Understanding ARFID: More Than Picky Eating

Posted on July 16, 2024July 11, 2024 by Alison Pelz, LD, RD, CDE, LCSW

Avoidant/Restrictive Food Intake Disorder (ARFID) often remains underrecognized and misunderstood.

Adults who have struggled with Avoidant/Restrictive Food Intake Disorder for most of their life may feel it is impossible for things to be different. Parents who have a child struggling with ARFID have, more often than not, literally tried everything to help their kiddo eat, but nothing seems to be working. ARFID is often equated with picky eating, but it’s actually much more complex than that.

Although ARFID is a newer diagnosis, there is really nothing new about it.

Prior to being added to the DSM-5, it was included in a broader category called “Feeding Disorder.” It was added to the DSM-5 in order to develop better ways to treat it.

Parenting a Child with ARFID

If you are a parent, well meaning doctors may have minimized your child’s selective eating. This can be particularly true if your child is on track with growth. This can be frustrating for a number of reasons. You spend significant time to figure out how to feed your child – and it takes a lot of mental energy and often can feel very limiting to keep dealing with this challenge day after day.

If it’s left unaddressed, ARFID can lead to nutritional deficits, which can impact both physical health and emotional well-being. Early detection of ARFID is important so it doesn’t turn into a life-long struggle. Understanding ARFID is crucial for effective intervention, and a comprehensive treatment strategy tailored to the individual’s specific needs is necessary.

Understanding ARFID

Avoidant/Restrictive Food Intake Disorder is not just a simple case of picky eating; it is a complex psychological condition that can cause significant nutritional and reduced quality of life, particularly if it endures into adulthood.

Unlike other eating disorders that are often driven by concerns about weight and body image, ARFID is characterized by an avoidance of food based on sensory sensitivity, lack of interest in eating, depressed appetite, and/or fear of adverse consequences such as choking, throwing-up, or an allergic reaction.

Individuals grappling with ARFID may face a persistent difficulty when it comes to eating sufficient quantities or varieties of food. This can stem from deep-seated anxiety, gastrointestinal discomfort, or past negative associations with food.

Recognizing Avoidant/Restrictive Food Intake Disorder Symptoms

Persistent avoidance of specific foods or food groups or low food intake are characteristic of ARFID. Physical responses such as gagging may coincide with this avoidance of certain foods.

The eating patterns of individuals with ARFID reveal a restrictive intake that fails to meet their physiological needs. Without treatment, ARFID can lead to potential nutritional deficiencies, weight loss, or developmental delays, irrespective of age, gender, or body weight.

Behavioral signs and changes in eating that may indicate ARFID include:

Poor appetite
Getting full quickly
Avoiding eating due to fear of choking
Picky eating that often gets worse over time

Avoidant Restrictive Food Intake Disorder (ARFID) is often misinterpreted as a phase among children or as mere pickiness in adults; however, it represents a significant feeding or eating disorder that hinders one’s capacity to consume an adequate variety and volume of food.

Impact of ARFID on Everyday Life

ARFID’s restrictive eating patterns in children can lead to low energy, isolation, and anxiety around meal times. For caregivers, it can be a struggle to know how to feed your child, or it can take lots of effort to prepare foods that you know they will eat in order to support growth.

For older children and adolescents, ARFID can make socializing, which often happens around food (such as parties, sleep overs, family events or team dinners), anxiety provoking for both the child and parents. The disorder’s consequences radiate outward, often simmering into familial tensions and social rifts, as loved ones grapple with the complexities of ARFID.

Adults with ARFID tend to have a decrease in quality of life. Moreover, the fear of eating outside one’s comfort zone can hinder personal and professional growth, particularly when mealtime activities are involved.

Ultimately, the disorder’s grasp can dampen overall quality of life, exerting a significant emotional toll.

Approaches to Treating ARFID

The main goal of treatment for ARFID is supporting the sufferer with eating enough (and enough variety) to keep their body nourished. For children, treatment works to support growth. Treatment for children, adolescents, and adults can help to improve overall quality of life.

Improved quality of life looks different depending on the individual with ARFID. For some, that may mean eating most food. For others, it may mean expanding the variety of food in order to support quality of life and being nourished.

Avoidant/Restrictive Food Intake Disorder treatment usually focuses on making eating or feeding a priority.

That is, for most folks, increasing the number of times each day they eat meals and snacks. Due to the nature of ARFID, eating often gets put off because it is uncomfortable for the person to eat, or they simply aren’t hungry.

Structured meal planning can be an effective strategy for managing ARFID, as it introduces routine and predictability into the dining experience. By brainstorming menus in advance, individuals and families gain clarity and a sense of control over their food choices.

Having structure and making eating a priority can help make sure people are getting adequate nutrition and reduce meal time stress.

In addressing the dietary concerns that stem from Avoidant/Restrictive Food Intake Disorder, we take a gradual approach to food exposure. Food exposures are designed in collaboration with the client and/or the family in order to personalize care.

Incremental exposure to food means starting with foods that are less anxiety-provoking, building up to a more diverse diet over time. Food-related anxieties are meticulously deconstructed, facilitating the individual’s encounters with previously feared foods in a safe and controlled environment.

Efforts are channeled into ensuring balanced nutritional intake while concurrently addressing emotional and cognitive barriers. Over time, the individual learns to associate eating with safety rather than distress, thus gradually dismantling the cycle of avoidance that characterizes ARFID.

My Approach to ARFID Treatment

When I am working with children with ARFID I work closely with their caregivers. I have learned from my training in Cognitive-Behavioral Therapy for ARFID that I can bring the expertise in eating disorders, and the parents & kiddo bring the expertise on their family, food beliefs, culture, and abilities (to name a few).

With adults with ARFID I use a similar mindset. I bring skills to the table to treat the eating disorder and they bring their expert knowledge of themselves.

Are you concerned that you or your child are dealing with Avoidant/Restrictive Food Intake Disorder? Sign up for a free consultation to learn more about how I can help you and your family.

Book Review: More than a Body

Posted on September 21, 2022August 5, 2022 by Alison Pelz, LD, RD, CDE, LCSW

Book Review: More than a Body: Your Body is an Instrument, not an Ornament

More than a Body is an important read for those suffering from a negative body image.

Authors Dr. Lexie Kite and Dr. Lindsay Kite (not only sisters, but also identical twins!) are well versed in body image research. Not only do the authors provide a great discussion of what body image is, and how it developed, they deliver an extensive discussion on the influence of society on our body image.

What is this book about?

Lexie and Lindsay provide a framework of body image disturbance and postulate that objectification, both historically and current, of women (and with increasing frequency, boys’ and men’s bodies) is one of the main causes of body image disturbance.

That is, we are trained to focus on how our bodies are seen by others versus what our bodies can do.

In turn, we internalize this message and begin to self-objectify our own bodies. This self-objectification shifts our attention to how our bodies look instead of how we feel in our bodies.

As you can imagine, self-objectification can lead to being preoccupied with the way our bodies look, including increased body comparison and body checking in mirrors.

This shift of our energy and awareness from how our bodies feel to how our bodies look takes up a lot of time and energy, and just leads to feeling badly about yourself and your body.

It often starts from a young age, because a lot of media promotes cultural standards of beauty, even still in 2022. The message has always been that it doesn’t matter how you feel in your body, it matters how the world around you sees your body.

The authors of More Than a Body put forth that women are conditioned to first define themselves by how their body looks and second that they are people with inherent worth.

In a way, the messaging is getting more troubling. Slowly but surely, companies are starting to get the message that appealing to old-school body insecurities doesn’t create as much of a profit as it used to. Instead of being loud about weight loss or fat shaming, companies now try to appeal to people by using language taken from the body positivity movement.

We’ve seen brands like Weight Watchers change their name to WW in an attempt to move their image away from weight loss to “lifestyle change”, while still promoting intentional weight loss and a disordered approach to eating. Everything is still reduced down to the way people look, and not their inherent value as humans.

In order to heal from negative body image, the authors urge us to internalize that we are people first. And our bodies know that we are inherently good.

What did I like about this book?

Importantly, the authors do acknowledge that most body image research is done on cis, white, and often straight-sized bodies. They also discuss weight bias and its harmful effects in addition to discussion on historically marginalized bodies.

The authors’ discussion of the body positivity movement is especially insightful.

They acknowledge that the body positivity movement has expanded the types of bodies (read: size) that are deemed socially acceptable. However, the body positivity movement is flawed because it still focuses on the objectification of women’s bodies.

The idea itself that bodies are to be looked at and objectified is problematic, because who we are as people goes so far beyond what our bodies look like. Having more bodies that we decide as a society are acceptable to look at does nothing to solve the problem of objectifying bodies in the first place, it just adds to the objectification taking place.

The Drs. Kite propose that the only way to improve body image is to eliminate self-objectification and connect with our bodies for what they do for us over how they look. This can be pretty tough to do in the age of social media advertising and diet culture.

The tagline of this book, “Your body is an instrument, not an ornament,” resonates with me as a woman, and in my work with clients.

It is a great mantra to keep at the top of your mind to shift your focus from how your body looks to what your body does for you.

The book is lengthy and provides more of a framework of why we are fraught with negative body image rather than provide solutions for body image problems. I appreciated that the authors used vignettes to explain their work, and they often cite research to back up what they’re saying.

If you’re looking into the background of where negative body image comes from and want to learn more, this book will be an interesting read for you. If you’re looking for actionable solutions for body-image problems, this book might not be what you’re looking for.

Who should read this book?

I would recommend this book to:

clinicians who treat people with body image disturbance
parents & caregivers who want to learn more about how to raise children with healthy body image
those who suffer from body image disturbance
folks who are in the later stages of eating disorder treatment

Although this book is better than some at expanding the body image discussion past cis, white, straight size, abled bodies, the fact that it is more than likely aimed at this audience (rather than the marginalized bodies it briefly focuses on) it is one of the limitations of the book.

The authors have developed an online course (which I have not taken) as another body image resource. But, I also hope that they consider developing a workbook to accompany this book to help guide folks through the difficult process of connecting with our bodies for what they do over how they look.

Are you curious to learn more about the authors of this book and their perspective on body image?

Here is a link where you can hear Dr. Linsday Kite speak on body image – this video also gives a solid introduction to the book.

Understanding your body image and where it comes from is key in eating disorder recovery. If you’re looking for more support in changing your body image, please click here to schedule a free 15-minute phone consultation with me.

5 Ways Journaling Can Help in Eating Disorder Recovery

Posted on February 16, 2022February 15, 2022 by Alison Pelz, LD, RD, CDE, LCSW

What do Oprah Winfrey, Freda Kahlo, Marie Curie, and Anne Frank all have in common? (Besides being exceptional women, that is.)

They all journaled.

When you read about why these incredible women kept a diary, building a strong connection with one’s emotions and thoughts is the theme that comes up.

People who suffer from eating disorders often really struggle to identify and cope with their emotions and thoughts. (And not just people with eating disorders, lots of people struggle to connect with what they’re feeling and why!) Often the eating disorder then becomes the way to cope with those emotions, unhealthy as it may be.

Having a strong journaling practice doesn’t mean that your eating disorder will just evaporate on its own. But keeping a journal is a tool that can help you in your journey in recovery, and support your work in therapy. If you don’t have a therapist or treatment team click here to learn more.

Journaling can help:

Rid unhelpful, repetitive thoughts swarming around in your head.

Simply writing thoughts down sometimes can provide a reduction of these thoughts. The more we hold onto or try to bury our feelings, the stronger they usually become–and the more it feels like they can start to control us. When you take time to get the thoughts out in some way, your mind is able to release them, instead of clinging onto them.

Identify your fears and worries.

Many people who have eating disorders often experience high levels of anxiety. Journaling can assist in identifying those fears and worries in order to evaluate if they are actually reflective of the truth. Learning to identify when our fear those fears are “real” can help both your problem solving skills and your ability to tolerate some levels of anxiety.

Increase a sense of control by reflecting and processing thoughts and feelings.

Giving yourself a space to review and reflect on what you’re feeling without judgement can help take the power out of those strong feelings. Instead of feeling like they are controlling you, learning to reflect & process them helps to teach you that your feelings are trying to communicate something to you, but they don’t have to dictate your life.

Explore and sort out your emotions.

Identifying, understanding and communicating emotions can be hard, especially for those with eating disorders. Often people with eating disorders use eating disorder behaviors to cope with their emotions. Journaling is a tool that can instead help you to navigate your emotions, so you don’t have to rely on your eating disorder to manage them.

Reduce avoidance of problems & stress.

While avoiding problems and stress may seem helpful particularly in the short-term, in the long-term it actually increases feelings of stress, discomfort, and fear. For example, if you are anticipating a tough conversation with someone the longer you put the conversation off the more stressful it becomes. Usually, once the conversation is completed there is a sense of relief. Merely writing about the anticipated conversation is a great first step to reducing avoidance. Eating disorder behaviors often serve as a way to avoid stress and discomfort, so developing a healthy practice to manage stress can help reduce reliance on those behaviors, as well as strengthen your stress management skills in the long term.

Tips to Get Your Journaling Practice Started

Journaling can be downright daunting–especially if you are not used to talking about emotions. But think of journaling as a practice, something that you may feel “not good at” at the beginning, but over time you will become more confident.

Make it part of your daily routine like brushing your teeth. Perhaps journal at around the same time or point in your day. Maybe start off with journaling five minutes a day and increase the length of time as needed or as your confidence builds around journaling.

What to Journal About:

There is no “right way or wrong way” to journal. The point of the journal is to get your thoughts and feelings out on paper. No need for perfect grammar, spelling, or handwriting.

You may start by writing about your day (what you did, thought, and any feelings that came up), or a particular situation that you felt strongly about–whether it was a good or bad feeling.

It may be handy to keep a list of feeling such as this one next to your journal. This can be a good tool to increase your emotional vocabulary, strengthen your ability to identify what you’re feeling, and really understand your emotions.

If you don’t know where to get started with your journaling practice, try one of these journal prompts:

3-5 things you are most grateful and why.
One thing you felt proud about today.
Something you recently did that was hard and how you manage it.
A stressful situation and how you can cope with it.
A letter to a future self.
What do you feel most worried about and why.
What others would say to you about why they care for you.
Eating disorder-specific:
Name 5 ways your eating disorder is helpful and 5 ways that your eating disorder is unhelpful.
If I didn’t have my eating disorder then I would be doing these five things.
If I didn’t have my eating disorder then I would feel these 5 things.
I would want my friends and/or family to know about my eating disorder ar these things.

If you are looking for more ways to support yourself in your journey of eating disorder recovery, talking to a therapist may help. Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders and loved ones.

4 Tips for Anyone Who Loves an Adult in Eating Disorder Recovery

Posted on November 10, 2021November 9, 2021 by Alison Pelz, LD, RD, CDE, LCSW

When you hear the words “eating disorder” what comes to mind? More often than not, eating disorders are associated with teenage girls. While it is true eating disorders often develop in adolescence, adults can have eating disorders, too.

It’s possible for eating disorders to initially develop later in life, not just during adolescence. It’s also possible that adults suffering from an eating disorder developed it during adolescence and never fully recovered. Life stressors (like a pandemic, for example!) later in life can also cause a relapse of eating disorders.

Eating disorders develop for a variety of reasons including genetics, temperament, gender, and dieting history to name a few.

It is less important why and how the eating disorder developed, and more important to focus on supporting your loved one in their eating disorder recovery.

If you love someone in eating disorder recovery, here are four ways to show your support:

1. Think about an eating disorder like a physical illness.

An eating disorder, like cancer, is not a choice. This is often misunderstood. If it was as simple as just choosing to eat more food, far fewer people would suffer with eating disorders.

If your loved one was going through treatment for cancer you may do some of the following: learn about their diagnosis, take them to treatment appointments, provide support, and check-in with them more frequently.

You can do the same with eating disorders. Eating disorders are dangerous and can cause long-term health effects and even death, and they should be taken seriously. See what you can do to understand that eating disorders (EDs) are a physical as well as mental illness.

2. Get educated on eating disorders.

Learning as much as you can about eating disorders is another way to support a loved one in recovery. Eating disorders on the surface appear to be about food. But, make no mistake, while food issues are part of the eating disorder, eating disorders are psychiatric illnesses that must be treated by experienced clinicians. Here are some resources to learn more about eating disorders:

The National Association of Eating Disorders
The Eating Disorder Sourcebook by Carolyn Costin
Eight Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb
Skills-based Learning for Caring for a Loved One with an Eating Disorder by Janet Treasure, Grainne Smith and Anna Crane

You can also ask your loved one if they would like for you to attend treatment appointments with them so you can get a better understanding of their treatment plan and goals.

There are also resources on social media sites like Instagram that offer helpful information about eating disorders, diet culture, and recovery. Make sure to check that the information you’re getting is coming from a reliable source – there are lots of folks out there who borrow language from body positive and anti-diet circles but who are still pushing intentional weight loss or food restriction. It can be really eye-opening to learn about the root causes of eating disorders, in addition to being a great way to support someone you love with an eating disorder.

3. Learn how to communicate with your loved one in a supportive way.

As with most things, supporting someone in eating disorder recovery requires communication. The best way to find out how to support them is to ask! Ask them directly what would make them feel supported or what they’re struggling with. Find out what they would find helpful or for ways you can provide support (or adjust your support if necessary).

It can be tricky to communicate about such emotionally charged topics. Statements such as these can feel supportive to your loved one.

“I know this is hard.”
“You can do hard things.”
“I am here if you would like to talk about it.”

There are a lot of ways to be supportive, but some statements aren’t helpful for folks in ED recovery. Unhelpful statements that you may be tempted to say (remember the ED is not only about the food)

“Just eat.”
“I don’t know why this is so hard…do what I do [insert advice about food, exercise].”

Remember, eating disorders are not just about the food. Everyone’s body is different, and most of us aren’t qualified to give out medical or nutritional advice anyway – we can leave that to the folks on the treatment team.

Another thing to keep in mind is that mealtime can be particularly stressful for those with eating disorders. Some meals and foods may be easier or harder for your loved one to eat. If you eat with your loved one at mealtime it may be helpful to focus on light conversations that have nothing to do with their eating disorder.

4. Be patient.

Eating disorder recovery is a marathon, not a sprint. Recovery is not linear, in fact, it can get quite messy. It requires lots of learning and unlearning, as well as patience and self-compassion.

Don’t give up, and keep checking in with your loved one. Get support for yourself if you need a space where you can process the emotions of supporting someone through recovery. It’s okay to recognize that supporting someone sometimes means asking for help yourself. The National Alliance for Eating Disorders has free support groups for loved ones.

If you are looking for more ways to support your loved one in eating disorder recovery, talking to a therapist may help. Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders and loved ones.

Consider Body Acceptance Over Body Positivity

Posted on October 20, 2021September 16, 2024 by Alison Pelz, LD, RD, CDE, LCSW

There’s a lot of buzz in the wellness and mental health worlds about body positivity and body acceptance, but what do those terms even mean?

Body acceptance is the idea that it’s not always possible to feel positively about your body, but it is always possible to accept it and treat it with kindness. The end goal of both of these is to increase the acceptance of all body sizes and to help people feel more comfortable in their own bodies.

In contrast, body positivity is the idea that everyone deserves to feel positively about their body image. If you’ve ever seen a post on social media telling you to “love your body”, then you’ve probably experienced body positivity.

At first glance, body positivity sounds great. After all, things would be so much simpler if we could all just love our bodies! However, that’s often easier said than done for a number of people.

The idea of body positivity has its roots in fighting diet culture, but the term doesn’t resonate with everyone. After all, feeling positive about your body is a tall order for a lot of people.

First of all, there is a multi-billion dollar diet industry that uses its considerable resources and influence to convince us all that there is something wrong with our bodies. Feeling insecure about how our bodies look is a surefire way to get us to buy products that will “fix” us. However, consider the idea that there was nothing wrong with your body in the first place.

People who are chronically ill or have varying abilities might not feel like they can be positive about a body that is constantly in pain or not able to move through the world easily. People who are recovering from eating disorders might not trust their body’s cues or might feel distress when thinking about their bodies.

Body acceptance might feel like a more attainable goal than body positivity.

You might also go back and forth between positivity and acceptance for your body depending on the day. Nothing lasts forever, and the feelings you currently have about your body probably won’t last. What will last are the consequences of the way you treat yourself, so do what you can to show yourself compassion.

It’s important to remember that one isn’t better than the other. Body positivity and body acceptance are options, and if one feels more attainable than the other, don’t push yourself to feel things about your body that you’re not ready for.

Here are some questions that I get asked frequently about body positivity and acceptance:

Question: I hear all of this stuff about body positivity and feel hopeless. I feel like I am nowhere near loving my body. Is it necessary for me to feel body positivity to recover from my eating disorder?

Answer: While body image, or what we feel and think about our body, is closely tied to eating disorders, body positivity is not necessary for recovery. Body positivity is an ideal outcome of recovery, but it’s not the only outcome available.

In a nutshell, body dissatisfaction or a negative body image often contributes to the extreme eating and exercise behaviors we see in folks with eating disorders. In fact, if negative body image is not in check, the eating disorder will keep going. However, feeling positive about your body is not required to start recovery.

Body acceptance is often a more accessible place to start. As mentioned above, body acceptance is the practice of acceptance, even if you aren’t completely satisfied with it. Body positivity is the practice of feeling positively about your body, which can be a lot harder to do.

It is okay to like some parts of ourselves, but not all. Like so much in life (jobs, school), we may like some parts but not all. Either way, we accept that the parts we don’t like are there.

Question: I really don’t like my body. How can I at least work on increasing body acceptance?

Answer: The knee jerk reaction in our culture is if we don’t like something we need to “fix it”. Certainly, diet culture gives a false notion that if we “work hard enough” then we can have the body we want.

I am here to say I have never met a person with an eating disorder that is NOT a hard worker.

Body acceptance is about changing our thoughts about our body, not about changing our body to match our thoughts.

A typical thought someone may have with body dissatisfaction is “If I get my body to look a certain way I will be more confident.”

While there may be some truth to that, changing your looks is not the only way to feel confident. Confidence can come from so many places, but unless you address the root of that insecurity, a new one will pop up in its place.

If you broaden your thoughts, you will see that there are lots of other ways to build or have confidence without staying in your eating disorder.

Another typical thought someone may have about body dissatisfaction is “I am afraid of what people are thinking of me.”

That is to say you fear people will react negatively to you. Lots of times, you don’t even have proof of this happening, but the fear is there all the same.

Unfortunately, many folks who struggle with eating disorders have been teased, ridiculed, or bullied about their body. Many people who struggle with eating disorders come from families that place high value on looks. (If that’s the case for you, this is something to address and unpack with a therapist.)

More often than not, when we assume people are thinking something bad about our bodies, we don’t have any evidence to back this up.

These thoughts and worries are the real distress, not our bodies. Freeing yourself from the worry that other people are judging your body can give you more time to think about what it would feel like to accept your body as it is.

If accepting your body still sounds scary, there are things you can do to help. One way to increase body acceptance is to identify parts of your body that you do like. It is OK to like some parts of your body but not all parts. You can keep a journal where you write down what you like about your body. You can write down something that you’re grateful for that your body does – like how your stomach holds in all your organs and protects them, or how your thighs help you get from place to place. You don’t have to love each little bit of your body to want to take care of it and keep it safe. Acceptance is enough.

Increasing body acceptance is key in eating disorder recovery. If you’re looking for more support in developing body acceptance, please click here to schedule a free 15-minute phone consultation with me.

Maintaining Eating Disorder Recovery as a College Freshman

Posted on September 8, 2021September 7, 2021 by Alison Pelz, LD, RD, CDE, LCSW

College can be a difficult transition for anyone, but if you’re in recovery for an eating disorder, it can be a particularly stressful transition!

Some of the challenges of maintaining your recovery while returning to school include:

Change in Routine

When in recovery, changes in routine can be tough. Routines allow for some comfort and dependability, because when we have them, we know what to expect. Routines also have very practical uses in recovery–they affect meal planning, treatment appointments, sleeping habits, etc. All of which play a role in recovery! Navigating a new routine can be challenging, and can feel overwhelming, so giving care and consideration to what your new routine will be is important.

Increased Demands + Independence

Going to college is an exciting time because it is the first taste of independence so many of us have! However, gaining independence is also a lot of responsibility–especially if we’re not used to it. It can be easy to not set any boundaries for yourself, but that’s not a sustainable way to take care of yourself. At the same time, you’ll also need to use some of that newfound independence to balance the demands of your school work, which might be more intense than you’re used to. It can be extremely stressful navigating that responsibility for the first time, and increased stress can lead to an increase in eating disorder symptoms.

Exercise + Diet Culture

On a college campus you’ll be surrounded by other young people, who are also surrounded by the constant messaging on social media about diet and beauty standards. Additionally, gyms on campus may be full of college level athletes training in ways that other folks who don’t need intense conditioning for a sport shouldn’t be pushing themselves to compete with. You might be surrounded by fear of the “freshman fifteen” or feel pressure to skip meals to study for exams with other students. The culture around food and exercise on a college campus may not be the healthiest one–and it’s important to prepare for that with a counselor beforehand so you have coping mechanisms you can use when need be.

What can you do to maintain your recovery?

Consider your schedule

Be gentle with yourself as you adjust! College is a big change and you don’t need to try to do it all at once. This means, don’t push yourself to take too many classes your first semester while you’re still getting used to the new expectations. Really think about what your limit is before you feel yourself burning out.

Consider also taking classes that you wouldn’t consider as the most challenging. It’s a whole new style of learning in college, there’s nothing wrong with taking it slow to figure out what you can handle. That way you’re not overworking yourself and you are reducing the amount of stress you might experience.

When thinking about your schedule, consider any habits you have that are helpful to your recovery (social meals, treatment appointments, etc.) and what will be needed for those in your regular routines.

Make a recovery plan before you go

Are you working with a therapist right now? Will you continue to work with them? Or will there be someone on campus to connect with? Have group supports been part of your recovery plan? What is available in terms of group support at your school? Does your current therapist have plans or ideas on what will be important to your recovery at school?

Be sure to set up any regular appointments and checkups with your treatment team ahead of time, to help provide you the professional support you may need to stay “on track.”

Are you working with a dietitian right now? Work with them to help you maintain recovery.

You might want research on what mealtimes are like at school. Consider questions like: What food is available when? Where are the places to eat? What are their hours? Do you know what food do they provide? What are the meal plans like? Is there one that is more conducive to your recovery? Together with your dietitian it might be helpful to gather some information about what the different meal plans are, and make some pros and cons for each of them.

If you don’t have a treatment team, go to the student health center on campus and they will be able to assist you.

Remember: it’s normal for eating disorder symptoms to recur in times of high stress and periods of transition. But by taking time to consider how your recovery will be impacted in this period of transition, you can create a plan to cope with stress and continue with your recovery. Remember, you only have to take it one day at a time!

If you need help in your eating disorder recovery or not sure if you have an eating disorder or not, please click here to schedule a free 15-minute phone consultation with me.