Events

Helpful Suggestions: Eating Disorder Symptoms and the Transition to College

This article was written by Victoria Cane, Ph.D, LP, a member of SMEDA.  She is a licensed psychologist with a focus on treatment of eating disorders and emotion-regulation disorders for over 10 years.

Eating Disorder Symptoms and the Transition to College.


As an eating disorder treatment provider working with clients who are transitioning to college, my first thoughts aren't always welcome ones. If someone is struggling with symptoms like inability to sustain weight or general management of nutrition, or has not achieved abstinence from behaviors like bingeing/purging, it is hard to give support to taking on something as stressful as leaving home to start college life. And it is stressful. I recall my first semester at NYU and I'm really proud I made it through. There were times I wasn't sure I was going to. There was just so MUCH to take in and acclimate to. I had no idea I would become a psychologist back then (my major was drama) but I do recall the girl I met during that first week and being truly baffled that she would consider broccoli and a gallon of diet coke to be dinner when there was so much else to choose from at the cafeteria.

Parents/loved ones of those who have struggled with an eating disorder often find themselves paralyzed at the thought of not supporting the move to college. After all, it represents growth, progress, a natural next step in life development. My point as a provider, however, is that some of those growth markers, both literal and figurative, need to be in place first. This is where full participation in recovery-oriented treatment is so important. Although one study indicates that the transition doesn't necessarily trigger the onset of symptoms (the study found that most eating disorder symptoms were present before college), it also found that body image disturbance may worsen and symptoms were certainly not helped (Vohs, 2001).  One on-line resource very clearly calls for symptom absence before transitioning.

Assuming that the student has indeed engaged in their own recovery and symptoms are not acute at the time of transition, I begin to talk about transition management, including: finding mental health and medical resources beforehand and signing appropriate releases, identifying ways of staying accountable including weight checks if applicable, identifying other potential supports like student groups, and have a solid plan for what we call "cope-ahead" strategies; that is, rehearsing stress management skills before they are needed. We may also make a plan to check in and/or return to regular contacts when the student is on break.

In the type of therapy I rely on most often in the treatment of eating disorders, Dialectical Behavior Therapy (DBT), the provider hopes and "shoots" for the desired outcome at all times, while simultaneously being prepared for and helping the client prepare for set-backs. We do not "expect" set-backs, but should they occur, we make every attempt to correct them as quickly as possible. When a client leaves for college I wish them well and cheer for them. I think of them as fall gets colder, and I hope they are okay. Should they need to take a break to focus on health, and they seek my help, my immediate questions return to "what are the goals?" and "what is needed for recovery?"

 

On-line resource: http://www.mirror-mirror.org/transitioning-to-college.htm

Other resources:

Anonymous. (2012). Life Transitions May Trigger Eating Disorders. U.S. News and World Report. Retrieved September 18th 2013 from: http://health.usnews.com/health-news/news/articles/2012/04/25/life-transitions-may-trigger-eating-disorders

Strober, M., & Johnson, C. (2012). The Need for Complex Ideas in Anorexia Nervosa: Why Biology, Environment, and Psyche All Matter, Why Therapists Make Mistakes, and Why Clinical Benchmarks Are Needed for Managing Weight Correction. International Journal of Eating Disorders, 45, 155-178.

Vohs, K.D., Heatherton, T.F. and Herrin, M. (2001), Disordered eating and the transition to college:  A prospective study. Int. J. Eat. Disord., 29:  280-288. doi:  10.1002/eat.1019

 

 

 

 

May 2016 - May 2017 SMEDA Projects and Activities Completed

May 2016-May 2017 SMEDA Projects and Activities Completed

Compiled by

Lindsay P. South, MA/LPC, RPT-S
President, SMEDA

Ø  Development and Design of SMEDA logo

 

Ø  Website Redesign and Launching (Angela Morris and Peter Butts)

o   Blog Posts on topics such as Holiday Eating, Yoga and Eating Disorders

o   PayPal attached

 

Ø  Monthly publication of SMEDA Newsletter (now posted on-line as a blog), coordinated by Laura Smidchens.   Articles on topics such as Dialectical Behavior Therapy for Eating Disorders” and “Men and Eating Disorders” (both by Gary Snapper, LLP/LPC).

 

Ø  SMEDA Facebook Page posts with links to current research on eating disorders (Laura Smidchens & Vinay Reddy, MD)

 

Ø  Parent Support Group Reconceived into face to face parent meetings, online and telephone support and Parent Mentorship program (Angie Morris, Community Board Member and parent)

 

Ø  Free Monthly Support Group meeting for adults struggling with ED (Trina Weber, RD).  Approximately 7 adults attend regularly.

 

Ø  Dewpoint, support groups for adolescent girls and women with eating disorders at Well of Grace Ministries, Stevensville, MI (Flori Mejeur, SMEDA Lakeshore)

 

Ø  Outreach to local K-12 schools:  classroom presentations on Intuitive Eating, Eating Disorders Prevention, and What to Do if you Suspect Someone Might Have an ED (Moorsbridge Elementary, West Middle School and Portage Northern High School) (Trina Weber, RD)

 

Ø  October 2016 Co-sponsorship of and participation in St. Joseph Mercy annual eating disorders conference

o   Discounted rates for SMEDA members to attend @ $25 a person.

o   Info on SMEDA presented at table

o   (Trina Weber, RD, Deb Frisk, RD, Kris Gibson, MD, Lindsay South, MA, Sheryl Lowzowski-Sullivan, PhD, Cathy Cook, LLPC) SMEDA Professionals and 1 community board member (Angie Morris) attended.

 

Ø  Art Hop- Friday, February 2, 2017 at WMU’s Homer Stryker School of Medicine (Laura Smidchens)

 

Ø  Coffee Tasting Fundraiser-Saturday, February 11, 2017 ( 5 Coffee Roasters and at least 8 Companies involved)(Angie Morris, parent)  Profit:  $2,407.77

 

Ø  Public Speaking and Outreach:

 

1)      Brief presentation at Rambling Road Pediatrics clinical staff meeting -August 2016, (Lindsay South, LPC) this led to cultivation of new relationships with Dr. Dodich and Dr. Dobson, two female pediatricians at Rambling Road Peds.

2)      Panel Presentation to Dietetics Association in Battle Creek-September 27, 2016 (  Jillane Mofitt-Bernacki, LMSW, Danielle Seabold, parent/community board member)

3)      Presentation at Grace Health, Battle Creek on “Food Relationships and Identification of Disordered Eating Behaviors” during the monthly behavioral health staff meeting, February 17 , 2017 (Cathy Cook, LLPC, TLLP, RD)

4)      Lunch and Learning presentation to Potawatomi Reservation, March 15, 2017. ( Jillane Mofitt-Biernacki, LLMSW, Danielle Seabold, parent SMEDA board member)

5)      Article on the problems associated with dieting, (Title?), February 2017 Good News Gazette

6)      Article on eating disorders, “When Dieting turns into a Disorder,” South Haven Tribune, February 8, 2017. (Interview with Kristin Fiore, SMEDA Community Board Member and Susan Katz-Scheinker, RD, Flori Mejeur, LMSW)

7)      Radio interview with Lori Moore during Eating Disorders Awareness Week,  February 2017(Kris Gibson, MD and Angie Morris, parent)

8)      Panel Discussion at WMU after “Food Prisons,” a play about ED (Trina Weber, RD and Kris Gibson, MD)

9)      TV interview about eating disorders, February 2017 (Kristin Fiore, Community member/Down Dog Yoga)

10)   Panel Discussion on eating disorders, Kalamazoo College.  (Kris Gibson, MD, Deb Frisk, RD and Jillane Mofitt-Biernacki, LLMSW)

11)   Meetings with local representatives in Lansing to spread awareness for eating disorders. Representative Hoadley read a resolution on the House floor to support eating disorder awareness at 11:36 a.m. , February 22, 2017 (Jillane Mofitt-Biernacki, L LMSW and dietetic students)

12)   SMEDA Lakeshore mailed out over 100 letters to medical practices, counseling offices, and school counseling centers in Berrien County to raise awareness about ED and highlight SMEDA as a resource (March 2017, Flori Mejeur, Abby Black, RD)

13)   On March 28, 2017 SMEDA Lakeshore highlighted a presentation by Dr. Stephanie Style at Lakeland Regional Center.  The presentation was live streamed and was watched by over 600 people.  SMEDA members were present and offered resources and referral information.

14)   Guest Lecture, Introduction to Eating Disorder at WMU for Amy Getman’s undergraduate dietician course. March 13, 2017 (Danielle Seabold, parent SMEDA board member)

15)   Presentation at DeVos Children’s Hospital Conference entitled, “Adolescent Eating Disorders:  Early Detection and Treatment,” an Eating Disorders Interprofessional Teaching Event for third year medical students, undergraduate nursing students, Masters level dietician students and psychology PhD candidates, April 26, 2017.  Kristine Gibson, MD, WMU Stryker School of Medicine.

16)   Panel representation in Kalamazoo College’s Abnormal Psychology class discussion on eating disorders, May 24, 2017 (Jillane Moffit-Biernacki, LLMSW)

 

 

Ø  Monthly Case Presentations on eating disorders at SMEDA general meetings (Gary Snapper, LLP/LLP, Lindsay South, LPC, Trina Weber, RD, Cathy Cook, LLPC, TLLP, RD)

 

Ø  Topical Presentations for SMEDA general meetings:  “How to Cope with Therapy Interfering Behaviors” and “Evidence Based Treatment of Binge Eating Disorder” (Gary Snapper, LLP/LPC)

 

Ø  Conference for professionals on Eating Disorders and Substance Abuse coordinated with Castlewood Treatment Center, St. Louis in planning stages for Fall 2017 (Gary Snapper, LLP/LPC)

 

Ø  Formation of SMEDA’s Instagram Group, a new commitment to reaching young people about eating disorders.  First meeting:  Saturday, May 20.  Sawalls Health Food, second floor restaurant. (Angie Morris and Emily Marre)

 

Art Hop Series: Eating Disorders with Anxiety and Depression

The Art Hop exhibit countdown:  1 days left

Art Hop                                                                                                                                 February 3, 2017 5pm to 8pm                                                                                                             300 Portage Street (WMU Homer Stryker M.D. School of Medicine)

Lindsay P. South, MA/LPC, an active SMEDA Board Member and a Registered Play Therapist-Supervisor, has written this brief explanation about one way to manage anxiety and depression that may accompany an eating disorder.  Her piece will be displayed at the exhibit along with food play examples.  http://www.southwestmichiganeatingdisorders.org/directory/

 

Eating Disorders and Anxiety

Many individuals struggle with comorbidity:  co-occurring diagnoses.  Although malnutrition certainly makes anxiety and depression worse, sometimes even after weight is restored, it becomes clear that an anxious wiring system was present long before the eating disorder developed.  Restricting food, overeating, or purging just becomes another way of managing underlying anxiety.

Anxious children can learn to manage their anxiety.  In her workbook, “What to do When You Worry Too Much,” Dr. Huebner helps kids externalize their anxiety with the creation of a worry monster.  Making these creatures and learning to talk back to them is a cognitive behavioral method of helping kids be in charge of their anxious thinking.