Evidence-Based Comprehensive Psychological, Nutritional and Medical Care

Eating Disorders in the School Setting

By Julie Raime and Nancy Anderson

Many times an educator is the first person who notices some of the warning signs of an eating order. Think of all the time that a student spends in a classroom setting and how many different people consistently see them everyday. This may be the core classroom teachers, the PE teacher, the school counselor and the nurse. So, what are the signs that these educators and school health professionals should be looking out for? An eating disorder takes on many different faces, but if everyone is aware of these signs and symptoms then help can be sought sooner than later.

What does an eating disorder look like among the peer group and social interactions?

Often isolation is the first outward sign of an ED amongst teenagers. A change in social habits can look like a child pulling away from the peer group and not engaging in the social patterns they previously enjoyed.  They can isolate themselves as the eating disorder worsens as a means to hide their behaviors. At times, the patient can feel rejected or alienated when peers express concerns over their eating habits. Sometimes the ED has been precipitated by teasing and comments from peers. Other times, what starts as an attempt at improving health with diet and exercise gets out of hand but initially the body changes are reinforced through praise. Social media can play a negative role in the validating of disordered eating and body image. Parents should always be aware of their child’s presence and identity on all social media outlets.

What does an eating disorder look like from a nurse’s point of view?

A student that struggles with an eating disorder may be a frequent visitor to the school nurse. Their symptoms can include complaints of nausea after eating small or normal amounts, bloating or water retention not attributable to other physical problems, constipation, reflux, chronic sore throat, swelling of glands around the jaws, frequent and unusual dental problems, general complaints of lightheadedness, fainting and frequently feeling cold.

What does an eating disorder look like on the sports field in and out of school?

This is a student athlete that is “practicing” or “training” for several hours a day and are often secretive about their workouts. They can be quite rigid and compulsive with their drive to perfection. These students will find a reason to avoid eating with the team and will be averse to resting, rehydrating and refueling their bodies. They are at a higher risk for stress fractures and also can exhibit dizziness, weakness, fainting and weight loss. Their declining performance should be a red flag to those adults around them.

Our Educational Program

McCallum Place provides an educational program for our adolescents and young adults. Each educational plan is customized according to the patient’s school’s curriculum. Our teachers act as liaisons between the patient and their school by communicating on a weekly basis with counselors and teachers. Individual needs are addressed and materials are modified to ensure student success in our adaptable educational environment. Educational support is provided five days a week with additional independent study times available on the weekends. Our classroom environment is a bright and spacious area that is conducive to small groups and individual work. Students are encouraged to bring their own devices (laptops, iPads etc) for educational purposes. We can provide loaners if these aren’t available.

The McCallum Place teachers collaborate with the patient’s treatment team to plan for how their specific eating disorder impacts their learning and to ensure the whole patient is supported. Providing an individualized program like the one here at McCallum Place is very important so that the patients can successfully transition back to school after treatment.