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Sample Relapse Plan for College Students

This resource was shared by Dr. Sarah Ravin at FEAST of Knowledge 2022, designed for a female patient who was heading off to college.


Green Light Signs: Suggest that AN is in remission
• Maintaining weight within ideal range
• Getting regular menstrual periods
• Consuming enough nutrition to meet her body’s needs
• Serving herself appropriate portions to maintain weight
• Energetic, social, and happy
• Ability to tolerate a day without exercise
• Good insight
• Eats mostly with ease

Yellow Light Signs: Suggest that a person is struggling with AN symptoms and needs extra help
• Weight drops
• One missed menstrual period
• One episode of purging
• One or two skipped meals
• Exercising more than 1 hour per day
• Inability to tolerate a day without exercise
• Social life limited by exercise or food compulsions
• Irritability
• Irrational or unreasonable thinking
• Inadequate portion sizes; over-estimating the amount of food eaten
• Defensiveness about food choices

Red Light Signs: Suggest that a person has relapsed
• Weight drops significantly
• Two or more missed menstrual periods
• Major preoccupation with calories, body image, and exercise
• Two or more episodes of purging
• Social withdrawal
• Significant food restriction
• Several skipped meals


Green Light Interventions: 
• Weekly weigh-ins at student health center.
• Takes medication daily.
• In-person contact with a parent once a month.
• Sticks to limit of no more than 1 hour of exercise per day.
• Weekly FaceTime contact with at least one parent.
• Monthly sessions with therapist from home.
• Parents and therapist maintain weekly email contact.

Yellow Light Interventions: 
• Student will tell a parent immediately if she notices yellow light signs in herself
• Parents will talk with the student immediately if they observe yellow light signs in her
• Phone session with student, parents, and therapist will be held within 72 hours of observing yellow light signs.
• Weekly sessions with therapist until she returns to the green light zone.
• If she remains in yellow light zone for three weeks, a parent will travel to the university to provide daily meal support and will remain there until there is significant improvement.

Red Light Interventions: 
• If the student enters the red light zone, she will take a medical leave of absence from school immediately and will return home to focus on her recovery.
• The family will attend an in-person session with therapist within one week of the student’s return home. The purpose of this session will be to create a treatment plan to help the student recover and return to college when she is well.

This plan shall remain in effect for the entirety of the student’s first semester of college. The family will meet with the therapist again during winter break to revise this plan based on the student’s progress.

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