By Laura Cohen, F.E.A.S.T. Parent Support Volunteer
As if having a teen with an eating disorder was not hard enough, add the pressure of college looming in the near future…or whatever post graduate looks like for your teen. It is normal to have many stressors at this time in their lives from the college application process to what is prom going to look like. At a time when your teen should be practicing leaving the nest, our kids are often regressing socially. If you feel alone and like no other parents understand…know that you are not alone. I see you. I, most likely, have been you.
The first day (and first 2 months) of my daughters’ senior year of high school we were living across the country in a dingy and depressing hotel room while she was in a partial hospitalization program for her eating disorder that she had been battling for a couple of years. Instead of the last “first day of school” photo and enjoying the ritual of seniors decorating their cars (or their parents cars) with paint markers, we were finding our way around an unknown city and picking up coloring books and card games to distract her mind from the loud eating disorder voices while we had dinner back in our hotel room. We had so little hope and so many questions and “what if’s” flowing in our minds……. constantly.
I am going to dive into a few of the many decisions and situations that we ran into throughout her senior year. Please note that this is OUR story. Everyone’s story is going to look different and my hope is that some of this information can assist you through some hard choices and situations.
Situation #1: “If my teen misses part of the school year due to treatment, should we divulge this information on the college application?”
Let’s face it – if your child misses school and / or is not well enough to work at their usual potential it is evident on their transcript. In our situation, first quarter had a few “incompletes” and a few “pass/fail” because she was not physically in school for ¾ of the first term. My daughter wanted to apply “early action” to a few schools so those grades had to be submitted. We really went back and forth with what to do about the situation. We were blessed that my husband runs a college advising business, so we brought her situation to his team. The consensus was to be honest. In her application, she added a letter that explained that she decided to enter treatment at the beginning of her senior year for her eating disorder. She noted that she wanted to get the help she needed to be able to have a normal college experience and this was the sacrifice she took. She let them know she was doing well and back in school. We truly thought that she would be deferred from all her schools until she had a complete term of grades. And that would have been ok. Well, guess what? She applied to 6 schools and got into all 6!!!! It was such a good feeling to know that the schools were not judging her and instead were willing to take a chance on her. As a side note, she did not write her personal essay about her eating disorder. She wrote it about a totally different part of her. She is more than her eating disorder and the schools like to see that.
Situation #2: “How do we know if your teen is ready to go to college?”
There really is no one single assessment that you can do to access if your teen is ready to attend university. Gosh, that would be amazing to have! The first advice I give parents, because it was given to me, was to be very upfront with your teen. Do not tell them they CAN go to school “for sure” if they get accepted. Only apply to schools that you would be ok with them attending- assuming they were healthy enough to go. Through the entire application and acceptance process, we were very clear as parents that the acceptances were part of the process AND the actual act of “going” was contingent on her ability to be in a place of strong recovery. Our daughter also knew that a strong relapse prevention plan/contract would be in place when she did go off to school. This was non-negotiable. Here is a great post about what we mean by a “contract” (https://www.feast-ed.org/sample-relapse-plan-for-college-students/).
Situation #3: “Can the same treatment team still see my teen when they go to college?”
The answer is: It depends. We made the unconscious mistake of not thinking about this when my daughter applied to schools. I assumed that since there is a phone and / or zoom, that her team could see her wherever she lands. Once the acceptances came in and we started to think about the options, my daughter’s therapist – who is integral in her recovery and support – let us know that if went to college across state borders that she could not technically continue to see her while at college. This truly affected her final decision. I highly suggest that if you wish to continue working with your team, to ask them how they handle kids when they go to college in a different state. There are options and every situation is different. Some campuses may even have an eating disorder specialist on staff (this would be more at a larger university). The health centers have dealt with eating disorders before but as a parent I would contact the health center prior to start of the year. This should be PART of the relapse prevention plan. You want to think about how weights will be monitored while at school. This can often be done at the health center and I have also heard of students getting weights/vitals done at a local urgent care. Getting these details ironed out BEFORE your kid arrives is ideal.
Situation #4: What about the actual eating at school. What do I have to be aware of?
This is another area that I suggest a bit of thinking before your kid leaves for university. At most schools, freshman are required to be on a meal plan. This is not a bad thing. I have heard of schools that the biggest meal plan does not even allow the kids to have 3 meals a day. Clearly, they have not met a parent whose kid has an eating disorder to give their opinion about that one!!!! Check out the meal plans closely and try to choose one that will give your kid the options that they need. Having a mini fridge and microwave is probably a good option in the dorm room so they have more options for snacks and/ or meals if they do not go to the dining hall. One word of caution – we just went to visit a campus a few weeks ago and decided to eat in one of the dining halls. On EVERY item there is a complete calorie count and nutrition breakdown. There was no way to avoid it as it was on a digital screen above every station. They also had some plates dispersed in the plate section that had graphics on the actual plates that showed how to use the “MY PLATE” plan. While I know the schools are trying to address “nutrition” in the dining halls (I am a former RD so it is odd to look at these programs with a different set of glasses), these programs can be quite triggering for our kids. These are things to be aware of so you can address them with your kid, if needed, instead of just hoping for the best.
Situation #5: Friendships when you have an eating disorder can be challenging and this can be felt more at the end of senior year.
It is not uncommon for seniors to get “more” social and connected at the end of their senior year. Many schools have different events for seniors leading up to graduation. And with these events, there can be pressure to have a “group” and be more “social” and have more fun! All of those things can be uber challenging for our kids. It is not uncommon for friendships to be affected while one battles an eating disorder. And prom……that is a whole other topic for discussion. Along with the social pressure also comes the prom dress for girls. And many kids may start more “crash” diets at this time so the talk of food and exercise can be at a high. These can all be challenging areas and best to be aware of them so if you see signs of distress it may be easier to have acknowledgement of possible triggers in your back packet.
My hope is that if some of these “situations” pop up, you will be more prepared. As parents, it is also a time to reflect how far our kids have come. Some of this reflection can be painful for parents whose kids may have had things robbed of them by their eating disorder. I challenge you to take this reflection and reframe how far your kid has come even if it does not look how you expected it to look. That is ok. Be proud of them for what THEY accomplished and that may mean that they simply attended school and try to release any comparisons to the other kids. Let them know you are proud of them. And know that I am proud of you for being a fellow eating disorder caregiver.