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School strategies for assisting students with eating disorders

Teachers, administrators, and staff
  • Develop a student assistance program (SAP) and protocol, if one is not already in place (see sample SAP student information form), for students, faculty, and staff to channel nonacademic concerns about a student. This should create an appropriate pathway that adheres to the local laws and regulations governing communications among teachers/parents/students/outside healthcare.
  • Designate a subgroup (of at least two members) of the SAP to "get smart" about eating disorders and share their knowledge and expertise with other school personnel and plan an in-service, if possible.
  • If a full in-service is not possible, plan some time at a faculty meeting to discuss eating disorders or hand out basic information to staff on healthy body image, nutrition, signs and symptoms of eating disorders, and coach and teacher tip sheets.
  • Create specific guidelines on referrals for students suspected of having an eating disorder. Be prepared to refer students and families to appropriate local counseling resources and medical practitioners that specialize in eating disorder treatment.
  • Update school policy on anti-harassment and anti-discrimination policies to ensure they include provisions about physical appearance and body shape. Ensure that a protocol is in place for students to report teasing, bullying, or harassment based on weight or appearance. Be sure the consequences for bullying behavior are clear.
  • Decide which staff will take responsibility for monitoring and communicating changes in a student's wellbeing through appropriate channels to concerned parties (and in accordance with confidentiality, laws, and SAP protocols). That teacher or staff person should take on the role of "checking in" with the student each week for a few minutes to see how he/she is. This may involve informal chat during lunch, recreation time, or before or after school as appropriate.
  • Use checklists of typical physical, social, behavioral, and psychological signs and symptoms of eating disorders to facilitate monitoring changes that could signal progression to a more serious condition so that a student can be referred to specialist support as warranted.
  • Make it a policy not to weigh students publicly or in close proximity to fellow students. Consider eliminating weigh-in policies for sports programs if they are not absolutely necessary.
  • Advocate for nutritious foods in school cafeterias and elimination of unhealthy foods and vending machines with unhealthy (junk) foods.
  • Consider offering a community outreach program on eating disorders with invited experts.
  • Review posters/books/materials in the school to ensure they include all body shapes, sizes, and racial groups.
  • Ensure that students of all sizes are encouraged to participate in school activities such as band, cheerleading, student government, theater groups, etc. Ensure that students are not typecast by appearance in drama roles.
  • The guide below is specific to girls, but includes information on how to assess how effectively a school promotes health, healthy body image, and healthy eating behaviors among students and staff: http://www.teacherscollegepress.com/pdfs/FOOschoolguide.pdf
Assist the student
  • If a student discloses a personal problem, consider the setting in which the disclosure has occurred. If it is during a class or other setting where others are present for example, practice protective interrupting. For example: Thank you for sharing that… I'd really like to follow this up with you after [class, recess, gym].
  • Be aware that a student who has divulged very personal concerns has chosen the particular teacher or staff person to divulge to for a reason. Acknowledge to the student how difficult disclosing personal concerns can be.
  • Ask the student with the eating disorder privately how he/she would like teachers (and others) to respond when asked about how the student is doing.
Assist fellow students of students with an eating disorder
  • When supporting the student's classmates, protect confidentiality and privacy by providing generic information about how to be supportive to a friend who is experiencing the eating disorder.
  • Remind friends that they are not responsible for their friend's eating disorder or recovery.
  • Encourage students' friends to continue usual activities with the person experiencing the eating disorder.
  • Consider the needs of the student's immediate friendship group. They may be feeling a loss in their friendship circle or confusion about how to relate to their friend.
  • Be mindful of other students' reactions to the eating disorder; for example, provide age-appropriate, selected information.
  • Support friends and fellow students by providing information and opportunities to talk about:
    • emotions they may be experiencing
    • coping with the changes in their friend (for example, behavioral and social changes such as increased agitation or social isolation)
    • strategies to support their friend
    • strategies to support themselves (taking time-out)
    • their responsibility as a friend (to provide friendship rather than to 'fix'' their friend)
    • the ineffectiveness of focusing on food, weight, or appearance with their friend
  • The friends of the student with an eating disorder can be supportive by learning basic information about eating disorders. Such information could be integrated into health education or lifestyle classes, if those classes are available for students.
Key Sources: Click here to see sample SAP student information form

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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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