The holidays can be the first opportunity parents have to notice changes in their college student that may signal an eating disorder. Eating disorders often disguise themselves as “healthy habits,” making them easy to miss until they’ve taken a stronger hold. Warning signs include noticeable weight changes, food avoidance or rigidity, increased exercise preoccupation, and anxiety around meals. If something feels off, trust your instincts. Defensiveness or denial from your young adult is itself a red flag worth taking seriously.
A practical first step is offering a previously enjoyed “fear food” and observing their flexibility around it. From there, a medical check-up, an evaluation by an eating disorder professional, and setting up a treatment team at their school are all important actions to take before they return to campus. In more serious cases, taking a semester off for college student eating disorder therapy in LA may be the most effective path to recovery.
The return home for the holidays after the first semester at college is often the first time you’ve spent significant time with your young adult since they moved away. Maybe your college student looks a little thinner to you. Or maybe they are not eating the foods they used to eat before they left for college. Or maybe they have a newfound interest in working out.
Might this be a symptom of a new (or the return of an old) eating disorder? Or might it just be new healthy habits? The distinction can be difficult. Eating disorders can often masquerade as healthy behaviors and fly under the radar. So read on to learn what to look for and what to do if you suspect an eating disorder has taken hold of your college student.
We’ve written previously about the immense challenges of the transition to college. College is a time of vast transition and development. Young adults’ identities are coalescing around their peers, and they are forming their own values, which may differ from those of their family of origin.
It’s also a time when mental health problems, including eating disorders, are likely to emerge for the first time. The median age of onset of eating disorders occurs from age 18 to 21 years (Hudson et al., 2007; Ward et al., 2019). A recent study found that among undergraduate students in the United States, the prevalence of eating disorder risk rose from 15% in 2013 to 28% in 2020/2021 (Daly and Costigan, 2022).
No young adult is immune; eating disorders affect people of all genders, races, ethnicities, sexual orientations, and socioeconomic statuses. Eating disorders often occur alongside other mental health disorders, including depression and anxiety. They carry a risk for significant medical consequences and have the second-highest mortality rate of all mental health disorders.
Some potential warning signs to watch for in your young adult:
If you are not sure whether their behaviors warrant further attention, one strategy is to try to provide one of their favorite (more indulgent) foods and see if they are willing to eat it. People with eating disorders will often be inflexible around these kinds of challenges. If your young adult will eat foods that might be scary for a person with an eating disorder, that’s a good sign that they still have flexibility. If they balk at eating that food, that is more concerning.
You can talk to them and express concern about what you are noticing. If they deny having an eating disorder, but it doesn’t match what you are seeing, I wouldn’t stop there. In fact, defensiveness might be a red flag. I would keep trying to eat with them and gather more information. Your parental instincts are important and can be trusted. Having further conversations—using a nonjudgmental stance—is important. People with eating disorders often experience shame and are frequently unaware of the severity of the illness. Drawing attention to it without increasing shame is important. No one knows your child as well as you do, and no one will be as protective of them as you. Parents can be integral parts of their young adults’ recovery, and setting the stage for your involvement in these early conversations can be vital.
Taking them to their childhood pediatrician while they are home for a weight check and vitals—including orthostatic vitals—can be a good safety measure. You can also have them assessed by an eating disorder professional—either a therapist or dietitian—while they are home. Keep in mind that if this provider recommends intensive treatment or they don’t return immediately to school, this is a warning to heed.
If you identify a problem, I suggest—at a minimum— setting them up with a treatment team at their school. Keep in mind that most colleges do not have the staff to provide ongoing treatment for all of their students’ mental health needs. They will likely refer them to an eating disorder therapist in the community. Many providers may have waiting lists, so helping your young adult do the initial legwork can be helpful. I also suggest asking your young adult to sign a release of information. This ensures their treatment team members can contact you in case your young adult needs more support or a higher level of care.
Learn more about eating disorders in teens and young adults by reviewing our webpage about Eating Disorders in College, our webpage about FBT, and Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T).
If there is a newly emerged eating disorder, you can also consider whether they should even go right back to school. Or alternatively, take some time off for treatment. Quite frequently, people with eating disorders need more support than can be provided by just weekly therapy and dietary sessions. They may need a more comprehensive program that includes support at mealtimes. An effective alternative to higher levels of care is Family-Based Treatment, in which parents provide meal support. You might want to consider having your young adult take a semester off and live with you. That way, you can support their eating and recovery.
At EDTLA, we suggest 6 months of stable recovery before a young adult goes to college. We also recommend having a college contract in place.
If something about your college student’s relationship with food, exercise, or their body doesn’t feel quite right this holiday season, acting sooner rather than later is one of the most important things you can do for their long-term recovery. Seeking specialized eating disorder therapy for college students while your young adult is still home gives your family a crucial head start. Before they return to the campus environment that may have contributed to the problem in the first place.
You don’t have to wait until things become more serious or more certain before reaching out for professional guidance. Evidence-based eating disorder therapy can help your college student and your family navigate this difficult and often confusing time with clarity, structure, and compassionate support. At our Los Angeles eating disorder therapy practice, our experienced therapists specialize in treating college students and young adults with a family-centered, evidence-based approach. With online counseling available throughout California, support is accessible no matter where your student is located. Taking that first step is simple:
When a college student comes home for the holidays and the signs of an eating disorder are impossible to ignore, having an experienced treatment team ready to step in can be the turning point your family has been waiting for. With timely, specialized therapeutic support, your college student can expect to begin stabilizing their relationship with food, rebuilding trust around eating, and developing the recovery foundation they’ll need to return to campus — and life — with greater strength and resilience.
At Eating Disorder Therapy LA, our therapists provide individualized, family-centered, evidence-based care to college students, teens, children, adults, and caregivers across the full spectrum of eating disorders and related concerns. In addition to college student support, we offer specialized therapy for Anorexia Nervosa, Atypical Anorexia, Bulimia Nervosa, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), and Family-Based Treatment (FBT). This approach is particularly well-suited for young adults whose recovery benefits from active family involvement. We also provide support for Excessive Exercise, Body Image challenges, and Phobias Related to Swallowing, Choking, and Vomiting.
To ensure that care remains accessible no matter where your college student is located, our Los Angeles therapy practice offers both online counseling and group therapy for eating disorders, alongside small group FBT and ARFID consultations, eating disorder education, speaking and training, school programs, and clinical supervision for eating disorder therapists.
For additional resources to help you navigate this journey, we encourage you to explore our eating disorder blog and Dr. Mulheim’s published books. When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders (available in 2026). To speak with our team directly, call (323) 743-1122 or email Hello@EDTLA.com. We’re here to help your family take action while the window of opportunity is open.
As a clinician who has worked closely with countless families navigating the unsettling discovery of an eating disorder in their college student, Dr. Lauren Muhlheim knows how disorienting and urgent those first conversations can feel. And how critical early, informed action truly is. The founder of Eating Disorder Therapy LA, Dr. Muhlheim, holds the credentials Psy.D., FAED, and CEDS-C, and has dedicated her career to equipping parents with the knowledge, tools, and professional support needed to intervene effectively when an eating disorder takes hold.
As one of a small number of FBT-certified therapists in Los Angeles, Dr. Muhlheim has guided many families through the process of stepping in as active participants in their college student’s recovery. Providing meal support, rebuilding trust around food, and creating the stability needed before a young adult returns to campus. Her expertise in this area is reflected in her two published books. When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders (available in 2026). As well as one of the only FBT training courses for dietitians in the field. She specializes in evidence-based treatment for anorexia, bulimia, binge eating disorder, ARFID, and related concerns across the full lifespan.
Dr. Muhlheim is licensed in California, Indiana, New York, and Oregon. She also holds a telehealth license in Florida, ensuring that her specialized support for college students and their families is accessible well beyond the Los Angeles area.
Daly M, Costigan E. Trends in eating disorder risk among U.S. college students, 2013-2021. Psychiatry Res. 2022 Nov;317:114882. doi: 10.1016/j.psychres.2022.114882. Epub 2022 Oct 2. PMID: 36228436.
J.I. Hudson, E. Hiripi, H.G. Pope Jr, R.C Kessler, The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication Biol. Psychiatry, 61 (3) (2007), pp. 348-358
Z.J. Ward, P. Rodriguez, D.R. Wright, S.B. Austin, M.W. Long, Estimation of eating disorders prevalence by age and associations with mortality in a simulated nationally representative US cohort, JAMA Netw. Open, 2 (10) (2019), Article e1912925
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