Recovery Signs that Show You're Ready for College

TLDR:

Going away to college is a huge transition for anyone, but especially for someone in eating disorder recovery. There are physical and emotional signs that you are ready for this step, such as absence of ED behaviors, maintaining weight, and comfort with a variety of foods and food situations. There are also some therapeutic challenges you can do to help increase your readiness.

Eating Disorder Recovery Journey

When it comes to eating disorder recovery, there's one universal truth: Recovery isn't linear. Everyone's journey to recovery will look different, and that's ok! Even the definition of "recovery" varies depending on the context. As we know, recovery is a journey not a destination. Along that journey are sign posts that indicate college readiness. Sometimes a client's eating disorder recovery journey may necessitate delaying college for a while, taking a part-time caseload, or living at home while attending college. This is totally fine! You are a whole person balancing physical, emotional, relational, and intellectual needs (among others).

What if you want to attend college full time away from home? How would you know that you are ready for this step on your recovery journey? There are some specific markers that I would recommend be in place before starting college in this case. I'll discuss signs that show you are ready for college and therapeutic recommendations to help you get ready. I have adapted my recommendations from Dr. Mulheim's College Readiness Checklist.

Physical Signs of College Readiness

• Maintains weight in range established by ED treatment team for 3-6 months (based on growth charts).

• Menstruates regularly (for female bodies).

• Absence of ED behaviors for 3-6 months. No purging, restricting, skipping meals, dieting, bingeing, over-exercising.

• Rare relapses or missteps. Any ED behaviors are acknowledged to support person(s) and treatment team and made up for. For example, a client missed a meal and admits it to parent and therapist along with eating extra to make up for the food deficit. Another example is if a client went running when running wasn't allowed in the recovery plan, they admit it and then voluntarily miss exercise for 3 days to make up for it.

• Eats 3 meals and 2-3 snacks daily.

• Eats a variety of foods and drinks, including the ability to eat previously feared food.

• Able to plan and prepare their own meals and snacks, even if simple.

• Able to eat out at restaurants, fast-food places, and at other houses.

• Comfortable around foods previously binged.

• Does not weigh self excessively (more than 1x/week) if ever. Feels ok with current weight if treatment team allows client to know their weight. I personally prefer that clients don't weigh themselves, and if they know their weight it's because their physician or treatment team discussed it with them.

• Willing to increase food intake and/or decrease exercise to account for more walking on campus.

• Understands risks of alcohol use and doesn't count alcohol as part of meals/snacks. Remember that it can be easy to fall into another addictive behavior when one subsides.

Emotional Signs of College Readiness

• Has demonstrated ability to use appropriate coping skills for dealing with stress, anxiety, and depression.

• Able to take mental health (and physical health) medications consistently on their own without parent reminders.

• Willing to attend therapy and dietary counseling if recommended by treatment team.

• Able to eat in front of friends and other people.

• Able to eat a meal or snack even if friends or roommates or classmates aren't eating.

• Able to wear clothing appropriate for the weather and activity without hiding body.

• Understands body's need for sleep to support mental health and recovery.

• Flexible with meal/snack timing, missing workouts, and meals choices. In other words, perfectionism is managed.

• Switches the conversation if friends are excessively talking about dieting, weight, comparing bodies, etc. At the very least, able to continue in recovery when triggering conversations happen.

• Willing to ask for help if struggling with ED.

• Able to make social connections or get involved in school activities to combat withdrawal.

After reviewing this list, you may have questions. If you are concerned about some of these signs of college readiness, please discuss them with your parents/caregivers and your treatment team. If your support people have strong concerns, it's important to listen to them and take steps to address their concerns rather than try to convince, plead, or promise. Another sign of maturity is to consider feedback without getting defensive.

What if you still have some things to work on? That's ok. Here are some ideas to help you practice the skills you need to be ready for college.

Therapeutic Recommendations to Get Ready for College

• Eat at a new restaurant as often as reasonable.

• Make a new recipe.

• Go to the grocery store on your own.

• Eat with friends and try eating what they're eating. For extra points you can practice pacing (eating at a normal pace) with a friend who has a good relationship with food.

• Skip a workouts once in a while.

• Make a meal/snack schedule based on your college class schedule when you get it.

• Visit your college and eat something new at the dining hall.

• Write a list of coping skills to use when feelings get difficult to manage and practice them. This is a great time to practice new and different coping strategies; you might find one you like that you didn't before!

• Set a reminder to take your meds. Make a plan for how to get medication refills at college.

• Practice changing the subject with friends and family. (They don't have to be talking about triggering things in order for you to switch the subject.)

If you're reading this and you're on the road to recovery, I applaud you! Recovery is hard work and requires a great deal of time, focus, and effort. Please keep going. If some of these things seem hard right now, that's ok. With practice you will get there.

Parents, if you're reading this and wondering about your child's readiness for college, let me add a couple thoughts. You've worked hard to get your child where they are, and you wouldn't want to put them in an environment they're not ready for. It's worth it in the long run to adapt the college timeline to get more solid recovery. It's also worth it to bring your child home from college if they aren't doing well. Let's give your child every chance to have a successful life.

I hope this helps provide some clarity for the decision about college readiness in eating disorder recovery!