Off to school but worried about your eating or body image issues? Don’t be. Here’s why. 

An important point to make right off the bat: The transition from high school to college is a challenge for nearly everyone. Some people just hide their anxiety better than others. 

Everything is new, and it can take time to find a good routine. Meanwhile, it can all feel a bit overwhelming.  

The good news is, there’s plenty you can do to ensure you stay healthy and grounded. The key is being proactive about it. 

Priority Number One: Have a plan in place before you head off to school. 

College, especially freshman year, can be an amazing time—but also stressful. And no wonder. You’re away from home, maybe for the first time. It’s a totally new social scene, and you likely know way fewer people.  

Then there’s the class load. Right. Enough said.  

Again, all of that can feel intimidating, which is why it’s important to make a plan that encompasses several key areas of college life. These include:  

• Your eating routine. 
• Your daily schedule. 
• Your ED treatment team (if applicable). 
• What to tell your roommate/new friends. 

Your eating routine: As the clinical nutrition manager at Koru Spring, I like to tell our residents that their daily meal plan is their “prescription against the eating disorder.”  

At college, it’s the same thing, so start with the basics. You’ll first want to consider food accessibility. Will you be on a meal plan? If so, where will you be eating those meals?  

If you’re in a dorm, there may not be a kitchen. That means you’ll likely be eating most of your meals in the college cafeteria. Will there be other food halls nearby? Is there a place to buy satisfying snacks late at night?  

If you’ll be living off-campus, you will want to find nearby grocery store options, and figure out how to get there and back.  

The point is, it’s important to get the lay of the land on your eating plan so you can quickly get on a regular schedule. That routine is important. Remember to aim for consistency, variety, and accountability with your eating.  

Your daily routine: If you struggle with ED behaviors, it’s important to establish an overall routine at college to go along with your eating routine. I don’t mean every second has to be planned—that’s not practical. 

Rather, try to create a daily schedule that includes meals, classes, study time, sleep, joyful movement and/or other self-care activities, and adequate time for rest and relaxation.   

Students with reasonable, well-designed routines are less likely to encounter the high-stress periods that may increase the risk of ED behaviors.  

Establish a treatment team: For people in ED recovery or who struggle in other ways, the idea here is to have a trusted group of people you can turn to for help if things feel like they’re starting to unravel. 

For a person with disordered eating or an ED, this team would ideally include: 

• A therapist or mental health counselor 
• A dietitian who can help with meal planning and accountability 
• A psychiatrist who can prescribe medication, especially if there’s a co-occurring condition present such as depression or anxiety disorder. 

You may want your team to be available in person if needed. If that’s the case, consider contacting the campus health clinic before you arrive to campus, and enlist their help in building your team. Your home-based treatment team may be able to help with referrals as well.  

Alternatively, you may want to stay with your home-based team. In that case, be sure to set up virtual contact with them, and alert them to this new channel. 

What—and how—to tell your roommate about your mental health situation: If you’re living with an ED or have serious eating or body image issues, it may be helpful to share that information with people close to you. That may end up being your roommate, or others you meet at college. 

If you decide to do that—it’s always your choice—you may want to say something like: “Eating/body image is complicated for me, and I’m working on some things. I hope you’ll support me in this.” And go from there.  

You might also want to make it clear that you are willing to support that person as well. You never know, they may be in a similar situation. 

Two warning signs that something is amiss 

When stress levels go higher—as they inevitably will—it’s good to pay attention to two things that often signal that a person is pushing too hard: skimping on sleep, and skipping meals. 

Both can lead to low mood, decreased energy levels, and compromised ability to concentrate. Therefore, be determined to get adequate sleep (aim for 7 or 8 hours at minimum), and always give yourself time to eat breakfast before you head out to study or to your first class. Also, make a habit of keeping snacks in your book bag or in the car for between classes. If that low blood sugar feeling starts to hit, grab that snack. 

Keep alcohol in its place 

Alcohol use is so integrated into our culture and so positively portrayed in advertisements that we forget how addictive and destructive it can be. Including on college campuses. 

For people living with EDs or disordered eating, alcohol can be hugely disruptive. Heavy alcohol use makes it harder to stay consistent with an eating plan, and exacerbates co-occurring mental health conditions that people with EDs sometimes have.  

Bottom line: We need to be very careful about how much and how often we drink. 

A word about the “Freshman Fifteen” 

This term refers to the myth that students typically gain 15 pounds during their freshman year. They don’t, which is why I call it a myth. I’ve seen reports that freshmen sometimes gain 3 pounds on average, if that, with males gaining slightly more than females. 

To me, this enduring myth reflects our diet culture, and is part of the relentless effort to scare people into thinking (1) they’re overweight, (2) being overweight is bad, and (3) they therefore need to lose weight as soon as possible.  

You have my permission to ignore all the Freshman 15 talk. It’s not based in fact. 

Final advice on EDs and college 

A “parent pact” can be a great accountability strategy that can be helpful for young people in ED recovery going off to college.  

The way this works is, you make an agreement with your parent or parents on what you need to do to maintain your recovery. This may include specific criteria that need to be met in order to stay in school.  

Examples include: 

• Staying at or above a certain weight based on treatment team recommendations. 
• Seeing their therapist every two weeks. 
• Staying on depression medication as instructed by a psychiatrist. 
• Reaching out to a parent/doctor/trusted friend if such and such happens. 

This may seem like a lot of oversight, but the point is accountability. The more specific you make your pact, the better. 

The point with the parent pact is this: Staying in recovery is difficult to do on your own, especially during big life transitions. Starting college is definitely one of those transitions, and “contracts” like the parent pact can help. 

It’s a powerful accountability tool and safety net that will help put everyone’s mind at ease.