F.E.A.S.T's Around The Dinner Table forum

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My son has been weight restored since around Feb. He hovered close to that weight for many months prior to that. But all in all, has had steady progress. This past school year (his senior year) he made many friends, had a girl friend, was able to eat out a lot with friends, absolutely no compulsive exercise, and just in the past 3 months has challenged himself on his own with many final fear foods such as syrups,donuts,ice cream. 
So, he will be attending college in July. The 1st term is a 6 week summer term about 3 hours from home. He has practiced eating at a local buffet/ cafeteria several times and did fine. We have discussed with his therapist and RD who both really feel he is going to succeed. And , if he does not we are prepared to pull him home again.
Needless to say, there has been a huge increase in anxiety with final exams and HS graduation, girlfriend moving out of country this week and college orientation. And now, yes, in the past 2 weeks has lost 3 lbs. simultaneously,  Has admitted to skipping his lunches, has really lashed out that we have brainwashed him and tricked him into believing “food is medicine”, and really just crazy behavior. I found his nighttime shake in the closet and just lost it with him. 
I’m sure we can get the weight back up . I will try to get it even higher. We will work with therapist for more anxiety reducing techniques. And any advice is appreciated.
current weight 143.6 lbs, height is 67 inches. Was at 146.6. 
(2 and 1/2 years ago was at 95lbs. And 65 inches.)

Great job getting your s to WR and doing well overall.
Yes, these transition times do add anxieties and I know for my d, during anxious times she tends to eat less.
So yes, get his weight back up and I do think having a plan to help to decrease his anxieties would be helpful.

It sounds like you have thought this out very well and have a plan in case he cannot manage. I feel you have done a great job up to now and have a good safety net in place for the near future. I am glad he admitted to you that he is missing lunches, now you know what support he needs.
I am sorry it is a bit wonky right now and you have great plans in place. 

Just a question as he will be far away, does he prepare his own meals? I would think that him learning that is part of the hand over as he moves away from home.
all the best
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
Is there a counselor/RD that he could work with at college? Or even a medical doctor that could regularly take his (blind) weight so he’s still being monitored? Could he FaceTime sessions with his current team? 

I wondered if something like that might help give him additional support and accountability? Our s is much younger, but having his team has been encouraging to him (also kept him/us accountable). They’ve helped through anxiety with finals, tests, etc. I wondered if that could possibly be a continual thing for your s — although he’s away for school, he still very much has a team that’s checking in and supporting him weekly?

How often will you get to see him with him being away?  
Thanks for the reassurance. 
Scaredmom- He will be living in the dorm right next to the main cafeteria. He has the full meal plan. It is open until 7:30. There is also chick-fil-a and pollo tropical on campus which he is comfortable with.  He is good at his own snacks- full fat yogurt, granola, bananas, milk,OJ mostly. And will have a fridge in dorm for these items. 
Workingthrough - RD is scheduled through FaceTime and regular therapist may have to be a phone call. We plan to visit at the 3 week mark to check on him, but will also FaceTime occasionally. Not sure about the weights yet. Possibly the campus med center. Although, when at orientation we privately asked about a therapist that may have “eating disorder” specialty. And they say have only one who holds a support group , but say there are no boys. He won’t go for that.Hard to believe a college of 40000 students doesn’t have more support.
That’s too bad to hear about the lack of resources on campus. Surely there are others that suffer. 

You have everything lined up so well!, he’s blessed to have you! Hopefully with it being summer, his class sizes will be smaller and teachers more willing to work with/notice him, less traffic on campus getting settled, etc. also. 

Will he have roommates? It would be so great if he had good roommates to keep him involved as well as continually (hopefully) modeling normalacy in eating as well. 

Has he had his graduation already? Hopefully once that door is closed and he’s feeling settled, things will roll back into place. You’ll know what/how to watch and how to fix things as well.

He’s truly blessed to have you. I hope so much that things go smoothly and it’s just a hiccup with everything happening right now all at once. Thinking of you - and him. 
I have no experience with this as my daughter is much younger. She is talking about going away to sleep away camp next summer and I don't see that happening as of now. I do want to warn you that just because professionals tell you he is ready to go doesn't mean that isn't he case. Did you read Brave Girl Eating? The professionals told the mother that her daughter was ready for Independence and this caused a relapse. I think you need someone in place to check on him regularly or you will need to go after a week or find a place closer to home. Go with your instincts and not with what professionals advise you. They seem to push the process unrealistically.
It sounds as though you have put some scaffolding in place to help your s manage through the summer.  Transitions are definitely times to be extra vigilant for someone who has had an ED.  It's great you are going to visit at the 3-week mark. 

When our d began university, we had strong supports in place.  We engaged a primary care provider off-campus, as the student health services are really only able to manage things like minor injuries or illnesses and birth control. We also had the ED psych who had known my d for 2 years available as a 'case manager'.  I feel strongly that a medical provider with good evidence-based experience with EDs is an essential team member for a kid who is going away for college.

We had a contract in place, which specified the steps that would be taken if there was weight loss...ranging from a short 2-week period to self-correct, to me coming for meal support, to medical withdrawal if weight loss continued for a month.  We had an eyes-on visit monthly to assess both physical and mental health.  A reminder that college can be a challenging environment, even for one in robust physical health.  There are so many things to navigate...friendships, independence, course loads, day-to-day living.  Not to mention the stress for someone in recovery, who will find eating-disordered behaviours all around them on campus.  Preparing and planning as much as possible will help the transition to go as smoothly as it can.  

Sending warm support,
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Thanks all for your feedback. We will definitely put one of those green, yellow, red light contracts in place. And I will start looking for an off campus doctor as well. 
Hi jcutch,

You have done a really wonderful job weight restoring your son and doing your best getting him ready to go off to college. If he does that summer session, which is only 6 weeks, you will be able to see whether he is able to manage before the fall semester, and what sort of support he will need, before he goes off for 4 months. Having a safety net in place is a wise idea.

As we learned, college health centers are really not equipped to handle eating disorders, which require specialized and sometimes lengthy treatment. My d. had a ED team off campus at a nearby hospital. We did however find that because of her illness, the school was able to give our d. a housing accommodation which was that she qualified for a suite with a kitchen, so that she did not need to rely solely on the dining hall for her food. 

So you have an number of choices. You can make it a condition that no tuition gets paid if weight is not maintained, or that he has to remain in treatment as long as he needs to, or whatever limits you think might be helpful in order to support his recovery. You can make it clear that if he loses x amount of weight he will be considered in the danger zone and you can have him come home on the weekends since it is only 3 hours away and if your schedule allows for it, spend some time with him up there eating. Any sort of transition tends to be challenging for our kids and the time after the end of high school and the transition to college is one of those times. And know also, that universities will give medical leaves of absence when necessary and in the event that he needs more support and needs to take some time off, they will hold his place for him when he is well enough to return, if the proper paperwork is submitted.

Needless to say, there has been a huge increase in anxiety with final exams and HS graduation, girlfriend moving out of country this week and college orientation. And now, yes, in the past 2 weeks has lost 3 lbs. simultaneously,  Has admitted to skipping his lunches, has really lashed out that we have brainwashed him and tricked him into believing “food is medicine”, and really just crazy behavior. I found his nighttime shake in the closet and just lost it with him. 

This does seem of concern, so you are right to be reaching out for ideas and to be watching what is happening carefully. 
Hoping for all the best for your son,



Just to throw in my 2 cents:
He is WR for a very short time
My d was WR about a year before we allowed her to go to University and she is still living at home
Is there no possibility to join a college where he can stay at home for some time?
This is a big relapse risk to start that too early. Even with a contract.
Keep feeding. There is light at the end of the tunnel.