Recognizing Eating Disorder Relapse When
Your Loved One Returns to College
Nicole Siegfried, Ph.D., CEDS; Chief Clinical Officer
Returning to school after receiving treatment for an eating disorder is no easy task. Family members are understandably worried. Often, their loved one’s eating disorder developed during a time of transition, so facing the transition of returning to school can be daunting. To provide support during this transition, Alsana offers flexible intensive outpatient “IOP” programming to accommodate college schedules.
One of the best ways families can support their loved one with an eating disorder in preventing relapse when they return to school is to be proactive. Many times, families and their loved ones with eating disorders return to school without being prepared, which creates anxiety and a sense of helplessness. There are some ways to prevent relapse and create more confidence returning to school.
Relapse Prevention Plan
Often eating disorders can be secretive, so relapse can be hard to recognize. It’s important to have a plan in place for if your loved one relapses. This plan should include an agreement of what your loved one will do if they relapse, such as agreeing to a higher level of care.
This agreement can have a list of signs and symptoms of relapse specific to your loved one. Common signs of relapse include
- skipping appointments
- losing weight
- missing classes
- not responding to phone calls or texts from parents
This can be something that the client creates with their treatment team and that is reviewed and signed by the client, the outpatient team, and the family. Everyone can receive a copy. When families and their loved ones have a relapse prevention plan, everyone can be on the same page and act accordingly if the transition to college doesn’t go as planned.
Key Buffers for the Transition to College
There are some key buffers for relapse that family members can help their loved one integrate into their return to school:
“Back to the Basics”
When clients return to school, they and their families often view this as a time to decrease support or move away from some of the interventions that were helpful in the recovery process. I often hear families and clients say things like, “now that you’re back in school you don’t have time to see your dietitian once a week” or “now that I’m back at school, I’m going to do walks instead of yoga.”
Instead, this should be a time when clients do what I call “going back to the basics.” Instead of moving away from structure, clients should be going back to more structure—often the structure that was needed earlier in the recovery process. For instance, it may be that when clients return to school they see their therapist and dietitian more often, like they were when they were first diagnosed (even though things are going well now). It may be that they go back to a support group that they haven’t attended in a while. I always want to emphasize that this is a time to pull into the structure of recovery rather than pull away, even though the added stressors of school create other demands.
Often when clients in recovery return to school, they jump in with both feet. Instead, it is recommended that clients “dip their toe” into the waters of college and ease themselves in slowly. This is a time to take a reduced course-load and limit extra-curricular activities. It is not the time to join the dance team, become Spanish Club President, and volunteer at the Humane Society. Clients with eating disorders can often be ambitious in their plans for recovery. Their loved ones can help them prioritize and minimize.
Change Playmates and Playgrounds
In substance abuse recovery, the importance of changing your “playmates and playgrounds” is often emphasized. In eating disorder recovery this can be equally important. For instance, if your friends connected over dieting and losing weight, it may be time to develop new friendships or even new friend groups that are focused on values related to your recovery. This can feel somewhat jarring for clients, and it’s important for families to be able to support their loved one in making these changes.
Plans for meal support
When clients return to school, it is important that they have plans for how they will “do meals.” Do they need a meal card with their university? Will they cook at home? Will they eat with friends? These options need to be explored prior to returning to school with plans and back up plans for meal consumption.
Sometimes clients need more than the support that outpatient treatment can provide. The structure of a flexible IOP may be helpful in bolstering the college student’s recovery. When a client can return to school and get the support of treatment, they are more likely to stay in recovery and stay in school.
The Value of Additional Support
Alsana’s flexible intensive outpatient programming is available in four-hour blocks from 7:00 am-7:00 pm Monday-Friday, and 7:00 am-3:00 pm Saturdays and Sundays. College students are able to choose the time of day that works best with their schedule or the time when they need the most support. Clients will have sessions with their individual therapist, dietitian, group therapy, and meal planning and support.
If your loved one could benefit from additional eating disorder recovery support, contact us here to learn if flexible IOP programming is a good fit or call (855) 915-0213.