Understanding Eating Disorders: A Basic Guide for Educators

Eating disorders are serious mental health conditions which can significantly impact the well-being of students, both physically and emotionally. As educators, you are a valued support who can identify concerns, and even early warning signs, to assist in recognizing and supporting students who may be struggling with these complex disorders.

What Are Eating Disorders?

An eating disorder is not a choice, but rather a complex mental health disorder. Like most disorders, eating disorders exist on a spectrum of severity, which is based on frequency and intensity of eating disorder “behaviors”. Common types of eating disorders include:

• Anorexia Nervosa: Characterized by restricted food intake, fear of gaining weight, and a distorted body image
• Bulimia Nervosa: Involves cycles of binge eating followed by compensatory behaviors like purging, exercising excessively, taking laxatives, among others
• Binge Eating Disorder: Recurring episodes of consuming large quantities of food, often accompanied by feelings of loss of control and significant emotional distress, for instance, shame.
• Orthorexia: An obsession with eating healthfully to the point that it interferes with one’s life (for example, the practice of “clean eating” or another lifestyle diet). Orthorexia is not currently a formally recognized diagnosis, though it has profound impacts on people’s lives.
• Other Specified Feeding and Eating Disorder (OSFED) is a formally recognized diagnosis which is marked by an unhealthy relationship with food and body, though the individual with these symptoms does not fit the criteria of any other eating disorder.

Warning Signs Specific to the Educational Setting

There are many signs and symptoms which may signal eating disorder behavior or risk for an eating disorder. A student may show some, but not all the following behaviors, and to varying degrees.

Potential eating disorder “red flags” an educator may witness in the school setting:

• Restriction around food (skipping meals, eating small portions, pushing food around their plate rather than eating)
• Eating in isolation or isolating oneself in general
• Exercising a lot and/or getting upset if one cannot exercise
• Feeling shame or frustration around how much one eats
• Fainting or lightheadedness
• Skipping lunch to do schoolwork or to help a teacher on a routine basis, or justifying why they’re not eating, for example: “I’m not hungry” or “I don’t feel well”
• Engaging obsessively in diets, including “lifestyle diets”
• Negatively talking about their body
• Routinely going to the bathroom after meals (potential for purging)
• Lying about eating meals or snacks
• Body checking (standing in front of the bathroom mirror, especially at length, and assessing their body for appearance)
• Compensatory behaviors after eating, such as purging/vomiting, exercising, or using laxatives
• Feelings of anxiety, shame, guilt, around eating food
• Preoccupation with obtaining a certain number of steps per day, “closing their rings” or reaching movement and exercise goals indicated by a smart watch

A student who is struggling with an eating disorder may be hard to identify in the classroom. If you know a student who is encumbered by one or more of the following: anxiety, depression, perfectionism, people-pleasing, rigidity, compulsiveness, preoccupation and/or control, this student may struggle with disordered eating behaviors, if not a “full-blown” eating disorder. It is not uncommon for a student who is “bubbly” and seemingly happy and “on top” of their assignments, to silently struggle. Consider these indicators to take note of the student’s behaviors.

If a student presents as underweight, this is a serious concern, though it’s crucial to remember that an individual can be in any sized body and struggle with an eating disorder. It’s a common misconception that an individual must be under weight to be of concern. This is untrue. Anyone, in any sized body and of any race or sex, can and do struggle with eating disorders.

How Educators, School Staff, & School Community Can Help

There are many ways to offer support within the school setting while also creating an environment which encourages a healthy relationship with food and one’s body. And while educators, and the entire school community, are tasked with so much, creating an empathic and empowered school environment may not require much more than what you’re already doing.

Working towards creating a supportive school culture in the following ways can go a long way in supporting students’ recovery from an eating disorder:

• Promote and model body neutrality and/or body positivity by utilizing neutral and/or positive talk about your own body’s abilities and capabilities
• Offer a safe space by fostering open conversations about mental health, normalizing struggles, and offering empathy
• Avoid weight-based discussions and “diet talk”. Do not openly talk negatively about your body or disclose a desire to lose weight. Stay away from conversation about dieting, including “lifestyle diets” such as keto, clean eating, and intermittent fasting.
• Offer direct support by asking the student specifically how you can (reasonably) help them within the school environment

Early identification and compassionate support are critical in helping students recover from eating disorders. By remaining observant, informed, and empathetic, educators can make a profound difference in students’ lives. If you are concerned about a student, speak to your school guidance counselor (or other proper support person) regarding how to proceed. Many students will deny having an eating disorder, or such behaviors, simply because they don’t understand eating disorders, or because they’ve normalized their behaviors, or because they don’t want to “get better”. Often, extra support is required.

Thank you for your continued compassionate support for our students.

Resources for Support

Professional Organizations

• National Eating Disorder Association (NEDA): https://www.nationaleatingdisorders.org/
• Family Empowered and Supporting Treatment for Eating Disorders (F.E.A.S.T.): https://www.feast-ed.org/
• Recovery Warriors Podcast Resources: https://recoverywarriors.com/podcasts/

Helpline Resources

• National Alliance for Eating Disorders Helpline: 1-866-662-1235
• Crisis Text Line: Text “HOME” (English) or “AYUDA” (Spanish) to 741-741

Vector Solutions Staff & Student Courses

• Eating Disorder Awareness and Prevention (Teachers, Faculty and Staff)
  This course will help you to identify the signs of eating disorders, how to encourage a healthy relationship with food and exercise, and how to support a person in recovery within an educational setting.
• Student Mental Health: Awareness, Intervention and Referral
  This course provides an overview of student mental health concerns and educators’ responsibilities. Topics covered include the scope of mental health needs in school-age students; warning signs and risk factors; and when and how to intervene and refer/report students who need support.
• Mental Health & Well-Being Library for Middle and High School Students: Support healthy development, resiliency, and well-being with with engaging, video-based courses. Deliver critical prevention education on depression, stress and anxiety, self-harm, eating disorders, suicide, and more.

Disclaimer

This guide is for informational purposes. If you have concern about a student, consult your school or school district’s policies regarding how to proceed.

About the Author

Natalie Asayag, LCSW, is a seasoned clinical social worker and founder of Renew Wellness & Psychotherapy, LLC, with over a decade of experience promoting mental well-being in the therapeutic setting.

She has delivered presentations on an array of subjects including anxiety, body image, eating disorders, trauma, and somatic responses. Her talks have taken place across a diverse spectrum of platforms, from higher education institutions to national organizations.

Her extensive experience working with students across a spectrum of settings, encompassing schools, homes, and therapeutic spaces, has uniquely positioned her to grasp the profound implications of mental health challenges and the importance of implementing strategies and nurturing secure environments in our educational institutions.

Natalie has authored courses for Vector Solutions, working to advance mental health awareness and education for high school students and educators in the areas of self-harm awareness prevention and eating disorder awareness and prevention.