Clinicians' Corner / Helpful Hints

Q & A for Students with Eating Disorders (and Their Parents)

Fall is a time of transition for all students returning to school, but this transition may present several unique challenges for those with feeding and eating disorders and their families. Children and teens with feeding and eating disorders and their parents commonly have questions about who and what to tell about the disorder and how to maintain progress that has been made in treatment over the summer. Here are a few typical concerns – and some recommendations on how to approach them – based on our work with children and families with feeding and eating disorders.

Questions from Students

What do I say to teachers and friends about having an eating disorder and my treatment?

It can be challenging to decide who and what to tell about having an eating disorder. Sometimes, you may choose to keep this information private, especially if the eating disorder doesn’t interfere with things like school or socializing. In other cases, telling trusted friends, teachers, or guidance counselors may be helpful because it allows them to support you in your recovery.

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Photo Credit: Creative Commons by Pexels/Kaboompics

  • Friends can help encourage you to make choices that benefit your health (e.g., finishing a difficult meal).
  • Teachers can provide an accommodation if you need to miss class or eat a snack during the day.
  • Guidance counselors can help you work with teachers to make up missed work or figure out how to follow your treatment plan during school. A guidance counselor can also be a person to talk to at school when you feel overwhelmed or anxious.
  • Consider telling friends what is and isn’t helpful. For instance, asking friends to refrain from making comments about their own or each other’s bodies – even if the comments are innocent – might help reduce your focus on or concern about body size, weight and shape.

For additional strategies on talking to friends about your eating disorder, see this related post.

Will my friends notice that my eating or my body has changed during the summer?

Like adults with these disorders, many youngsters worry that friends will notice that their eating or body has changed since the prior school year. Whether such changes are actually noticeable varies depending on the extent of the change.

  • In many cases, people are not likely to notice minor changes in your appearance, even if they seem very apparent to you. Most of the time, people are concerned with their own stuff, not yours. A friend who is focused on surviving geometry, making the swim team, or even having the “right,” fashionable wardrobe is not so likely to notice slight changes in your appearance or behavior.
  • Even if other people do notice that your body or eating has changed, it is quite possible that they regard these changes to be a positive thing. Just as your parents have likely been concerned about you, so too have your teammates and friends, and if you are in a noticeably healthier spot with your eating behavior or weight, they might be relieved to see it.
  • Close friends often want to give a compliment, yet sometimes ‘supportive’ comments may not be helpful to you. Of course, positive, encouraging comments may not feel that way to you just yet – and that’s okay – but it’s worth thinking through your thinking on this (on your own or with your therapist). This can help you to find ways to feel the support that others are offering, or to talk with friends about what actually would feel more supportive. You might, for example, wind up saying something like this: “I know you mean it as a compliment when you say I look healthy, but it is hard for me to see that as a positive thing right now.”

Questions from Parents

Should we tell the school about my son/daughter’s eating disorder and treatment?

Whether to tell the school about your child’s disorder can depend on a number of factors including:

  • Severity of the illness
  • Stage of recovery
  • The child/teen’s preference
  • The providers’ recommendations
  • Need for accommodations at school

If a child is functioning well socially, able to carry out snacks/meals independently, and committed to treatment, it might not be necessary to involve school personnel. In other cases, such as when a student’s medical stability is questionable, during early stages of recovery, and when accommodations are needed, the school can be a valuable resource in helping support your child’s continued treatment progress.

We’ve decided to inform the school. Who should we contact?

It is often helpful to first contact a person who oversees your child’s education/care during school, such as a guidance counselor or school nurse. Contacting a specific teacher that your child trusts may also be beneficial. Teachers can provide guidance and information about communicating with other school personnel.

What should we say?

Though school staff typically have experience in helping students with psychological and learning problems, teachers, nurses, guidance counselors will be open to input on what will be most helpful for your child. Work collaboratively with your child’s clinician to communicate ideas regarding the types of accommodations from which your child may benefit. At early stages of treatment, your child may require supervision at or after meals. Let the school know about anticipated school absences (or early dismissals on a regular basis) due to treatment and, in some cases, the need for extended time to complete assignments. At your child works toward recovery, he/she may benefit from simply having a designated “check-in person” if challenges arise.

Does my child need formal accommodations at school?

Depending on the severity of your child’s illness, the types of accommodations needed, and school collaboration, informal accommodations are often sufficient to ensure that your child’s needs are being met. Informal accommodations might include a plan agreed upon between the child’s nurse, guidance counselor, and parent regarding where the child will have snacks, or extra time provided by a teacher to complete an assignment.

When treatment results in extended school absences or in cases where it has been difficult to maintain the provision of accommodations at school, a 504 plan may be useful. A 504 plan is a legal document outlining needs and accommodations, and they are available to students with a wide range of physical or mental illnesses or disabilities to ensure that the child’s academic needs are met.

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