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Eating disorder signs and symptoms specific to a school setting

During adolescence, young people often experience sudden variations in height and weight. For example, girls can gain an average of 40 pounds (lb.) from age 11 to 14—and that's normal. A girl or boy who puts on weight before having a growth spurt in height may look plump, while a student who grows taller but not heavier may appear rather thin. The points outlined below are not necessarily definitive signs or symptoms of an eating disorder-only an expert can diagnose. However, be concerned about the student who appears to be the "perfect" student or who strives for perfection. Be concerned if a student consistently shows one or more of the signs or symptoms listed below.


  • Change in attitude/performance
  • Expresses body image complaints/concerns: being too fat even though normal or thin; unable to accept compliments; mood affected by thoughts about appearance; constantly compares self to others; self-disparaging; refers to self as fat, gross, ugly; overestimates body size; strives to create a "perfect" image; seeks constant outside reassurance about looks
  • Talks about dieting; avoids nutritious foods because they are "fattening"
  • Is overweight but appears to eat small portions in presence of others
  • Appears sad/depressed/anxious/expresses feelings of worthlessness
  • Is target of body or weight bullying
  • Spends increasing amounts of time alone
  • Is obsessed with maintaining low weight to enhance performance in sports, dance, acting, or modeling
  • Overvalues self-sufficiency; reluctant to ask for help
  • Sudden weight loss, gain, or fluctuation in short time
  • Abdominal pain
  • Feeling full or "bloated"
  • Feeling faint, cold, or tired
  • Dry hair or skin, dehydration, blue hands/feet
  • Lanugo hair (fine body hair)
  • Diets or chaotic food intake; pretends to eat, then throws away food; skips meals
  • Exercises for long periods; exercises excessively every day (can't miss a day)
  • Constantly talks about food
  • Makes frequent trips to the bathroom
  • Wears very baggy clothes to
    • hide a very thin body (anorexia) or weight gain (binge eating disorder); or
    • hide "normal" body because of disease about body shape/size
  • Is fatigued; gets dizzy
  • Avoids cafeteria
  • Carries own food in backpack or purse
  • Shows some type of compulsive behavior
  • Denies difficulty
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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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