As students and families settle into the “back to school” season, the shift from summer routines to the demands of academic life can feel more complicated than expected. Resuming daily, in-person schedules may seem straightforward—after all, it’s familiar territory, but many find the adjustment harder than imagined. From time spent in front of computer screens to busy campus hallways, this period of change can heighten stress and ichatmpact mental health. This period of transition may bring eating disorder symptoms to the forefront, underscoring the need to consider how treatment, recovery, and school life intersect. Below are a few considerations for adolescents and families navigating eating disorders, treatment, recovery, and the return to school this fall.

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Navigating Eating Disorder Stressors During the School Transition

Stressors may show up differently across individuals struggling with eating disorders. Adolescents have widely taken to social media to stay connected and current, while unknowingly participating in a tumultuous exchange of information, status, and acclaim across virtual platforms. This has fostered comparisons of food choice, bodies, physical activities – often determined by the number of likes or followers on their social platforms. With the gradual transition out of this digital retreat, there is a high likelihood of social anxiety and comparison: except now in real time, in real peer groups: Who spent summer doing what? Who changed? Who didn’t? Who “decided to get healthy?” Who “let themselves go?” Separate from these harmful judgments of food choice and body, desires for productivity to compensate for the perceived lull throughout isolation may breed a drive for competition, perfectionism, and accomplishment.

Unfortunately, these perfectly coincide with the entire essence of school-based academics, activities, and athletics, and may even be encouraged. School health and nutrition classes may devote additional time on textbook nutrition topics: glorifying “healthy foods” and stigmatizing “junk foods,” and may even require the reciting of this information to pass the course. Further, to make up for any disjointed or bypassed sections in previous semesters, course loads are being filled to the brim to meet overall requirements, leaving less time for breaks, meals, snacks, and enjoyable extracurriculars. Meal support, a critical component of eating disorder treatment may not be available. Triggers or stressors for eating disorder behaviors may be widespread and unpredictable, warranting increases in awareness and accessible support.

Signs of Eating Disorder Struggles During the Return to School

Any transition can be challenging, and eating disorder triggers may be variable and expansive, making awareness critical to supporting a loved one in eating disorder recovery. Staying alert to indications of eating disorder behaviors, both identified and potential, such as the following can serve as perfect opportunities for support and intervention with treating teams:

1. Be aware of increasing anxiety at home or in a new environment.

Pressures may be high with navigating the unknowns of the school year, and/or compensating for previously adapted school schedules. Opportunities for regular meals and snacks may be deemed lower priority, and even bypassed in the busy school day to focus on the demands of academic course loads. Your loved one may express anxiety about social engagements and activities with friends.

2. Notice any deviations.

Deviations from the consistency of a recommended meal plan, attending therapy or group sessions, and less engagement with support or self-care opportunities established with treatment providers may warrant concern. Food behaviors may be reinstated to cope with the potential demands and emotional stresses of these changes. Notice any changes to frequently accepted foods, patterns of flexibility, and consistency with meal plans. Gently bring attention to these observations and communicate as needed with the providing team.

3. Consider conversation themes.

‍Discussions of food- and body-related topics, comparison to peers, health class topics, or athletic requirements may be a flag for concern. Particularly abrupt interest in athletics or performance-based extracurriculars may benefit from further discussion or exploration as well.

4. Observe opportunities for coping and self-care.

‍With the support of treatment and outpatient providers, your loved one is learning to navigate their world without eating disorder behaviors. Coping skills, grounding tools, and self-care tasks (journaling, reaching out, tactile supports, taking breaks, etc. – the list goes on) suggest that your loved one may be managing without the eating disorder. The dwindling or absence of these necessary practices could suggest increasing difficulty with more healthy coping.

While experiencing any of these difficulties or noticing these eating disorder behaviors within loved ones may be unnerving, these obstacles can create opportunities for integrating recovery-oriented approaches and support for long-term health and wellness.

Integrating Eating Disorder Recovery into a School Day

Successful transition through levels of eating disorder treatment already asks for comprehensive planning, communication, and support. With added considerations for a transition back to school, planning and support take on a critical role in the recovery process. Priority on communication and connection will go a long way – whether it be encouraging your loved ones’ direct communication or requesting support from trusted friends, teachers, counselors, and coaches.

1. Collaborate with the school counseling staff to help integrate recommendations from the treatment team, encourage accountability, or help problem solve school-day challenges.

2. Discuss meal plan recommendations and any necessary dietary accommodations with school staff (i.e. ensure adequate meal and snack opportunities, as well as appropriate menu offerings, portions, and opportunities for variety).

3. Consider discussions and support of meal plan adjustments recommended with the start of a sport or activity season.

4. Connect the providing treatment team with relevant school staff as well, including counseling, dietary, and athletic departments to eliminate splitting and potential gaps between these supportive domains.

5. Practice setting boundaries in support of your loved one around triggering and harmful topics often normalized in academic curriculums: health and nutrition classes, weight assessments, BMI classifications, athletic requirements, etc.

6. Access outpatient support groups, now offered both in-person or virtually, in your community. These resources are often available through treatment programs, outpatient providers, and school counseling centers.

Integrating Academic Support Into Eating Disorder Treatment

Should eating disorder treatment programming be recommended, your loved one’s needs will be evaluated across a variety of domains to identify the most appropriate course of treatment. Within this assessment, any necessary education accommodations will be discussed to encourage appropriate time and focus on participation in the treatment process. Treatment programs offered at the partial hospitalization (PHP) and intensive outpatient (IOP) levels may be attended in conjunction with regular or slightly modified school schedules. Recommendations for treatment at the residential level of care often require the most comprehensive education planning and accommodations, which can be navigated with the support of an education liaison. This liaison is available to facilitate communications between the medical and clinical providers in the treatment setting and the academic supervisors to identify appropriate accommodations, revised course requirements, extended deadlines, and a variety of additional supports to ensure priority focus on treatment while minimizing disruption to academic participation.

Focus on Wellness in the Transition Back to School

As the transition “back to normal routine is exciting for many, it is important to remember that loved ones struggling with eating disorders are navigating additional complexities that make this process particularly difficult. Awareness of these challenges, as well as possible resources and strategies for coping with them, can shift these potential obstacles into an opportunity for strengthening recovery foundations, accessing support, and reintegrating into life with proliferating wellness.

If you or a loved one need help, contact Monte Nido to learn more about our care programs including adolescent specific care.

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