Eating disorder resources for current and previous clients

The transition back to school marks a fresh start for many students, but for those at risk for or recovering from an eating disorder, it can also be a period of heightened vulnerability. New academic demands, shifting routines, and evolving social dynamics can lead to increased stress, which research shows is closely linked to the onset or worsening of disordered eating behaviors.

By understanding the relationship between stress and eating disorders, and by knowing the signs to look for, parents, teachers, and healthcare professionals can help ensure that students receive timely support and intervention.

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The Relationship Between Stress and Eating Disorders

Stress and eating disorders are deeply interconnected. In many cases, stress serves as both a trigger and a maintaining factor for disordered eating behaviors. For some, stress prompts restrictive eating as a way to gain a sense of control; for others, it can lead to overeating or binge eating as a way to cope with overwhelming emotions.

Anxiety disorders frequently co-occur with eating disorders, and the demands of the school environment can intensify both. Academic performance expectations, social relationships, and extracurricular responsibilities often create a high-pressure atmosphere, especially for teens with perfectionistic tendencies or a fear of failure.

These stressors can push vulnerable students toward unhealthy coping mechanisms, such as manipulating food intake, overexercising, or withdrawing socially. Over time, these behaviors can escalate, making early recognition and intervention critical. By addressing the underlying stress and providing healthier coping tools, families and professionals can help reduce the risk of an eating disorder taking hold.

Can School Stress Cause Eating Disorders?

School stress alone does not cause eating disorders, but it can be a powerful contributing factor, particularly for individuals with genetic predispositions, past trauma, or other mental health concerns. For adolescents, the school setting presents unique challenges: high academic expectations, peer pressure, social comparison, and in some cases, bullying or appearance-based teasing.

Transitions, such as moving from middle school to high school or preparing for college, can be especially destabilizing. These life changes often come with increased responsibilities, new environments, and a need to adapt quickly - all of which can heighten stress and trigger disordered eating patterns.

Perfectionism, a trait linked to both academic achievement and eating disorder risk, can further intensify the impact of school stress. Students who tie their self-worth to grades, sports performance, or social approval may use food and body control as a way to manage anxiety.

If these behaviors become habitual and unaddressed, they can progress into a diagnosable eating disorder, underscoring the importance of early identification and support.

Eating Disorders in High School Students

Adolescence is a peak period for the onset of eating disorders. Among high school students, these illnesses affect individuals across all genders, races, and body types, disproving the myth that eating disorders only impact a narrow demographic.

Common diagnoses in adolescents include anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID, and other specified feeding or eating disorders (OSFED). These conditions can present differently from one student to another, and symptoms may be hidden behind academic success, athletic performance, or a socially active lifestyle.

Stigma remains a significant barrier to help-seeking in this age group, with many teens reluctant to disclose symptoms for fear of judgment or misunderstanding. Early intervention during high school is critical; timely, evidence-based treatment can improve recovery outcomes, reduce medical complications, and interrupt the progression of symptoms before they become deeply entrenched.

Signs of Stress-Induced Eating Disorders

Parents, educators, and peers can help by recognizing early warning signs of eating disorders, which may include:

• Skipping meals or drastically reducing food intake

• Eating in secret or avoiding eating with others

• Preoccupation with calories, weight, or body shape

• Sudden weight loss, gain, or fluctuation

• Excessive exercise or rigid workout routines

• Frequent trips to the bathroom during or after meals

• Mood changes, including irritability, anxiety, or depression

• Withdrawal from friends, activities, or school events

• Decline in academic performance or increased school absences

• Frequent complaints of stomach pain, bloating, or other digestive issues without a clear medical cause

While these behaviors can have many causes, persistent or worsening symptoms should be taken seriously. Eating disorders can develop gradually, and subtle changes in behavior or mood may be the first indicators. Early recognition is one of the most effective ways to prevent symptoms from escalating.

Tips to Help Reduce School Stress

There are many ways to help students manage back-to-school stress in healthy, sustainable ways:

• Encourage regular meals and snacks to support focus and energy

• Promote adequate, consistent sleep schedules

• Help students set realistic academic and extracurricular goals

• Provide time for unstructured relaxation and hobbies

• Model and teach mindfulness or breathing exercises for stress relief

• Maintain open, nonjudgmental communication about school and social pressures

While these strategies can reduce stress, it’s equally important to monitor for signs that stress is impacting a student’s health or daily functioning. If concerns arise, involving a mental health professional early can help address challenges before they escalate into more serious issues.

How Parents and Teachers Can Help

‍Parents and educators play a vital role in supporting students’ mental health and fostering resilience during stressful transitions. Strategies include:

• Maintaining open, judgment-free communication about challenges and concerns

• Avoiding comments about weight, appearance, or eating habits

• Offering reassurance that academic performance does not define worth

• Encouraging healthy coping outlets, such as creative activities, social connection, or physical activity for enjoyment rather than appearance control

• Coordinating with school counselors, coaches, and other professionals to ensure consistent support

By creating an environment of acceptance and understanding, parents and teachers can help students feel safe to share their struggles. This approach not only helps with early identification of eating disorder symptoms but also reinforces protective factors that can reduce vulnerability.

When Is Eating Disorder Treatment Necessary?

‍Early intervention is a key predictor of positive recovery outcomes. Treatment should be considered when changes in eating patterns are persistent, interfere with daily functioning, or cause noticeable physical or emotional distress.

Even “mild” symptoms should not be dismissed; without professional intervention, they can escalate quickly. Warning signs that treatment may be warranted include significant weight changes, physical health concerns, or an inability to manage school, work, and relationships due to eating disorder symptoms.

Parents and professionals are encouraged to seek an evaluation from a qualified eating disorder specialist if concerns arise. A comprehensive assessment can help determine the appropriate level of care, ranging from outpatient therapy to residential treatment, and provide the structure and support necessary for sustained recovery.

Learn About Eating Disorder Treatment with Monte Nido

Monte Nido Clementine’s programs provide evidence-based, individualized eating disorder treatment for adolescents, integrating medical, nutritional, and therapeutic care within a compassionate, recovery-focused environment. Our approach addresses the complex interaction of biological, psychological, and social factors, helping clients build lasting tools for recovery while restoring a healthy relationship with food and body.

For students facing increased stress during the school year, Monte Nido Clementine offers multiple levels of care, allowing for a seamless step-up or step-down in treatment as needed. Our adolescent programs prioritize age-appropriate interventions, family involvement, and coordination with schools to ensure that treatment supports, rather than disrupts, a student’s educational goals.

If you are working with or caring for a student who may be struggling, our Clementine team is available to provide consultation, assessment, and guidance on next steps. Learn more about our programs and admissions here.

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It’s Ok, Eating Disorder Relapses Happen

First things first – relapses happen. Someone who has gone through eating disorder treatment (or even someone who’s about to go in for the first time) may think of a relapse as a failure of some kind, and that’s natural. After an enormous effort to grow in personal, behavioral, and emotional ways, a person might feel that returning to old behaviors is a setback.

However, as they say in eating disorder treatment circles, “Recovery is not a straight line.”

Most professionals in the treatment community recognize this and consider relapses as normal parts of the eating disorder recovery process. They stress to their clients, both those in treatment and those in aftercare, the importance of recognizing the signs of a potential lapse in the recovery program and reaching out for help.

Even if they don’t, and fall back into disordered eating behaviors, people who relapse shouldn’t feel guilty or as though they’ve failed in their recovery; it’s an opportunity to learn more about the underlying causes of their disorder. 

Relapses can also prove an opportunity to learn new coping mechanisms that will eventually strengthen the foundation for a long-lasting, recovered life.

In this article, we’ll review the risk factors for relapse and the telltale signs and symptoms that a relapse is on its way. It’s not just for people with the eating disorders themselves – family and close friends play a vital role in recovery as well. 

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Why Do Eating Disorder Relapses Happen?

It’s an imperfect analogy, but eating disorders are in many ways similar to addictions. The disordered eating behaviors provide emotional relief and a sense of control over negative emotions. Many disordered eating behaviors even cause the release of dopamine and serotonin into the brain, just like intoxicants or exercise. And just like addictions, continued disordered eating behaviors cause alterations to the way the brain works – necessitating cognitive retraining techniques like Cognitive Behavioral Therapy (CBT) to counteract.

Stress Can Be an Eating Disorder Relapse Trigger

Aside from the cognitive/psychiatric cases of relapses, certain emotional and stress-related factors can make a relapse more likely. One of the major known causes of eating disorders like anorexia nervosa, bulimia nervosa, binge eating disorder, and others is the presence of past trauma and PTSD. Psychiatrists and other eating disorder treatment professionals have heard countless personal tales about post-traumatic stress playing an integral part in starting to use disordered eating behaviors to cope. It’s no different after a person has gone through treatment. A resurgence of the negative emotions caused by PTSD can easily re-spark disordered eating behaviors even if they have been eliminated during treatment. For this reason, many treatment centers employ Cognitive Processing Therapy (CPT), a step-by-step dialectic therapy that was designed specifically to treat trauma.

These underlying causes of relapse are certainly very common, but usually, when a relapse occurs, there is a specific trigger that prompts the resumption of disordered behaviors. This is most often stress of some sort. This stress doesn’t always have to be negative; many major life changes can cause stress, and many are happy occurrences. Positive or negative, stress is the most prominent trigger for relapse; a study done in 2011 showed that a group of people with bulimia nervosa who suffered significant life events relapsed at a much higher rate than those who had not.

Some examples of major life events that can cause stress include:

• Getting a failing grade
• Abuse, physical or emotional
• Being in a car accident
• Getting married
• Graduating from school or college
• Being fired or laid off
• Getting a promotion or a new job
• Being robbed or burglarized
• Achieving a goal
• Having to give a speech or other public speaking
• Spending the holidays with family
• Having a child
• Having an abortion
• Losing a friend or family member

There are as many potential causes for stress as there are major life events. Following one of these events, a relapse may occur. At times, the relapse will come on slowly, with some small behaviors leading to the re-emergence of classic behaviors associated with eating disorders such as purging, binge eating, and calorie restrictions. At other times, a stressful event can spark a relapse quickly. Next, we’ll look at some of the signs that a person is inching back toward disordered eating and exercise behaviors.

What Are the Signs of a Potential Eating Disorder Relapse?

Every kind of eating disorder has its own unique symptoms, so there will be different warning signals for each. However, some changes in thinking patterns and behavior indicate a relapse might be coming among all eating disorders. During treatment, many of these behaviors were replaced with positive coping mechanisms, but they can lay low for months or years afterward. Very often, when a relapse is imminent, a person will experience one or two of these, and then a few more, and so on until the disorder has completely come back.

Here are a few signs that a person’s recovery has become at-risk:

1. Increase in negative body image or self-criticism

Body image distortions are central to eating disorders; they’re one of the first things addressed at both residential and day treatment centers. Learning to love and accept your body is also part of most treatment programs, with daily affirmations and mindfulness exercises that can be used during aftercare. When negative body image encroaches after eating disorder treatment, it’s a clear sign that a relapse may be coming. 

Some indications include an increase in self-criticism, i.e. “I feel fat,” beginning to wear baggy or less-revealing clothes to hide their body shape or even a general feeling of being dissatisfied with your body. Negative body image, especially when it centers on weight, can prompt behavioral changes designed to lose weight – a slippery slope for a person in recovery.

2. Changes in eating patterns

A major part of treatment is establishing a regular eating pattern with nutritious meals that provide nourishment as well as a renewed sense of enjoyment when eating. When a person in recovery starts to change these eating patterns, it might mean they are inching towards a relapse. The most obvious is when a person goes on a diet that requires calorie counting or cutting out entire food groups – any fad diet, in fact. 

A person in recovery from an eating disorder should avoid food restrictions, of course, but they might begin to justify small changes in their eating, which can turn into a relapse. Other changes might include a reluctance to eat in public or discomfort at family meals or when out with friends at a restaurant. An increase in private eating is also an indicator of a relapse, especially for a person in recovery from binge eating disorder or bulimia nervosa. 

Some other signs of a potential relapse are chewing more gum and increasing caffeine intake, especially black coffee or diet colas.  These aren’t the only eating changes that can be a warning sign – any sudden changes in the way a person eats can be a red flag.‍

3. Looking back on the disorder with fondness

Even after a successful period in eating disorder treatment, a person may not like the way they look or be completely happy with their weight. It can take a concentrated effort to promote self-love and body positivity. If a person in recovery is feeling nostalgic for the body shape their eating disorder brought on, they may resume those disordered eating behaviors. Commonly, they will look back at these perceived “positives” and ignore the myriad negatives that come with an eating disorder.

4. Worsening of depression or anxiety

Co-occurring disorders, i.e. another mental health condition in addition to a person’s eating disorder, are completely normal. These disorders are much more common in people with eating disorders than in the general population; they can be both contributing factors and results of an eating disorder. The negative emotions brought on by depression and/or anxiety can prompt disordered eating behaviors as a kind of relief – as mentioned before, the “feel-good” brain chemicals released by binge eating, purging, or restricting are often a disordered coping mechanism. If you notice a worsening of these symptoms in yourself or a loved one, it’s time to reach out for help – it’s a clear risk factor for a relapse.

What to Do if You Notice an Eating Disorder Relapse

When an eating disorder relapse occurs, remember it’s not a failure or something to be ashamed of. It’s a natural part of the recovery process. That’s why eating disorder treatment centers provide alumni support groups and other alumni services – to prepare for exactly these circumstances. 

When a relapse is coming, or when it has struck, it’s imperative to reach out for help. If you’re the person in recovery, you might want to speak to a family member or close friend, or if that’s uncomfortable for you, talk to a professional therapist or even place a call back to your eating disorder treatment center. If your loved one is in recovery and facing a relapse, you may want to have a compassionate talk with them. Make sure you ask how you can help and if they feel supported. A relapse can be scary – but it can also be treated.

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This week, one of our Primary Therapists discusses maintaining recovery during the summer holiday. Read on to learn some strategies to support your recovery.

How Summer Vacation Can Impact Eating Disorder Recovery

For most, summer holidays are full of excitement and pleasure. People often count down to summer for as long as they can remember. They begin preparing for the event weeks ahead by going shopping for a new outfit, picking out a recipe to cook, and reaching out to friends and family to coordinate plans. 

However, if you are someone currently in recovery from an eating disorder or disordered eating, a summer celebration might make you uncomfortable.

You might currently be experiencing an absence of joyful emotions for the last several weeks, months, or even years. All of your previously enjoyed activities that used to bring you joy might feel as if they have completely escaped you. Because of this, you might question whether you will be able to have fun or enjoy yourself by attending a 4th of July celebration, a family BBQ, or a friend’s pool party.

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Eating Disorders and Summer Depression

Depression can increase your desire to engage in your action urge (the urge that appears to protect you), which results in withdrawal and isolation from others. Opposite action asks you to question whether this specific urge to isolate makes sense in the moment or whether acting oppositely could be more beneficial. 

If you have already decided that you are not going to attend the celebration, this is the time to reflect on whether isolating is more harmful than attending. If you decide that the benefits of going to the event outweigh the potential consequences of avoiding the celebration, there are certain ways to plan ahead to make sure you are as comfortable as possible.

4 Strategies to Aid Summer Eating Disorder Recovery

1. Identify an ally: Choose a family member or friend that can be your go-to person. Have a plan about how long you’re going to stay at the event and how often you might need to check in with one another to assess how you’re feeling. Think about creating a code word/phrase to share when you need additional support away from the group.
2. Meal plan: Decide whether you are going to bring your own food or whether you are going to eat what the host has prepared. Do not allow this to be an excuse for engaging in eating disorder behaviors due to being unaware of what food will be available. Call the host or ask your friend/family to do this ahead of time if necessary.
3. Prepare for social interaction: Reintegrating back into a social group after a period of isolation can be anxiety producing. Your family and friends are most likely excited to spend time with you. They may have several questions in regards to how you are and what you have been doing. They might even unintentionally make a comment about your appearance with the belief that they are complimenting you. Be prepared. Brainstorm safe topics that you can discuss if you’re uncomfortable talking about treatment or your recovery. Role-play with someone prior to the event in order to explore how you will respond to certain questions. Ask yourself how much information you’re willing to share and with whom you feel comfortable sharing that information with. Think of a statement to use if you need to remove yourself from a conversation that is no longer beneficial.
4. Set an intention: On your way to the celebration, set an intention. What is the reason that you are attending this party? What is the desired outcome? Repeat this intention to yourself over and over until it resonates with you. When your eating disorder begins to distract you from this intention with attempts to engage you with thoughts related to food or body, challenge it by repeating this intention. Remind yourself of the initial purpose.

A Plan Can Ease Eating Disorder Recovery in Summer

Managing summer vacation celebrations while being in recovery can often feel extremely overwhelming if you are without a plan. Take the time to recognize any obstacles that may arise in order for you to cope with potential eating disorder urges. While you are challenging your eating disorder over time, you will soon be able to return to enjoying fireworks, bonfires, and BBQs as a means for celebrating the milestones in your life.

Need more support? Check out our alumni resources or reach out today.

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