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When your child goes back to college

By Dr. Carole Wehbe Chidiac, American Center of Psychiatry and Neurology, Dubai

My daughter is going back to college. Like most parents, I am worried about COVID-19; but unlike most parents, my concern this year is not worse than when she first left to college. I still remember very well the subject of my fears then: mental health in general, and eating disorders in particular.

And yes, eating disorders are much scarier to me than a COVID infection in teenagers and young adults.

I am a family medicine specialist and an eating disorders practitioner. I always knew the high prevalence of eating disorders in college, and this year I witnessed the effects of a pandemic on disordered eating.

The worst time to diagnose an eating disorder is during the summer between high school and college. Having worked all summer this year, the number of patients was overwhelming, as was the number of times I have had the most difficult conversation with parents.

High school seniors are definitely under a lot of pressure. They can be eating too much or too little, and exercising obsessively to cope with the amount of work. This is often normalized until it is obviously not normal. And this is when parents bring them to us expecting that in couple of months, they are going to be fine and they can go to college.

Going back to my daughter’s senior high school year, I remember my morbid fear when she wanted to become vegan, for ethical reasons, and when she wanted to diet to fit into the graduation dress she chose. After dreadful conversations, and some threatening that I am not ashamed about, she accepted eating dairy and fish but not meat or chicken. And after she couldn’t last a day on any diet she tried, and she got to the point of exchanging The Dress for a bigger size on her own, I was able to breathe normally again and spend a nice summer with her without arguing at every meal.

When I visited her a few months later, she wanted me to meet her new friends, so we invited seven of her friends, all of whom were foreign students from different cultures (Asian, Arab, Hispanic), to dinner. We were nine women in total having dinner in one of the best restaurants in Los Angeles. Two of the young ladies didn’t have a single bite because they said that they had an earlier dinner or a late lunch. One was on a protein diet, even though she appeared to be in great shape. Another, who enjoyed the pasta and the risotto with us, had a change of clothes with her as she was planning to go to the gym at midnight. Apparently, gyms in L.A. are open 24/7.

These friends didn’t include the one who was in hospital for low potassium (almost always linked to purging behaviors in teenagers and young adults) and the young man who couldn’t skip his 3 hour daily gym routine to have dinner with us.

Believe me, I am not exaggerating. Studies confirm it. The percentage of college students with eating disorders goes up to 50% in some studies, most of them having never received any treatment; and we are talking about the psychiatric illness with the highest mortality rate.

Many questions are still without a definitive answer, mainly when it comes to the role of the university and the involvement of parents in the lives of their (mostly) adult children.

Eating disorders cannot be cured in 1 or 2 months, and it is extremely dangerous to send a non-recovered person to live alone in a university setting. Being an adult is not an excuse; most students with eating disorders are still financially dependent on their parents and can’t live on their own without their parents’ support. So parents definitely play a role here.

I have heard parents say that their child has to start college because, “They can’t miss school”, but this cannot be a consideration when the student is seriously ill. Why do we have so many college students with eating disorders who are not getting treatment?

I strongly believe that any informed parent would choose the health of their child over their education without blinking, but so many times parents are not informed. Ignorance can kill when it comes to eating disorders, and proper awareness is unfortunately still lacking.

Wish you all a good school year despite the unprecedented times we are living in.

 

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4 Comments

  1. Julie Montal

    Dear Dr. Wehbe,
    Thank you so much for this article.
    Indeed I recall the year our daughter was accepted to college in the USA while she was in the Parisian hospital for her ED. I wrote to the college, explained the situation. Their reply: wait until she is well and she will be welcome. Perhaps that is what she needed to hear to begin recovery? She was determined. She agreed to speak to the college infirmary with us, to see a nurse once a week. The day we were to leave her there, 10,km away from home, she said: I don’t know if I can do this. We agreed, nothing is carved in stone. She stayed, had ups and downs, finished the 4 years with much support from the people there, who basically let us know how common the illness is, as unique as we know our daughter is. Looking back I know it was the right decision to let her be in that campus setting. Those were terrifying days for us. We felt lonely and fearful, though grateful for the opportunities given to her.

  2. Carole Wehbe Chidiac

    Dear Julie,
    I am happy your daughter had the support she needed from you and from the university. I am sure those were very tough days made much more bearable and less risky by this collaboration between the student, the parents and the university.
    The parents and the University have a paramount role in the “adult” student recovery.

  3. Cathy Baldwin

    Our daughter’s ED started at 16 and it was a long slide into “awful”; and, as she admits today (at 24 yrs old), the tricks she learned in the multiple ED facilities exacerbated her illness. Perhaps keeping her at home would have stemmed her slide. We allowed her to go to college and, by second semester, she was worse than ever and we pulled her out for her 3rd semester to get more intensive treatment. Finally, the only thing that helped was her faith in God and prayer. (Even her atheist psychiatrist admits that the only people she’s seen improve in their ED are those that have relied on their faith in God.) Today, she still has disordered eating (vegetarian, lactose and gluten-intolerant and very limited foods she’ll eat) but is of healthy weight and I see glimmers of the vivacious girl I knew in her early teens. The University was of no help and we had to manage things on our own. Good luck to all of you with ED children. I’m now 65 and still have periodic ED episodes, as do my sisters/cousins that suffered from this terrible illness.

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