How To Best Support Students in Eating Disorder Recovery
Eating disorders can affect students of all ages, genders, races, ethnicities, or sociocultural backgrounds. For students who are in recovery from an eating disorder, maintaining a consistent treatment schedule and staying connected with the treatment team is especially important during the academic school year.
By: Sadie Grant
An eating disorder is a serious illness that can be detrimental to one’s physical, emotional, and cognitive wellbeing. While people of all ages can experience a full-threshold eating disorder (such as bulimia, anorexia, or binge eating disorder) or disordered eating patterns (such as compulsive over-exercising, food restriction, or compulsive overeating), eating disorders are most common among adolescents. In fact, many children develop eating disorders as early as elementary school.
Today, we are going to discuss eating disorders among students. First, we will review why eating disorder prevention and awareness is so important among child, adolescent, and young adult students. Then, we will examine specific ways in which teachers, administration, staff, and parents can support students in eating disorder recovery.
Why should we be concerned about eating disorders among students?
An 8-year study on 496 adolescent women found that 5.2% of participants met the DSM-5 criteria for anorexia, bulimia, or binge eating disorder and that 13.2% had experienced an eating disorder before the age of 20 (Stice et al, 2010).
Compared to other 15 to 24-year-olds, those with anorexia are at 10 times the risk of death (Fichter & Quadflieg, 2016; Smink et al, 2012).
25% of individuals with anorexia nervosa are male and disordered behaviors such as binge eating, purging, and compulsive exercising are nearly as common among males as they are among females. However, many adolescent males do not receive a diagnosis or treatment until later in life due to the widely held assumption that eating disorders only affect women (Mond et al, 2014).
How do eating disorders affect a child's or adolescent’s ability to learn, socialize, and thrive in school?
According to the National Eating Disorders Association (NEDA)’s Toolkit for Educators, eating disorders among students:
Can be detrimental to cognitive development, concentration, and information processing
Greatly impact behavior and performance in school
Often lead to physical signs and symptoms, such sudden as weight gain or loss, dizziness, fatigue, gastrointestinal issues, feelings of body temperature fluctuation, dry hair or skin, calluses on knuckles, and dehydration
Impact body image: students with eating disorders may feel that they are fat or unattractive, experience distorted body image, and struggle to accept compliments
Can be related to bullying, ostracization, and isolation
Often co-occur with depression, anxiety, or other mental illnesses
What behavioral patterns may indicate that a student is struggling with an eating disorder or disordered eating?
Skipping meals, dieting, and throwing away food
Creating rigid food rules without a medical or religious reason
Exercising excessively
Constantly talking about and obsessing over food and ingredients
Frequently making trips to the bathroom
Counting food and/or calories
Wearing very baggy clothing
Eating meals alone
(NEDA, 2018)
How can teachers, administrators, and staff foster an environment of eating disorder awareness and support?
According to NEDA's Toolkit for Educators, schools should:
Designate at least two administrators or staff members, such as school nurses, psychologists, or guidance counselors, to learn about eating disorders. These individuals should disseminate their knowledge to other school personnel and develop strategies to identify, prevent, and support students with eating disorders.
Create specific guidelines for referring students and families to local recovery resources and medical practitioners.
Develop or update anti-discrimination policies to include protocol for weight/appearance-based bullying or harassment
Designate certain teachers or staff members to monitor student wellbeing
Consider eliminating BMI measurements in PE or other classes, or at least require that students not be weighed publicly or in close proximity to peers
Make sure that students of all sizes feel supported to participate in extracurricular activities, such as cheerleading, drama, sports, etc.
How can teachers support a student in eating disorder recovery?
Communication: If a teacher notices that a student is displaying eating disorder signs or being teased based on appearance, they should reach out to the student or their parents. Additionally, the teacher should speak to any student who is teasing or bullying about weight/shape.
Education and Awareness: Teachers should learn about eating disorders and be aware that eating disorders affect individuals of all shapes, sizes, genders, ages, and ethnicities. Teachers should also be aware that eating disorders can manifest in a variety of behaviors, such as eating only “healthy” foods, over-exercising, and experiencing negative body image.
Flexibility: An eating disorder is a serious illness that often requires intensive treatment. Homework and tests can be very stressful and can even exacerbate eating disorder symptoms. When possible, teachers should offer extensions and extra support for students in treatment.
Meal Planning: Many students in treatment for an eating disorder follow a meal plan and may need to eat meals or snacks throughout the day as part of their recovery process. If the classroom has a strict, no-food policy, a child or adolescent in treatment may need accommodation to eat during class.
Awareness: Children and adolescents are constantly learning from the environment around them. The words of a teacher can profoundly impact how a student thinks about food, weight, and beauty. Teachers should avoid commenting on students’ appearance and try to refrain from teaching about “good” or “bad” foods.
How can parents support a student in eating disorder recovery?
Understanding. It is important to keep in mind that an eating disorder is a complex, emotional, cognitive, and behavioral illness, not merely an academic issue.
Self Education. Parents should educate themselves about the underlying causes, treatment, and potential risk factors of eating disorders using the internet, books, blogs, research articles, or community programs.
Trust and Communication. Communicating with and trusting teachers, counselors, and other people who can support a student in recovery is essential to treatment. This includes being open to feedback.
Treatment. Parents should be aware that a full treatment plan, including dietary support, therapy, and medical assessment may be necessary to support a child in recovery.
Support. Joining a group for loved ones can help parents connect with others who are supporting someone in recovery as well as grapple with the challenges that may arise.
Modeling Behavior and Attitude. It is important for the parent of a child in recovery to be a good role model around food by avoiding talking about diets, weight, or shape.
Patience. Recovery takes time and is a nonlinear process.
At BALANCE eating disorder treatment center, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below or read more about our philosophy here.
This post was written by BALANCE Blog Intern, Sadie Grant.
Sadie is a recent graduate of Oberlin College with a B.A. in psychology. After recovering from disordered eating, Sadie became passionate about eating disorder awareness, body neutrality, and destabilizing beauty standards that are established by social and cultural norms. While earning her Bachelor’s degree, Sadie conducted quantitative research, worked with populations experiencing barriers to essential services, and studied Spanish. Sadie hopes to use her developing research and interpersonal skills to work in the field of eating disorders and address the way in which expectations around eating and beauty vary across different populations.
References
Fichter, M. M., & Quadflieg, N. (2016). Mortality in eating disorders – Results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, Epub ahead of print.
Harper, P., & Hardman, R. (2017, June 01). Eating Disorders, School, And Academic Achievement: A Formula For Failure. Retrieved September 16, 2020, from https://centerforchange.com/eating-disorders-school-academic-achievement-formula-failure/
Mond, J.M., Mitchison, D., & Hay, P. (2014) “Prevalence and implications of eating disordered behavior in men” in Cohn, L., Lemberg, R. (2014) Current Findings on Males with Eating Disorders. Philadelphia, PA: Routledge.
National Eating Disorders Association. (2018). NEDA TOOLKIT for Educators [Brochure]. Author. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/EducatorToolkit.pdf
Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414.
Stice E, Marti CN, Shaw H, and Jaconis M. (2010). An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. Journal of Abnormal Psychology, 118(3):587-97. doi: 10.1037/a0016481.
Vargas, E. (2018, September 10). Helping Your Students In Eating Disorder Recovery Thrive At School. Retrieved September 16, 2020, from https://www.waldeneatingdisorders.com/blog/helping-your-students-in-eating-disorder-recovery-thrive-at-school/