their general mental health. Ask them how they are coping with the stress of college. Avoid directly challenging them about the way they are eating or their weight. Get them talking to you about stress, then see if you can find out how they are feeling about eating. Let them know that stress can disrupt appetite and eating, and ask whether they think they need any help.
How to respond if your college student has an eating disorder
It’s very likely that your first instinct is to travel to your child’s campus to help. Of course it makes sense that if they are having a health crisis, you should be there. But here again you need to be thoughtful about how you can make the greatest impact.
Eating disorders tend to slip and slide away when directly attacked. So if your child sounds as if they really don’t want you physically there, you may need to get creative about how you can help from afar.
Of course you should be responsive if your child has asked for your physical presence. In that case, go! But in many cases college students don’t want that.
Luckily, there are lots of things parents can do. Even if you aren’t physically with your child or able to access their medical data, you can still help your college student recover from an eating disorder.
Learn about eating disorders
It’s important for you to learn as much as you can about eating disorders. Although they are relatively common and on the rise in our culture, there is a lot of misinformation about eating disorders. Most people imagine an eating disorder only impacts women and looks like anorexia. But those cases constitute just 10% of eating disorders.
The most common eating disorders are binge eating disorder, bulimia, orthorexia, and a category called Eating Disorder Not Otherwise Specified (EDNOS). With the exception of anorexia, eating disorders are not diagnosed based on body weight. People with eating disorders may be in small, medium, large, or extra-large bodies. And all genders (not just women) get eating disorders.
Eating disorders are mental illnesses. That means the diagnosis criteria is not about weight, but the degree of mental distress.
Eating disorders are maladaptive coping mechanisms that we employ to help us process uncomfortable physical and emotional states. This means they have a reason and a purpose. It may seem like recovery is about learning to eat properly. But in fact recovery from an eating disorder is more about finding out why we need the eating disorder. Once we get to the core issue and treat it, the eating disorder behaviors become unnecessary. This is why eating disorder recovery can be a long, winding path.
Eating disorder treatment options
It’s normal to automatically assume that the treatment for an eating disorder is a residential recovery center. And while that might be helpful for some people, many people recover without going to a facility.
If your child is medically unstable and has been hospitalized, then it is likely they will be recommended to inpatient treatment. In many other cases, the treatment path is less concrete. This is especially true for non-anorexia diagnoses.
Begin by asking your college student what the healthcare professionals recommend in terms of treatment. If they’ve been to the health center on campus, did the doctor, nurse, or therapist recommend a certain treatment? It’s important to take those recommendations seriously and let your child tell you how they feel about them.
You can recommend additional diagnosis, but try to allow your child to feel as if they have a part in the decision. Remember that recovery requires their emotional investment, so it can backfire if you try to force your opinions or attempt to control the situation.
Many people recover from eating disorders with a combination of medical monitoring, therapy, and nutritional counseling. It’s ideal to have people who have a speciality in eating disorders. Unfortunately, most health professionals have limited training and experience in eating disorders beyond anorexia. This is why it’s best to find a specialist if at all possible.
At the very least, you should encourage your child to be in therapy.
Build belonging and emotional safety
People who have eating disorders generally suffer from a sense of low self-worth. This means they don’t see themselves as valuable, and often feel “outside” or “other.”
So an important thing for parents to do is build belonging and safety. You want to remind your child that they are valuable to you and build a sense of emotional safety. Even if you are a single parent to a single child, you can build a sense of family and belonging. Families don’t need to be large to be powerful.
Schedule check-ins when you can talk and physically be together as much as possible. Send care packages, letters, and other reminders that you care. Talk about your shared history and look at photos together. But don’t take the lead. Ask your child to reflect their life story to you. Be prepared. They may have a very different vision of how their childhood was. They may have some pain to share with you. This is normal.
A person who has an eating disorder has a story to tell. And it may be painful for you to hear. But sharing their story and being loved even when they feel bad is very healing. Your acceptance of their life story, without trying to change what they believe happened, will go a long way.
Lots of people who have eating disorders have traumatic injuries. In some cases these may be situations in which they were abused, bullied, or harmed. But trauma also occurs when a child goes through a medical emergency, has a family member die, or parents who divorce. Children can even experience trauma when a new sibling is born or other disruptions that are perfectly normal but disrupt the child’s life. There are many situations that are interpreted as traumatic by the human brain. So if your child brings you traumatic memories, accept them and hold them in safety.
Say this not that
It’s hard for a lot of parents to know what to say. And the options are endless. But here are a few things that parents say to kids and a revised version that is more accepting and safe.
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.
Encourage them to be social
Loneliness and social isolation are significant problems for all people. They underlie many mental and physical health complications, including eating disorders. Going to college is a major life 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 college student has an eating disorder, you want to be aware of their social life. Lots of people who have eating disorders pull in on themselves and become less social.
Try to help them find social activities, even if it’s just meeting one person for coffee or a walk. Or they may join a formal social activity or club. This can 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.
Remember: it’s a mental disorder
The hardest thing to keep in mind is that an eating disorder is a mental disorder. So the treatment may seem like just teaching them to eat food like a “normal person.” But true healing comes from belonging and self-worth.
Learning to support your child’s mental health when they are away at college is a significant challenge. But it’s very doable. Your kid doesn’t need to live in your house for you to positively impact their recovery.
It can feel very hard for parents to support an adult child with an eating disorder, but you can do it!
Ginny Jones is on a mission to change the conversation about eating disorders and empower people to recover. She’s the founder of More-Love.org, an online resource supporting parents who have kids with eating disorders, and a Parent Coach who helps parents supercharge their kid’s eating disorder recovery.
Ginny has been researching and writing about eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.
Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.