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.

Coping With COVID-19 and Eating Disorder Recovery: Tips for College Students

Posted on September 23, 2020September 22, 2020 by Alison Pelz, LD, RD, CDE, LCSW

Let’s face it – starting a new year in college during the COVID-19 pandemic is rough. College life looks much different than it used to, with virtual classes and less socializing, to name a few things. If you add an eating disorder into the mix, it can make starting the semester feel downright daunting.

If your eating disorder symptoms have increased since the pandemic started you are not alone. Eating disorder behaviors are a way to manage and cope with stress, so more stress can equal the exacerbation of eating disorder symptoms.

Furthermore, the nature of physical distancing can lead to feelings of worry, sadness, hopelessness, and loneliness which also can trigger eating disorder behaviors, including dietary restriction, purging, binge eating, and overexercising.

Starting a new semester (or starting college for the first time) is associated with many “positive feelings” and excitement. However, along with these positive feelings, students may experience feelings of isolation, worry, and sadness, again exacerbating eating disorder symptoms.

Remember it is normal to be experiencing more stress, worry, and sadness during the pandemic. However, there are tools that you can use to manage your feelings.

Below are some tips to help you cope with stress, the pandemic, and your eating disorder:

Keep connected with your treatment team.
- Whether you are doing treatment in person or virtually, keeping regularly scheduled appointments is key to keeping your eating disorder recovery on top of the priority list. If you feel like you need more support during this time, ask your team about more frequent visits and/or attending virtual groups. To learn more about eating disorder treatment teams or how to get treatment, click here.

Stay social.
- College with a side of COVID can be very isolating especially if you participating in virtual learning. It is not uncommon to experience an increase in loneliness. Social connection with family and friends can help reduce feelings of loneliness, sadness, and worry. Keep socializing in whatever way feels safe to you a top priority.

Make time for hobbies and other coping skills.
- Coping skills and hobbies can help manage stress and uncomfortable feelings such as worry, sadness, and anger. Healthy coping skills are activities that you can help you positively manage stress. These can include talking with a friend, spending time outside, playing with a pet, reading, cleaning, doing a puzzle, praying or meditating, or volunteering, to name a few. Hobbies such as crafting, art, photography, and the like can also help reduce feelings of stress.

Keep a routine.
- Having a routine can help reduce stress levels by adding structure and organization to your day, even during the pandemic. Having a general—but not rigid—routine around eating, sleeping, socializing, and studying can be helpful in your recovery from your eating disorders and generally improve mental health.

Remember that it is normal for eating disorder symptoms to increase during times of stress, and the COVID-19 pandemic is a very stressful time. By practicing the tools above, you can learn ways to reduce your stress and continue with recovery.

If you would like to learn how I help clients manage stress or you need help in your eating disorder recovery, please click here to schedule a free 15-minute phone consultation.

4 Ways to Build Momentum in Eating Disorder Recovery

Posted on July 23, 2019July 18, 2019 by Alison Pelz, LD, RD, CDE, LCSW

Are you just starting out on your recovery journey? Or have you been in treatment for a while and feel like your recovery is stalled? You’re not alone.

Here are four tips to help build momentum or re-energize your eating disorder recovery.

Establish a complete eating disorder treatment team.

Without professional treatment, eating disorders tend to get worse, not better.

Unfortunately, getting inadequate treatment, such as stopping treatment prematurely or having an incomplete treatment team, happens all too often. It can lead to hopelessness about ever recovering, slow down recovery or lead to recovery burnout.

The gold standard of care in eating disorder treatment is to have a multidisciplinary team. An eating disorder treatment team usually consists of a therapist, registered dietitian, medical doctor, psychiatrist, family therapist, and possibly other specialists. Click here to learn more about how to find a therapist and establishing a treatment team.

Make recovery a priority.

Recovery can feel like a full-time job, which can be downright exhausting. Eating disorder recovery is definitely a marathon and not a sprint. It takes time to understand how the eating disorder serves you and to establish new healthier patterns to cope with life.

Recovery doesn’t happen in a vacuum. Recovery happens while you are in school or working and involved with family, friends, and hobbies. So, it is easy for recovery to be put on the back burner given all of the obligations you may be juggling.

Making recovery a priority is important because without recovery, your eating disorder negatively affects all areas of your life occupation or school, relationships, physical and mental health, and overall quality of life.

Having acceptance that recovery is going to take time and energy is a good first step to making it a priority. Carving out time in your day for self-care, meal planning, eating, rest, and treatment appointments can help you feel less overwhelmed.

Learn to say no.

This is a tough one for me and so many of my clients. Sometimes saying yes is like a reflex because it is so automatic.

Learning to say no is a must in order to make recovery a priority. Furthermore, you may learn in treatment that saying yes too much may be contributing to or exacerbating your eating disorder symptoms.

Not setting firm boundaries can lead to feelings of hopelessness, worry, anger, and resentment, to name a few negative emotions. When we over-extend ourselves, often eating disorder behaviors are used to cope.

Although there are several reasons why people struggle with saying no, often fear is the primary culprit. You may fear missing out, hurting others feelings, appearing selfish or rude, being judged, and feeling rejected.

Learning how to set boundaries takes lots of practice, so be patient with yourself. If you notice that you struggle in saying no, discuss this with your therapist and other treatment providers.

Ask for help.

Working on your eating disorder recovery is something that you are responsible for. However, that doesn’t mean that you have to do it alone.

As you know, loved ones can’t eat for you or attend your appointments for you, but they certainly can support you in your recovery in many different ways.

As you go through recovery, you are going to need help, and that is okay. Often, part of what keeps people stuck in the eating disorder is isolation and feeling like they have to recover alone.

Barriers to asking for help often include fear of appearing weak, feelings of shame or guilt, or worry about burdening others. Your fears most likely are unfounded, as most people like to help others.

So what does asking for help in recovery look like?

Well, at different times in your recovery, it could mean different things. But, for some, it could be eating a meal with someone, it could mean being social, or it could mean simply talking.

It could also mean asking loved ones to learn more about eating disorders or attending a family therapy session or doctor’s appointment.

Consider making a list of people whom you could ask for help by asking yourself, “Who has my best interest at heart and who believes in me?”. Having some people in mind ahead of time can make it easier to ask for help.

Lastly, don’t feel like you have to be in crisis to ask for help. If you have any inkling that you may need help, reach out. Sometimes just the act of reaching out and talking to someone can be supportive.

The recovery road is always bumpy. But, having a strong treatment team as a foundation, making recovery a priority, setting firm boundaries, and calling on loved one for support can often make the bumps feel more manageable.

4 Tips to Cope with Weight Gain in Recovery from Anorexia Nervosa

Posted on December 4, 2018May 7, 2019 by Alison Pelz, LD, RD, CDE, LCSW

Let’s face it – our society gives us strong messages from social media, print media, our schools, and the health care system that weight gain is bad. Wherever we turn we are given the message that weight gain is a death sentence. (Which, by the way, is not true! If you want to learn more on this subject I highly recommend reading Health at Every Size).

Folks who are in recovery from an eating disorder have a double whammy to contend with. One of the key features of anorexia nervosa (or really any eating disorder) is the fear of gaining weight. This fear plus societal pressure to look a certain way can make recovery from an eating disorder feel like an uphill battle.

Therefore, if you are in recovery from an eating disorder, it would make sense that you have an intense fear of gaining weight. However, weight restoration is a must in recovery in order to maintain your physical and mental health.

Helping clients improve body image while restoring weight, nutrition, and health can be the hardest part of the recovery. But it is possible with perseverance, patience, and hope.

I have gathered some wisdom from around the web from other treatment professionals and those in recovery to help you along with the process.

1. You are gaining weight that you shouldn’t have lost in the first place.

The weight gained in eating disorder recovery isn’t just regular weight gain–it’s weight restoration. You are healing through the weight gain – giving back what you shouldn’t have taken from your body in the first place.

Weight restoration can be complicated and difficult, and shouldn’t be a journey you embark on alone. To better understand the process, read this article on what weight restoration is, what it’s comprised of, and what you should expect when going through it. It also includes a discussion of particulars you might not be familiar with, like refeeding syndrome (the complication of increasing food intake too quickly) and hypermetabolism (the increased rate of metabolic activity that often comes along with an eating disorder).

It also covers how difficult the process of weight restoration can be in recovery–and why it is critical to not only have a meal plan for weight restoration but a therapist to help throughout the journey.

Read the whole thing here: Working Through the Weight Restoration Phase of Anorexia Nervosa

2. Accepting weight gain as part of recovery takes time (and lots of it!).

Accepting your body takes time. In fact, it can be one of the slowest parts of recovery. The author of this article provides several useful ways to cope with weight gain, including thanking your body! It is a must read.

Some of the tips covered are:

remembering our bodies changes are never as visible as we fear
keeping perspective & remembering that the alternative is worse

Read the whole thing here:

5 Ways To Deal With Weight Gain When You Are In Recovery From An Eating Disorder

3. Fear of weight gain usually reduces as your eating normalizes.

I have seen this in my clinical practice. As clients start to feel better physically because they are feeding themselves more regularly throughout the day, the fear of weight gain can lessen.

As weight gain also naturally redistributes after the initial gain, the prospect of weight gain becomes less overwhelming. Once your body has come out of life-saving mode, the weight you’ve gained back won’t just sit in one place. It will spread across your body, and will not be nearly as visible as someone in recovery might worry about when starting the process.

“Will I gain weight forever?”: What we know about weight trajectory during recovery from an eating disorder

Yes, Weight Gain Is Hard. Thankfully, We Have 8 Ways to Cope With Weight Gain For You

What this article shows us is that the odds of perpetual weight gain after the initial restoration, are actually pretty low. Your body will adjust back to a stable, healthy weight, and for the most part, stay stabilized.

4. Weight restoration allows you to enjoy life more fully.

“Going to concerts has always been one of my favorite things to do. The atmosphere, the music — I can go on about it for hours. Ever since my eating disorder came to peak, I’d lost this love.”

Dietary restriction and malnutrition often occur pretty slowly, and sufferers from eating disorders may often not notice that their sense of joy and zest for life is blunted and dulled. Without proper nourishment, your body just isn’t able to sustain you through life as well.

With proper nutrition, you will begin to get feel more like your old self. Your body will have the nourishment it needs to keep healthy, to keep energy sustained, and you will be able to once again be an active participant in your life & hobbies.

How I’m Learning to Love Weight Gain in Eating Disorder Recovery

With your renewed energy, your emotions will feel full and vibrant again–allowing you to enjoy life in a way you may have not even realized you were missing out on. With weight gain comes this capacity to feel full and alert and restored.

Accepting weight gain in eating disorder recovery can be a long and difficult journey. It isn’t something that happens overnight. Work and support are necessary components to the journey. Keeping these four key things in mind can help you on your journey to recovery and weight restoration.

Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders.

Tips to Support Eating Disorder Recovery this Semester

Posted on September 4, 2018August 30, 2018 by Alison Pelz, LD, RD, CDE, LCSW

It’s that time of year again—back-to-school! If you are in eating disorder recovery, sometimes transitioning back to school can be challenging. But with a little planning, patience, and resolve, you can continue to make progress in recovery.

I know my kids are excited about going back to school, sort of. They are looking forward to seeing all of their friends and being involved in sports, but not necessarily looking forward to the school work.

Hopefully this summer you have had a much-needed rest from writing papers, taking exams, and late-night study sessions. Maybe you did some traveling, worked, or just spent time with family and friends.

No matter what you did this summer, you can prepare yourself for a smooth transition back to school without interrupting your eating disorder recovery.

Pitfalls of eating disorder recovery when returning back to school:

1. Change in routine.

Returning to school, of course, can be exciting with seeing all of your friends. You may be even excited to start new coursework. However, change in routine when in recovery can be tough. Routines make us feel comfortable because we know what to expect. Routines can help you stay on track with your meal plan, treatment appointments, and sleeping habits. Disruption in routine can mean a disruption of established patterns of recovery.

2. More demands.

Returning to school is associated with an increase in demands and deadlines due to coursework plus navigating relationships, social life, extracurricular activities, and for some, a part-time job. It is not unusual to see an increase in eating disorder thoughts and even symptoms when stress increases.

3. Increase in independence.

You probably love the independence of living on your own or with roommates and making your own choices when at school. If you spent a good portion of your summer with loved ones, you may have their support in your treatment and recovery. Of course, as an emerging adult, having your parents’ input may feel somewhat annoying after a while. But in any case, as you ease your way back into school, you may have increased stress because your support system isn’t readily available.

4. Comparison Trap.

It is in our DNA to compare ourselves with others. Evolutionarily, comparison helped us decipher threats from safety. As our brain has evolved, comparison has been used to help with our social-neural network. It helps us learn more about ourselves—for example, what we are good at and what we are not.

I knew early on in life I was not going to be a mathematician, and I am sure comparing myself to others helped me understand that. But I did understand that I was good in the sciences. This is an example of how comparisons can be helpful, not harmful.

Conversely, comparing ourselves with others all of the time can be detrimental. During adolescence and young adulthood, it is easy to fall into the comparison trap, constantly comparing yourself to others as you are trying to figure out who you are away from your family. The comparison trap can be especially challenging for those in recovery because it can make you second guess what you are eating, how you are exercising, and other health behaviors.

5. Diet culture.

In the world of eating disorder treatment, the constant barrage of messages about dieting and how we should look is termed “diet culture.” Diet culture is alive and well in our country. It feels like on college campuses, diet culture is “on steroids,” so to speak. It reinforces the habit of comparing ourselves to others to see how we are supposed to look and feed ourselves. Instead of teaching us to listen to what our own body needs, it makes us question how we feed ourselves. It makes us feel disconnected from our bodies and food. Conversely, a key component of eating disorder recovery is to tune into our bodies and tune out societal messages. Diet culture can easily make you feel like a fish swimming upstream.

Although there are some potential obstacles to eating disorder recovery when returning to school, there are several ways to keep the momentum of recovery going over the fall semester.

5 tips to stay on track with eating disorder recovery during the fall semester:

1. Get support from your treatment team.

Seek support early on in the semester, even if you think you don’t need it. You may have made strides over the summer in your recovery. Extra support during schedule changes can help you move light years ahead in your recovery. Whatever your fall schedule looks like, strategize ahead of time. How are you going to keep on top of your meal plan, self-care, and treatment appointments? Collaborate with your treatment team in advance about your schedule.

2. Say no to perfectionism.

There is a quote that goes, “Strive for progress, not perfection.” I love this quote and often say it to myself. Most folks with eating disorders do struggle with perfectionism. As perfectionists, we can want to do a good job and put in lots of effort in our work. However, striving to be perfect when we live in an imperfect world can be paralyzing, exhausting, and it can erode our self-esteem. Perfectionism can flare up eating disorder symptoms as well.

School and peer groups can also trigger some of those thoughts of having to be perfect or the best. So as you are setting academic, social, and personal goals this semester, focus on progress and doing a “good enough” job rather than a perfect one.

3. Self-care.

Often, folks think that taking care of themselves is an act of selfishness. Self-care is not being selfish. Self-care is about paying attention to your physical and emotional needs in order for you to avoid burnout, whether it be from school, in recovery, or in life.

Practicing self-care helps you to have the physical and emotional energy to thrive. Self-care could include: taking a bath, getting a pedicure, getting adequate sleep, connecting with a friend, setting boundaries (saying “no”), doing something creative, spending time alone, and giving yourself permission to simply be.

4. Ask for help.

Talk with your family, loved ones, or support person about how you plan to stay on track with your eating disorder recovery. Discuss potential areas of concern, learn how to ask for help, and communicate areas of success to loved ones. Interact regularly with your treatment team, particularly if you feel like you are struggling.

5. Learn to say no.

Taking on too much, particularly early on in eating disorder recovery, is an easy way to get derailed. This may mean saying “no” to fun social engagements, taking less coursework, or working fewer hours at a job. Do you want to learn how to say no confidently?

Sign up here to get my free guide “25 Ways to Say No Politely For Those in Eating Disorder Recovery“!

While there are ways to hinder eating disorder recovery over the semester, with planning and persistence, you can keep recovery front and center!