In our first post, Why do Eating Disorders Develop in College, we talked about risk factors for developing an eating disorder in college and why it happens so often to this age group. In our second post in this series, we discussed “to Defer or Not to Defer”, sending your child back to college with an eating disorder or delaying school temporarily. Today, in the third and final installment in this series, we will discuss “A Return to College Contract”- how to create an agreement with your college student and make a plan to make recovery a priority when returning to college. We will discuss what needs to be included in this plan and how to present it to your teenager or young adult.

If you have a college student in Ohio and you are concerned about their eating habits and looking for eating disorder treatment in Ohio, please click here. to schedule a free consultation call. I can work with students and families throughout Ohio virtually, so that even when you aren’t in the same space, you can still connect with your young adult.

The first thing I think many of you might be thinking is- how can I make my child stay home from college or sign a contract when they are an adult? Many parents feel they can’t influence their child’s decisions once they become 18 and go to college and many teens will threaten parents with language like this. First of all, remember you are doing this for their health and safety and remind them. Second, think about ways you are helping to support them. Are you paying for tuition or board? Are you co-signing loans? Are they living with you during breaks and summers? Do you own their car? Though a college student may feel like an adult, they are likely still very dependent on you financially and emotionally. I do not suggest posing empty threats to your child, but I do suggest evaluating ways in which it would be difficult for them to continue without your support. As I said, do not threaten to stop paying for college or take away their car, but use these facts to empower yourself if you are feeling like you can’t make decisions for your 18+ child. These are simply requirements you are putting in place in order to continue providing financial and emotional support to your child.

Components of the Contract

Now let’s discuss my recommendations for what to include in your college contract. This will look different for every child and it is a great thing to discuss in family therapy! Click here to get started with eating disorder treatment for your child.

Weight Checks

When and how often will your child be weighed? & What happens if weight is down?

This will look different depending where your child is in recovery. For some, weekly weigh-ins may be appropriate. For others, bi-weekly or monthly may be more reasonable. There are scales that do not display weight, but connect digitally to share weights with providers that can be a great tool for someone in recovery at college. It could also mean going to the nurse on campus or a provider close by for weight checks, either blind (the patient not seeing the weight) or open. It could also be your child weighing themselves on facetime if this is appropriate at this point in their treatment.

My advice is to be very specific about your plan for weight loss while away at college.

What will you do if your child has a weigh-in and they have lost weight? Will you be calling more? Does that mean they need more frequent check-ins with their team? Do they need to have all meals with a support person? Be specific about the weight loss plan and consequences. It may be a certain number of pounds, a certain length of time with weight loss, or other factors to consider with your team. Make a plan for how to intervene if this happens and when a plan for more intense treatment or a return from school needs to be made.

Treatment Team & Frequency

Decide what treatment for your child will look like at school. Will they meet with their same providers virtually? How often? How will you check that they are attending? What happens if they miss an appointment?

Will they get a new provider closer to campus? How will that provider communicate with their current team?

Make sure you have Release of Information signed for all team members so they can communicate as well as any school personnel who may need to be involved such as coaches, sorority leaders or Resident Advisors.

Will you continue to have family sessions? In person or virtually? What will you do if a class conflicts with treatment times? What takes priority?

It may be beneficial to think about a 504 Plan for your child. This can be helpful if treatment requires them to miss class or be away for long periods of time. This article goes into detail about 504 plans in college.

Check Ins with Parents

How often do you expect your child to communicate with you about their eating disorder goals? Will you be involved in their therapy sessions? Do you want photos of their meals? Facetime during lunch? How will you know they are staying on track and meeting their recovery goals?

This is important to discuss. Sometimes parents will need to be involved daily, where other times, a weekly check-in about things will do. Also consider in-person visits-how often would you like to see your child in person? Will you go to them or they come to you? Seeing your child in person in their environment is a great way to gauge their mood and demeanor as well as getting a sense for their surroundings. Is there food in the fridge? Are their roommates supportive and engaging? How far is the dining hall from their dorm? These are all questions that can be best answered by seeing for yourself. Your child might not be happy about this, which is why it is important to put it in their contract and be able to remind them it is part of the agreement to let them go to college and must be upheld.

Support System

A really important part of the contract is going to be your child’s support system at school. Decide who they will tell about their eating disorder and recovery plan and who they can go to when they need help. It is important your child choose a few close friends and roommates to tell about their ED. They do not need to tell every roommate (sometimes there are so many!), but it is important that at least one person they are living with knows about the eating disorder and knows how they can support them through it. It can be beneficial to have a conversation with you, your child and their chose support team when heading back to school so you know exactly what your child is communicating to them. They might tell them about their meal plan, treatment frequency, movement plan and limitations (watching out for excessive exercise) and how they can be supportive (eating with me, avoiding negative body image comments, no dieting in the house, going grocery shopping with me, etc.) Talk with your child’s treatment team before this meeting to write down exactly what you want to communicate. Let the support system know how they can get in touch with you if they have concerns about your child.

It is also important to locate emergency and mental health services on campus and include those in the plan. This way, if your child is struggling and can’t talk to you or their therapist, they know where to go to get help.

Other things to consider in the contract- movement plan, grocery shopping plan, work plan, travel plans (spring break) and more.

Think about how aspects of college life may impact the eating disorder and how to best prepare for them. At the end of the contract, lay the ground rules for breaking the contract (i.e., return home, parents visit weekly, therapy frequency increased, etc). Parents and child should both sign the contract and give a copy to each. Your child should take it to school so that it can be referenced if needed. It can be hung up in their room as a reminder to stay on track with recovery and a motivator to continue with their progress.

Returning or going to college with an eating disorder is a difficult thing, and it can be done safely with the right team, the right plan and the right support.

If you have a child or teen in Ohio who is dealing with eating concerns, please visit my site to learn more about eating disorder treatment in Ohio. I provide virtual eating disorder therapy services from Columbus, Ohio and work with teens and young adults in college. I treat anorexia nervosa and bulimia nervosa in adolescents in Ohio.

Schedule a free consultation call.

This blog is intended to be educational and informational and does not substitute for professional medical and therapeutic help, which is highly recommended when treating an eating disorder. If you would like help treating your child’s eating issues or want to learn more, Schedule a free consultation call today.