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Understanding Eating Disorders


Questions Frequently Asked by Educators

Please note: For ease in reading, we have mostly used "she" and "her" in the description below even though eating disorders exist in men, women, girls, and boys. This advice is suitable for a student of either gender.


I'm a middle school teacher. I suspect that one of my students has an eating disorder. Is it advisable to contact her parents?

The answer to this question depends upon a number of factors. First, you’ll want to review your school’s privacy and confidentiality policies, which vary from one state to another. While some students at risk for eating disorders may be amenable to allowing the school to notify their families, others will be adamantly against it. In some cases, if the student is at risk – and depending on the degree of risk – the school may be mandated to contact her parents. You might have to talk to your student more than once in an effort to evaluate this situation and to determine what course of action would best ensure her safety. Some schools have programs whereby teachers entrust concerns about a student to a team that is responsible for addressing nonacademic issues and for adhering to state confidentiality laws.




When a student has an eating disorder, what is the impact on her classmates and friends?

In addition to being worried about the student with an eating disorder, peers may feel frightened and puzzled by the changes they have observed in her. Chances are she shuns social activities – especially those involving food – and seems unusually withdrawn, anxious or angry. Her friends and classmates may feel at a loss regarding how to relate to her, and as a result, may withdraw from her. Seeing a friend/classmate with signs of an eating disorder may tap into a concerned student’s sense of having the problem herself; school professionals can help assess this.

For more information about effects on peers, please visit: Helping Your Student, Helping Your Friend, and the National Eating Disorders Association Educator Toolkit.




Are students who are teased by peers about their body size/weight vulnerable to developing an eating disorder?

Yes. Although not everyone buys into mainstream culture’s mandate to be thin, weight bias is common. Mean-spirited body remarks from peers can make a young person feel “down” about herself and may contribute to her development of abnormal eating behaviors. It is important for schools to implement anti-bullying policies and to include weight-related teasing on the list of behaviors that are not acceptable.




How does having an eating disorder affect school performance?

The semistarvation associated with anorexia nervosa affects the brain. Some patients in the throes of this illness show diminished concentration, memory and attention, which often return to normal once nutritional health is restored. The obsessive thoughts about food and weight that plague individuals with anorexia can distract them from their schoolwork. So can psychiatric conditions (such as depression and obsessive compulsive disorder) that tend to coexist with eating disorders. Many students with anorexia are driven to excel academically and – despite difficulties concentrating – manage to maintain top grades; in order to accomplish this, however, they may pour many extra hours into homework at the expense of time they could spend relaxing, seeing friends, or enjoying hobbies.




How can a school be helpful to a student receiving treatment? Should the school be in contact with the student's medical team?

Communication is the key to comprehensive treatment. The school nurse or guidance counselor/school psychologist can serve as a liaison between the school and the student’s treatment team. One important role for school professionals is to monitor the degree to which the student is adhering to her treatment program. The school nurse can offer the student support around lunch and help reinforce boundaries or limits. If medication, such as an anti-anxiety pill, has been prescribed on a “prn” (as needed) basis for the student to take during the school day, the nurse can evaluate her need for it and administer it. Although guidance counselors and school psychologists generally do not provide psychotherapy, they would collaborate with the student, her family, and teachers to address questions such as how she can best cope with schoolwork missed during absences (due to treatment) or how she might spend her time when her classmates are in physical education class. Many treatment plans call for restricted exercise and this is often very upsetting to patients. The student’s athletic coach can communicate with the treatment team and with her parents so that everyone is “on the same page” regarding her program.




How can schools help prevent eating disorders?

During the past decade, professionals have developed a number of programs aimed at adolescents, designed to reduce the risk of developing eating disorders. Research has shown such programs to be effective. Some are school-based curricula; others are in CD-ROM format and still others are accessible via the Internet. Offered by an increasing number of schools, prevention programs cover media literacy, appreciation of self and body, reframing negative self-thoughts, and countering weight bias. Here are some examples of prevention programs:


Sources:
~Herzog, David B., Franko, Debra L., Cable, Pat. Unlocking the Mysteries of Eating Disorders. New York: McGraw-Hill, 2008.
~National Eating Disorders Association Educator Toolkit. Seattle: 2008.



Photo Credits:

"Millie V. QS2:"
"Loneliness:"
"Joel doing homework:"
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"Role of media:"



This page was posted on January 21, 2010.