Eating Disorders and Summer Camp: Making the Tough Decision
As we kick off summer season, many kids and teens across the country are headed to summer camps. If your child or loved one is struggling with an eating disorder, you may be wondering whether it’s safe to send them.
While it’s painful to watch your child struggle and keep them from the activities they love, we do not recommend sending a child to sleepaway camp if they are actively engaging in eating disorder behaviors. Day camp may be an option, but please see our recommendations below. By prioritizing their mental and physical health this summer, and helping them get the support they need, they are more likely to enjoy future summers in recovery.
What’s more, seeking eating disorder treatment in the summer doesn’t necessarily mean saying goodbye to all summer plans. If they are committed to treatment and recovery, your child or loved one can find healing while still participating in volunteer opportunities, classes, enrichment activities or even a part-time job.
We spoke with Brittnee Smith, MS, LPC, NCC, CEDS, senior primary therapist at Eating Recovery At Home, our virtual intensive outpatient program for eating disorders, to learn more about the risks of sending your child to summer camp while struggling with an eating disorder. She also shares tips and scripts to help you communicate and explain this decision to your child.
Should children with eating disorders attend summer camp?
When you send your child to summer camp with an eating disorder, you run the risk of triggering a relapse or exacerbating their symptoms. Part of this is due to the change in routine, which can be stressful for anyone. However, people with eating disorders often struggle with changes to routine more than the average person.
“Camp invites uncertainty, including a new schedule, new mealtimes, different food than their norm, and meeting new adults and peers,” Smith explains. “In these situations, children with eating disorders will reach for something that is certain: the control they feel when they engage in behaviors, or the relief behaviors offer in managing their stress.”
The change in routine plus decreased observation and limited access to their support system puts these kids and teens in a very vulnerable place. “Even if you are confident in your child’s ability to interrupt behaviors, if they were ever to take a chance, this would be it,” Smith says. “It would not be uncommon for a child to engage in eating disorder behaviors their entire stay without anyone knowing.”
What’s more, when your child returns home from camp, their eating disorder may come back in full swing. In some cases, you could anticipate seeing an increase in behaviors, or even new behaviors altogether, requiring more intensive treatment.
How to talk to your child about the decision
As parents and caregivers, we need to make decisions that are best for our loved ones, even when it’s hard. It’s common for a child to feel upset, embarrassed or sad when they learn they can’t go to camp because of their mental health. Your responsibility in this conversation, in addition to making decisions that keep them safe, is to “help them through their anger, sadness, and FOMO (fear of missing out),” Smith says. “The best way you can support them would be connecting with these emotions and normalizing them. Of course they are upset!”
To support them with compassion, try using a skill called “emotion coaching.” This involves three steps:
- Label the emotion, situation or difficult thoughts they might be having.
- Demonstrate why you understand.
- Say what they need to hear or offer emotional support.
Here’s an example — you can replace the underlined sections with your own narrative. “I have some news that I know is going to be hard to hear. We can’t take you to camp because we need to focus on your eating disorder. I can imagine you are upset because you have been looking forward to this all year, because you may feel like your friends are having fun without you and because you didn’t ask for this eating disorder -- so this doesn’t feel fair. I hear you and want the best for you.”
After the conversation, you can follow up with a hug, space or distraction. “If you offer space, plan to reconnect with them after a certain amount of time,” Smith suggests. “A distraction may include watching a movie, listening to music or learning a new coping skill.” If appropriate, you can also suggest an activity that is more feasible and safer than going to camp, such as going to a museum together or another day trip.
Should children with eating disorders attend day camp?
You may be wondering: What about day camp? The counselors could observe meals and monitor snacks! The reality is that this can still be harmful and communicates the wrong message to your child.
“I can see how any loving parent who wants their child to connect with their peers and summer activities would consider this as an option,” Smith says. “Logistically this makes sense, but my worry is, what does this communicate? The last message we want to send is, ‘You can have your eating disorder and have a normal life without any consequences.’”
As you work to help your child heal from their eating disorder, it’s important they understand that continuing to use eating disorder behaviors without seeking help comes with consequences. For this reason, we recommend waiting to send a child to day camp until they are eating disorder behavior-free and competent in using skills to manage their stress.
“The only way I could see day camp as an option for a child using eating disorder behaviors would be as an incentive that is earned through a long-standing pattern of compliance with their meal plan and/or behavior interruption,” Smith caveats. “If this is earned, the parent also must be willing to take the privilege away if the child engages in behaviors while at camp.”
Should children in eating disorder recovery go to sleepaway camp?
If your child has been stable in eating disorder recovery, we still recommend that you check with their treatment team before committing to sending them to sleepaway camp. Why? Their brain can take six months to a year after weight restoration to return to full functioning.
Changing routines comes with a high risk for children in eating disorder recovery, especially children who attended treatment previously. Thankfully, there are steps you can take to reduce the risk of relapse.
- Create an incentivization strategy. Incentivize attending camp through behavior interruption and compliance with the treatment plan. Your child will need to earn attendance by demonstrating a pattern of interrupting eating disorder behaviors. If they have engaged in behaviors, it is a safe bet that they may not be ready.
- Come up with a meal plan. What will meals look like? Will there be enough provided, or will you need to pack snacks to satisfy the meal plan? Can you be present for observation or is there a trusted adult who could alert you to any concerns? If your child engages in behaviors during camp, are you able to pick them up? Planning will help increase certainty for your child and set expectations (e.g., “If you engage in a behavior, I will pick you up from camp”).
- Practice exposure therapy. Your child can practice exposures to portioning and selecting food -- if appropriate and approved by your outpatient team. This should be gradual, starting with offering two or three choices and building up to meal selection and portioning. This way they can build their skill slowly and receive feedback before they are in a new environment -- or inform you that they may not be ready for this step. If phones are allowed, you can set the expectation that they send you before and after photos of their meals.
- Keep staff in the loop. If you are comfortable, sharing your child’s eating disorder symptoms with the camp staff will add an additional layer of support. Ask them to contact you if they observe any warning signs.
- Create a cope-ahead plan. Highlight the triggers your child can anticipate in camp, skills they could use to cope and anticipated barriers to using these skills. Have this written down on a note card so it can always be accessible to them. Identify how they can be in touch with you should they need support.
Prior to making this decision, you should receive personalized guidance from your outpatient team. They will discuss their recommendations and help you prepare.
If your child needs additional support this summer, consider programming at Eating Recovery Center. We offer specialized programs for children and adolescents, including Eating Recovery At Home, a virtual intensive outpatient eating disorder treatment program that can be tailored to your child’s summer schedule. With treatment, your loved one can build skills to make progress in their recovery.
Take the first step today by calling 1-877-825-8584 for a free assessment.