The end of summer is bittersweet for many young adults, but for those recovering from an eating disorder, leaving the security of home for college can make things additionally complex. From anxiety-inducing exams to dining hall food options, college students may face a host of challenges that can complicate their recovery. So how can families prepare for college — including if their loved one should go back to school or if the family should prioritize treatment over academics?

“During times of change, it is really common for one’s eating disorders to become louder,” says Equip Peer Mentor Vanessa Do. “Therefore, it’s really important for families to be aware and vigilant regarding potential relapses or increased eating disorder behaviors. The newfound distance or lack of supervision may create potential space for the eating disorder to sneak back in, so it’s important to continue to have check-ins and open communication to keep the individual accountable (and supported) on their journey of recovery.”

Fellow Equip Peer Mentor Stacy Jones agrees, noting that students just embarking on their college journeys or starting at a new school may have to be extra vigilant. “Being away at college means being in a new environment,which can be stressful or activating for the person and their eating disorder,” Jones says. “It can require extra protective factors like regular check-ins or local support groups to make sure they are able to stay on the path of recovery.”

Establishing and maintaining strong connections with family and care team members can be critical for college students in recovery. But perhaps the most important point to keep in mind is that mental, physical, and emotional well-being should always take precedence over grades, tests, and socializing. It can be tough to keep this hierarchy of needs in mind once the semester starts, but the more family members can help underscore and reinforce these priorities, the better success a student may have in their recovery.

“College is harder than many parents remember it — even without an eating disorder,” says Equip Family Mentor Lisa Stein. “Know that some things will go wrong and that your loved one must have the mental and physical strength to deal with these disappointments and distractions without resorting to their eating disorder.”

For those unsure of how to help their loved one safely return to school — and for those unsure if a return to college is really the right choice at this point in their recovery process — here are some strategies and suggestions from those who’ve been there.

Seriously consider a break from college

It can be incredibly difficult to put academics on hold — particularly for those who are high-achieving and ambitious students. But eating disorder recovery isn’t always linear, and sometimes setbacks are part of the process. Before officially starting a new school year, have frank conversations about where a loved one is in their recovery to set the stage for the best possible outcomes in the future. And in some cases, that may mean taking an extended break.

“If your child is still saying they can't wait to get to college to get away from you, lose weight, and continue with their eating disorder, they are not ready for college,” Stein says. “This may seem obvious, but sometimes parents miss these warning signs ”

Having frank conversations about where a loved one is in their recovery can help set the stage for the best possible outcomes in the future. And in some cases, that may mean taking an extended break.

“My biggest suggestion for patients planning to go to school, is to actually consider taking some time off,” says Equip therapist Sara Quint, AMFT. “I was in and out of treatment every other semester, and it was always devastating to have to take more time off. I wish I had prioritized my recovery sooner, and recognized that each and every person is on a different path — school will still be there, and classes are so much more enjoyable without the constant mental fog, distraction, and confusion, trying to ‘just get through the semester,’ all caused by the eating disorder.”

Prepare for the logistics of college life

A big part of ongoing recovery is having a handle on the practical components of everyday life, including when, where, and what to eat. While staying on track with nutrition can be more manageable at home with a full support network, the independence of college life can set some students up for triggering situations or even relapses.

“Your loved one should plan a schedule conducive to allowing for time to eat three meals and snacks,” Stein says. “College dining hall lines are often slow, understaffed and don't have the exact items your loved one may want. My loved one remarked how challenging it is to wait half an hour for a bagel and cream cheese. Your loved one should be able to be flexible and pivot to make sure they get the nutrition they need.”

Practice strategies for coping with harmful body talk

Harmful commentary on food, exercise, and appearances is everywhere, from social media to magazines and more, but toxic messaging about diets, weight loss, and exercise can be particularly prevalent on college campuses.

Families can prepare for these difficult situations ahead of time by:

• Help your loved one practice recognizing these messages and how they may create challenges during recovery
• Develop a plan on how to deal with roommates who may be struggling with eating challenges themselves
• Create a list of strategies and skills to use to in when feeling triggered

It’s also worth considering the repercussions of what would happen if a student in recovery were placed in close quarters with a peer who hasn’t dealt with their own eating disorder. Discussing all the possibilities ahead of time and devising action plans and coping strategies may be important tactics to practice before school starts.

“College students are inundated with diet culture messages and may be assigned a roommate with eating challenges themselves,” Stein says. “Your child must be well enough to not allow those distractions to trigger them and affect their eating.”

Schedule regular check-ins and help put resources in place

Some practical ways to ensure your loved one has a good support system while in college are:

• Videos calls or event visiting them at school to get a better understanding of their physical state and safety
• Find and set up resources on campus ahead of time
• Locate local peer support groups, organizations, and treatment centers
• Examine food options available at the school, and coming up with multiple plans on how to ensure adequate nutrition

Jones believes part of the ongoing conversation between family members should involve locating local support for the student. “Asking your loved one what they are needing and having a conversation is a great way to understand how to best support them,” she says. “Find and set up resources — therapist, accommodations, etc. — at the college prior to getting there or a plan for what to do when getting there.”

Do adds that local peer support groups and organizations may be critical for ensuring medical and nutritional support as well. “I think continuing therapy is extremely important due to the multitude of changes occurring simultaneously during the college years,” she says. “But it may be helpful to examine the food options available at a school before committing to it, and coming up with multiple plans on how to ensure adequate nutrition.”

Is it the right time to return?

In the end, the decision to start or return to college is really up to each individual and their support network to decide. There may not be a one-size-fits-all plan for success, but by having open, honest conversations, families can help their loved ones maximize their chances for health, happiness, and success.

“Although recovery does vary between individuals, a solid sign that one is ready to go to college is their consistency of being able to have minimal to no eating disorder behaviors,” Do says. “If even with full autonomy and choice of their food, the individual actively chooses to fuel themselves adequately without ‘giving in’ to their eating disorder on a consistent basis for a while, it is a good sign that they may be able to practice this when they are at college. I also think a good sign is when individuals are very open and honest when discussing their eating disorder because it shows that they are motivated for recovery and vigilant about potential relapses.”