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Impact of eating disorders on cognitive abilities and functioning in school

Eating disorders can profoundly affect a child's ability to learn. Understanding some of the ways an eating disorder can affect cognitive function may help educators to recognize that a student may be in trouble. Listed below are key ways that an eating disorder can affect a child's cognitive functioning because of poor nutrition. A child's cognitive function will also be affected by the mental disorders that often coexist with an eating disorder, including anxiety, depression, and obsessive-compulsive disorder.

A review of the research on the impact of under-nutrition found that under-nutrition:

  • can have detrimental effects on cognitive development in children;
  • has a negative impact on student behavior and school performance;
  • makes students feel irritable, decreases ability to concentrate and focus, decreases ability to listen and process information, may cause nausea, headache, and makes students feel fatigued and have lack of energy;
  • makes students with disordered eating behaviors less able to perform tasks as well as their adequately nourished peers;
  • leads to deficiencies in specific nutrients, such as iron, which has an immediate effect on students' memory and ability to concentrate;
  • can make students become less active and more apathetic, withdrawn, and engage in fewer social interactions;
  • can impair the immune system and make students more vulnerable to illnesses; and
  • increase absenteeism in affected students because of the above impairments.
Despite malnourishment, the perfectionist attitude of those who suffer from anorexia and bulimia may compel them to maintain a high level of academic performance, which is even more difficult given their compromised physical and mental status.

In addition to the effects described above, preoccupation with food often dominates the life of a student with an eating disorder. A study on people with eating disorders indicated a preoccupation with food.

    In our clinical practice we surveyed over 1,000 people with clinically diagnosed eating disorders. We found that people with anorexia nervosa report 90 to 100 percent of their waking time is spent thinking about food, weight and hunger; an additional amount of time is spent dreaming of food or having sleep disturbed by hunger. People with bulimia nervosa report spending about 70 to 90 percent of their total conscious time thinking about food and weight-related issues. In addition, people with disordered eating may spend about 20 to 65 percent of their waking hours thinking about food. By comparison, women with normal eating habits will probably spend about 10 to 15 percent of waking time thinking about food, weight, and hunger.
     —Reiff D and Lampson-Reiff KK. Eating Disorders: Nutrition Therapy in the Recovery Process. Mercer Island, WA: Life Enterprises, 1999.
Key Source:
U.S. Dept of Health and Human Services National Women's Health Information Center, BodyWise Handbook Eating Disorders Information for Middle School Personnel 2005 http://www.4women.gov/bodyimage/kids/bodywise/bp/BodyWise.pdf


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Bulimia nervosa is an eating disorder in which a person engages in binge eating (eating a lot of food in a short time) followed by some type of behavior to prevent weight gain from the food that was eaten. This behavior can take two forms: self-induced vomiting, misuse of enemas, laxatives, diet pills (called purging) and excessive exercise, fasting, or diabetic omission of insulin (called non-purging). Some people with bulimia nervosa may also starve themselves for periods of time before binge eating again. Bulimia nervosa has important mental, emotional, and physical aspects that require consideration during treatment.

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