College & Eating Disorders, Pt. 2: To Defer or Not to Defer
That is the question.
Last week we discussed 1) Why eating disorders develop in college years. To continue in this 3 part series, today we will discuss part 2) To Defer or Not to Defer. Next week will be the final part, 3) A Return to College Contract.
In our first post, returning to college with an eating disorder, we talked about risk factors for developing an eating disorder in college and why it happens so often to this age group. We talked about what to look out for and how to talk to your teenager about it. Today, we are going to talk about what to do if your college student has been diagnosed with an eating disorder, or you suspect they have disorder eating issues and what you should do now. The question I hear often is, “Should we send him back to school or not? We just don’t know what to do.”. So today, we will discuss our part 2 topic, To Defer or Not to Defer-To send your child back to school or keep them home when an eating disorder is present.
If you have a college student in Ohio and you are concerned about their eating habits and looking for eating disorder treatment in Ohio, please click here. to schedule a free consultation call. I can work with students and families throughout Ohio virtually, so that even when you aren’t in the same space, you can still connect with your young adult.
This is a big question and one that does not have an easy yes or no answer.
First of all, it is your decision as a parent. No member of your treatment team can make the right decision for your family- they can only guide you and provide you information from their clinical experience. That being said, my first advice is to create a treatment team for your child. If you are looking for a therapist working with adolescent and young adult eating disorders in Ohio, please reach me here to schedule a free consultation call. In addition to a therapist with specialty and training in eating disorders, you will also want a competent pediatrician or family doctor who has knowledge of eating disorders. Unfortunately, not all pediatricians and family doctors have training or education on eating disorders, so make sure you ask about their knowledge and their approach to managing eating disorders in their patients. Something I often see with doctors and what worries me the most is the lack of concern for teens and young adults losing weight. They often do not pay much attention to this at all and certainly don’t see it as a problem. I cannot tell you the amount of times I have had patients with severe eating disorders who have gone to see their family doctor with documented weight loss for no medical reason and have not been screened for an eating disorder. And then when they are diagnosed with anorexia nervosa or bulimia nervosa and return to the family doctor, there is still often no concern for the weight loss, no plan to restore weight, and no plan for follow up care. So make sure you find a doctor you can trust who will monitor labs, vitals, weight and physical symptoms for your child. This might mean finding a doctor at home and one at school who will work together collaboratively to manage your child’s care. It may also be helpful to bring a registered dietician who is trained in eating disorders onto the team. Health at Every Size or the HAES movement is also a great qualification to ask about in your providers.
After you have built your treatment team, it will be important to consult with them about whether your child so go or go back to college or not. I would suggest your start this conversation early, well before the decision needs to be made (loans signed off, deposits for housing paid or classes enrolled) and talk about what you would need to see in order to send your child back. If you do decide to send them back to college, in our next post we will talk about a “contract” or “agreement” to put in place to set guidelines for what you expect if your teen does return to campus. But before you make that decision, lets go into what you should consider.
#1- How long has this eating disorder been present and how much time do we have to get started with treatment?
One thing we know for sure about eating disorders (based on research) is that early and aggressive treatment (meaning usually the highest level of care or treatment method that has been recommended for your child) gives us the best outcomes and best chance for full recovery.
Where in other illnesses, we want to do the least amount of treatment needed to resolve the problem, we know that with eating disorders, the earlier and more intense we can be with quality treatment, the more likely we are going to see results of the eating disorder going away. So with that in mind, you want to consider how long have you been able to treat the eating disorder. Have you been dealing with it throughout high school and are debating on the first year of college? Has your child been working hard on recovery for a year and you are thinking about whether they can go back in the fall? Was this recently diagnosed over the summer and we are debating return to school with 1-2 months of treatment? These will all factor into your decision. Generally speaking, there are always exceptions, but the more intense treatment you’ve been able to do, the more comfortable and safe it would be to send your child to college. The thing that will be hard to measure and best discussed with your treatment team is the intensity of their eating disorder. Some may do fine at college with supports in place and some may crumble under the pressure and end up needing to postpone anyway.
#2- How is my child responding to treatment and what progress has been made?
This is an important question to evaluate with your treatment team. Look at the progress since before starting treatment and ask your team to remind you by checking notes and reports. Has weight gone up? Are vitals stabilizing? Are meals becoming easier and more consistent? Are they eating foods now they wouldn’t eat a month ago? How is their mood? Are they seeming more like their old self again?
Your answers to these questions will be very telling. Evaluating their progress based on specific metrics and goals you set at the beginning of treatment will help you to make an objective decision about where they are. If they have met some of the goals that were set at the beginning, it is a good sign they may be ready to go away to college.
The other side of that coin is the non-objective and biased opinion you will have as a parent and it is important to listen to that too. Imagine your child going back to college- how would you feel? What worries come to mind? If you feel a sinking pit in your stomach and bubling up of anxiety, that may be something to explore. As a parent, and especially a parent of a child with an eating disorder, you will always be worried about sending your child away to college. That worry will never go away and it is normal. However, if that worry or fear seems bigger than normal, it’s a good idea to investigate that. IS that your own anxiety that you need to process in your own therapy? Or is that because deep down you know your child is not ready to have all of that independence at this point in their recovery? This decision is often laced with things that need to be worked out on the parent’s end. There is a huge fear in both sending your child with an eating disorder to college and also in not sending them to college.
#3- Your child will not want to defer college. How will you handle making that decision for them?
Let’s face it- most often, your child is not going to want to defer going to or going back to college.
They want their independence and their eating disorder wants freedom. This needs to be evaluated-on one hand it is totally normal for a teenager or young adult to want to return to college with their friends and not be left behind or left out. On the other hand, their eating disorder may see it as an escape from your watch and decision making about their eating and exercise habits and they can relapse. You will have to make the decision without your child’s input on what is best for them. Your child is not going to tell you they need to stay home, even if they know deep down that they do. That is a difficult decision you have to make as a parent and your child will likely not be happy with you for it. You will have to ride out the emotional wave that comes with that decision. No teen or young adult will be happy having to stay at home when their peers are going to college- but they will be alive to be unhappy with you. And that is what you have to focus on.
Remember that temporary discomfort and unhappiness is much better than a life with an eating disorder which will lead to years of discomfort and unhappiness and many physical risks.
Just as your teen may not have been happy when you didn’t let them drive drunk or go to a risky party, you know you were doing it for their safety because you love them and want the best for them. You put up with the temporary irritation and anger in order to protect them and give them the best outcome and opportunities.
Deciding to defer or delay school for a short period of time is just like that- it is setting them up for more success in the long run.
If you have a college student in Ohio and you are concerned about their eating habits and looking for eating disorder treatment in Ohio, please visit my page to schedule a free consultation call. I can work with students and families throughout Ohio virtually, so that even when you aren’t in the same space, you can still connect with your young adult.
If you have a child or teen in Ohio who is dealing with eating concerns, please visit my site to learn more about eating disorder treatment in Ohio. I provide virtual eating disorder therapy services from Columbus, Ohio and work with teens and young adults in college. I treat anorexia nervosa and bulimia nervosa in adolescents in Ohio.
Schedule a free consultation call.
This blog is intended to be educational and informational and does not substitute for professional medical and therapeutic help, which is highly recommended when treating an eating disorder. If you would like help treating your child’s eating issues or want to learn more, Schedule a free consultation call today.