Thinking of Returning to School with an Eating Disorder?

With the school year nearing, it’s important to start discussing the relationship between school, body image, and eating disorders. Navigating school while living with an eating disorder is undeniably challenging. With school comes independence, social cliques, and sports—all of which can trigger eating disorder behavior. Despite the challenges school settings pose, there are preventative measures individuals can take to discourage relapse.

School as a catalyst for disordered eating

School comes with social cliques, scattered meal times, changing hormones, and early mornings—all things that may pose problems for adolescents and young adults. In fact, the general life of today’s adolescent children and young adults are significantly more stressful than ever before. A study funded by the National Institutes of Health discovered that depression rates are on the rise, going from 13.1% in young girls in 2004 to 17.3% in 2014. Not only are rates of depression rising, but anxiety is also increasing in young adults as well. The American College Health Association found that 62% of students reported suffering from “overwhelming anxiety” in 2016, versus 50% in 2011 and 29% in 2010.

This decrease in general wellbeing can be attributed to a number of factors: social media, smartphones, increased school work, violent neighborhoods, a tense political climate, the need for perfectionism, and various other social changes. These changes can result in depression and anxiety, which may increase the likelihood of developing an eating disorder. In students who are entrenched in a school culture fixated on high achievement and perfectionism, eating may become a way to gain control.

Typical warning signs of an eating disorder in adolescents and teens are: withdrawal from friends, skipping meals, and becoming obsessive about weight, size, and body image. Typically, teens will refuse to attend events that revolve around food in an attempt to hide their eating disorders from those around them. This may cause them to feel isolated and excluded, which could drive them to more severe disordered eating behaviors. In college students who suffer from eating disorders, those around them may notice social withdrawal, missed meals, or excessive exercising. Those suffering in college may also attempt to hide their disordered eating by hiding food and wrappers, refusing to eat in common spaces, making up excuses to skip meals, running late at night when those around them won’t notice, and other disordered behaviors.

Contributing factors to eating disorders in schools

Technology. It’s no surprise that the way teens and young adults are communicating today is different than 10 years ago. With most social interactions taking the form of text or online social media, it’s easy for individuals to feel disconnected and disillusioned. With the increased presence on social media, teens are seeing the tailored lives of those around them—the highlights reel. In addition to only seeing what other people want them to see, teens are exposed to harmful marketing tactics. Young adults are being bombarded by social media ads about weight loss, dieting, the “perfect” body, and other various body-shaming messages every day.

Social cliques. Fitting in during middle, high school, and even college can be exhausting. Certain social cliques may choose to relate to each other by focusing on negative feelings about themselves and others. Other groups may promote eating disorder behaviors such as dieting, losing weight, and emphasizing the importance of body image. In an attempt to fit in with certain social groups, some students may succumb to dieting, which is a precursor to losing weight. Students may also engage in disordered eating to lose weight in an attempt to align with what they believe others expect of them.

Bullying. Bullying is frequently seen in elementary through high school and can be a precursor to eating disorders. If individuals are made to feel bad about themselves or their bodies, those with eating disorders may revert back to their old ways of coping by relying on their eating disorder. In a previous post, we covered how bullying, body discrimination, and negative comments can lead middle school students to increased levels of emotional distress. This judgment around body image can spark disordered behavior in students as young as nine.

Scattered meal times and eating in public. Schools typically have students eat lunch anywhere from 10:30 AM to 1:30 PM and in some schools, students may only be given 20 minutes to eat. This structure around school mealtimes makes it challenging for students to eat intuitively. For example, a student may be hungry earlier than their lunchtime or they may need longer to eat until they are full. By not allowing students to follow their natural desires to eat, it may become hard for students to eat mindfully and well. In addition, individuals with eating disorders or those in recovery may have negative feelings, including guilt and shame, about eating in public. This may cause an individual to further restrict food as it is may be seen as more challenging to eat meals with peers and in school cafeterias.

Sports. Eating disorders are often seen in sports that place an extreme emphasis on body size, weight, or shape. These sports typically include gymnastics, dancing, and wrestling. However, eating disorders can be present in all sports and the signs and symptoms are generally increased training time, an aversion to refueling, and dramatic weight loss. If an individual is working out after practice, not eating enough to fuel them for their athletics, and/or weight loss that continues, it is likely that the athlete has an eating disorder.

Perfectionism. School settings are usually perfection-oriented with an emphasis on good grades, college acceptances, and sports wins. For individuals struggling with eating disorders, a poor test grade or the feeling of being academically monitored may cause them to slip back into disordered eating behaviors in an effort to regain control. They may also use food as a punishment for perceived academic failures.

Tips for Going Back to School with an Eating Disorder

Start treatment. If you have not yet started treatment for your eating disorder, it is important that you do as soon as possible. It is recommended to start treatment prior to returning to school as school can often worsen behaviors. If there is a concern of adolescents and young adults falling behind in school, programs like our Anna Westin House for Adolescents and Young Adults offer school and treatment in the same location so students don’t fall behind on their education while pursuing lifesaving treatment. For those attending college who have not started treatment, it is recommended to either do treatment and college in tandem or to postpone school until you are stable.

Have a plan. If you are in recovery, it is essential to enter school with a specific plan to maintain your progress. You can create this plan with your treatment team, a therapist, or loved ones. It should be tailored to your unique needs and challenges and should prioritize your health above all else. It is essential that this plan requires you to maintain a healthy weight and healthy eating behaviors. If unable to maintain health, it is advised you reenter treatment or get support immediately.

Find a local therapist. Once settled into school, find a counselor or therapist on campus right away, so you have a local, professional support system. You should let your therapist know about your eating disorder, so they can assist you as needed.

Know what self-soothing techniques work for you. If you experience anxiety or eating disorder thoughts, you should have an effective, safe coping mechanism. Techniques could include meditation, yoga, reading, writing, art, or anything that brings you a sense of calm. If you aren’t sure of how to mitigate stress, try one of our 10 suggestions.

Know your triggers. It’s important to know what may be triggering in a school setting. If it is challenging to eat alone in public, reach out to friends to support you. If hearing negative body talk triggers your eating disorder, avoid situations where individuals are likely to criticize their appearance or the appearances of others. If stress brings up eating disorder thoughts, make sure you are getting help from a therapist or friends and finding an activity that can mitigate stress.

If you are considering returning to school with an eating disorder and looking for support, reach out to us at 1-888-364-5977. We can provide you with treatment options and support that fits into your schedule. If you are a parent of a child who is returning to school with an eating disorder, you can help promote lasting success by modeling positive body image. Here are some real-life tips on how to model positive choices and body image for your child.