If you suffer from an eating disorder (ED), you may understand that symptoms began to develop during your teenage years.

You may have one of the three most common eating disorders — anorexia, bulimia, or a binge-eating disorder — or another less common variant. Whether you are currently struggling with your symptoms or you are in recovery, looking ahead to choosing a college brings special concerns. This guide will help you select a mental health–friendly college where you can thrive.

What to Consider Before You Start Researching Colleges

There are lots of questions you may have. Here are a few of the most-asked, along with their answers.

# What should I know about eating disorders?

For those of you reading this article who do not have an ED — a parent, teacher, or friend of someone with an eating disorder, perhaps — let’s summarize what eating disorders are. First, an ED includes extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious, complex, and possibly life-threatening illnesses that are best treated by prompt detection. The earlier the treatment, the better the chances of recovery.

Second, the rate of eating disorders has been increasing for years, and continues to do so, particularly among teens and college-age women. Men may develop eating disorders, as well, according to the leading nonprofit advocating for people with EDs, the National Eating Disorder Association (NEDA); check out the website for many helpful resources. NEDA reports that ten to 20 percent of college women and four to ten percent of college men may have some form of an ED.

Third, while an ED manifests with outward physical symptoms and a preoccupation with food and weight, treatment for eating disorders targets both its outward signs and, more significantly, the underlying psychological issues of an ED, which commonly include anxiety, body-image issues, depression, and/or obsessive-compulsive disorder. Treatment for an eating disorder can include both medication and therapy as directed by a treatment team, which likely includes a psychiatrist (for medication), a psychologist or social worker (for therapy), and a nutritionist (for maintenance of healthy food habits).

What is not unique about going to college with an eating disorder?

Going away to college is a stressful time of transition for all teens. Adjusting to a new environment is exciting but difficult for first-year college students.

What is unique about going to college with an eating disorder?

If you have been diagnosed with an ED, it is essential to be both physically and mentally prepared to be away from home in a new environment before you start your first year of school. You must be in stable condition and able to manage your symptoms and recovery plan before leaving for college, notes Dr. Raine Weiner of the Potomac Valley Psychotherapy Associates and the Eating Disorders Center of Potomac Valley in North Bethesda, MD.

If students are not in a stable place, Dr. Weiner strongly recommends deferring admission and taking a gap year for treatment to get well into recovery prior to beginning college. If a student begins college while still dealing with the symptoms of an eating disorder, the stress of the transition likely will only make that ED worse, notes Dr. Weiner.

Dr. Nancy Logue, a psychologist and ED specialist in Yardley, PA, also emphasizes how critical it is to be in recovery prior to starting school. Being in recovery before beginning college, Dr. Logue reminds the students with whom she works, is far more important than graduating in the same year as your peers.

What are common triggers that students with ED encounter at college?

According to these specialists, the following concerns are of particular importance to students entering college with an ED:

• One of the challenges that many students with eating disorders face is managing food on and off campus. Students with EDs should develop healthy eating habits before dealing with the array of all-you-can-eat buffets that are commonplace in college dining halls. There will be many unhealthy options that can trigger students with EDs, from the pasta station and ice cream bar at the cafeteria to late-night jaunts for pizza and beer.

• For students athletes with eating disorders, focusing intesely on exercising can become a trigger. This is particularly true for sports that put an emphasis on maintaining a certain weight, such as gymnastics, rowing, or wrestling.

• Pre-existing body-image issues, typical of many students with eating disorders, may be magnified in the close quarters of a dorm and/or on a campus where college students are likely to be overly aware of their appearance, their size, and whether or not their bodies are found to be attractive by other students. A great resource for students who find themselves in this position is Change the Message, a site co-created by Dr. Logue that encourages students to stop “bad body talk."

What Students with an ED Should Look for When Researching Colleges

Now that we’ve covered what you should think about before you start your search, let’s drill down to what you should look for in the schools you’re considering. Here are four key features that prospective schools should have.

# 1. A Fully-Equipped Campus Counseling Center

At a minimum, this means a college or university that has an accessible, well-staffed on-campus psychological and counseling center (CCC). Ask specific questions of the CCC when you are researching schools. For instance: Are walk-in appointments available? What are the wait times for evaluations? Are there limits on the number of therapy sessions a student can have? (Often, schools limit students to six to eight visits yearly.) What services are available, if any, after hours? Does the CCC have a psychiatrist who can prescribe medications? What kinds of therapy are offered — individual and group, as well as other wellness programs? If you must go off campus to find a doctor or therapist, will the college or university help you find resources?Does the student health plan cover all or part of these costs?

# 2. Special Programs for Students with Eating Disorders

Ideally, the CCC has its own ED treatment team, such as the one offered at Princeton University. This team includes a psychotherapist, a physician, an athletic trainer, and a nutritionist who work together to help students — providing a coordinated approach of counseling, medical monitoring, nutritional counseling, therapy, and exercise advice.

Another service you can inquire about is on-campus ongoing group therapy or support programs focusing on body image and self-esteem, such as the separate ones for men and women offered at the University of Maryland, College Park. Other resources for students with eating disorders are specialized screening programs at the health center, as well as training for advisers, athletic coaches, and RAs in ED awareness and support.

# 3. A Support System

You should make sure that the campus you are looking at is capable of providing a network of people who will support you through your recovery — whether the campus itself is composed of people you will meet on campus, or whether it offers you easy access to your existing support system. This includes regular medical monitoring by a physician — on campus, nearby off campus, or at home with your doctor during school breaks, if that is feasible — and a therapist as well as a nutritionist. A student with an eating disorder, more so than other college-bound students, may not be able to consider going to a small and/or rural college if it has limited on- and off-campus medical and psychological resources.

# 4. Student Advocacy Groups for Mental Health

Does your college of interest have active peer mental health awareness, advocacy, and/or student groups such as Active Minds or National Alliance on Mental Illness (NAMI) on campus? Does the college have supportive disability services that provide accommodations for both mental and physical needs? Does the college train its faculty, staff, and peer leaders in suicide prevention? Is the campus a high-stress place with ambitious students pushing to achieve in all sectors of their lives? A college known for its very high-achieving, extremely competitive student body may not be a good fit for a student with an eating disorder.

What Friends and Family Can Do to Help a Student with an ED

Friends and family can have a huge impact on a student’s stabilization and recovery. A friend can accompany a student who has an eating disorder to the college dining hall and encourage healthy meal choices. A friend can ask a student to take part in a fun activity that does not involve food or drinking. A friend can keep an eye and an ear out for signs of relapse or distress. And a friend can encourage a student to get help and stick with a treatment plan.

_Further Reading: How to Support a College Friend Through Mental Health Challenges_

Parents can be sensitive to their student with an eating disorder by providing a supportive relationship. Dr. Nancy Logue emphasizes that parental support includes “creating a space where a kid can talk about her behavior and her feelings," knowing that she won’t be judged for doing so. Parents can model their own healthful body image and eating habits as well as take part in family therapy if that is recommended. And if a student with an ED needs intensive treatment that can’t be managed on campus, a parent can facilitate finding (and, if possible, paying for) that treatment at an intensive outpatient treatment or residential program.

_Further Reading: How Parents Can Support Students with Eating Disorders in College by Ann Matturo Gault_

With these guidelines, a student with an eating disorder can make careful and wise choices about when and where to attend college — and how to thrive once on campus.

_You can use Noodle to search for colleges based on the criteria that matter most to you. Also, you are welcome to ask Noodle Experts questions about mental health and college any confidential questions you have._

Sources:

Logue, Nacy, psychologist and ED specialist, April 15. Phone interview.

Statistics on Males and Eating Disorders. Retrieved May 21, 2015, from [NEDA}(https://www.nationaleatingdisorders.org/statistics-males-and-eating-disorders)

Weiner, Raine, Potomac Valley Psychotherapy Associates and the Eating Disorders Center of Potomac Valley, April 17. Phone interview.