School In Eating Disorder Recovery
At The Holistic ED Recovery Center, we specialize in youth eating disorder recovery and parent/caregiver support. This means that all of the clients we are supporting through eating disorder recovery are also navigating recovery at school.
Navigating eating disorder recovery while in school can pose many challenges, and recovery must come first. If we don’t have our health, we don’t have anything. Many individuals who struggle with eating disorders are also perfectionists and place a huge amount of emphasis on grades and performance. A lot of recovery resistance can stem from the fact that recovery is taking time away from school, that unpleasant refeeding symptoms (i.e. fullness, sweats, anxiety and fear) are taking focus away from school work, and that they simply “don’t have time” for recovery, meals and appointments. Keep in mind also, that many individuals in eating disorder recovery are not used to making space for meals and snacks during their day, and this will feel jarring perspectively to the time and space they have allotted for school work and other daily tasks. It will feel all consuming and that may create panic and worry about school and performance.
Eating disorder recovery is “top heavy”. There is a lot of support and appointments needed in the early phases of recovery as the individual and family is landing in the work, getting used to the frequency of appointments, the meal times and meal plans, and more. It is not uncommon to be seeing us multiple times per week for family team meetings, nutrition sessions, coaching sessions, naturopathic doctor appointments as needed, supervised meals and snacks, and also making regular weekly or bi weekly visits to your medical doctor. Intensive and comprehensive support is so important, AND keep in mind that everything is a phase. We support, contain, teach, guide …and then taper. So there will be ebb and flow from week to week and month to month. You will never be in more appointments and support than what is necessary at each moment and phase of your eating disorder recovery journey.
In that early and most intensive phase of recovery mentioned above, it may be very difficult to maintain a full course load, be in classes all day, focus on school, stay safe from symptoms when out of the house or not supervised by parents, and manage both recovery and school (both can feel very overwhelming and a lot all at once). Health and recovery must always come first. That is not to say that it is not possible for your child to do school and recovery at the same time. For some it will be just fine, for others they will need to take a break from school for a period of time, and some will fall somewhere in between. In the past year alone we have worked with some individuals who moved through their recovery while staying in school but coming home to be supervised by us for all meals and snacks, some who took a reduced course load (meaning they took less classes each term, and then also took a couple classes over the summer), some who took a semester fully off, and some who took a full course load but online instead of in school so that they could be home for meals and safe and supervised by parents. There is no one right answer or choice for everyone, but rather this is a personal decision for each and every individual/ family and one we help guide as your treatment team.
Factors to explore as you are making your decision:
Eating disorder symptoms that show up in the classroom:
Trouble focusing, brain fog, ADD/ADHD symptoms
Agitation and irritability
Fatigue
Extreme perfectionism or procrastination, all or nothing tendencies
Heightened stress and anxiety about grades, quality of work, applications, academic performance etc.
Poor time management (i.e. making no time for anything beyond school work OR making no time for school work/ being “frozen” about what needs to be done and then doing it until all hours of the night)
Social withdrawal
Heightened body image discomfort and challenges, stress and anxiety about appearance
Ways that school can trigger or worsen Eating Disorder symptoms:
Comparisons: appearance, academic performance, acceptances (i.e. college applications, scholarships, student counsel, etc.)
Bullying: cyberbullying (i.e. social media), appearance based bullying
Diet and body talk: peers, teachers, coaches
Irregular meal and snack times that may vary from day to day
Eating in social settings: potential food and body comments during meal times, discomfort eating in front of people as reason to skip meals, comparing your food and serving sizes to others
Demanding schedules, workload, academic pressures
Regardless of the severity of your child's eating disorder and symptoms, it is important that all eating disorders are treated as urgent and recovery prioritized. If we could tell you only one thing it would be to not wait. Don’t wait for symptoms to worsen and for the eating disorder to appear more severe before intervening more intensively. This is not something that just goes away on its own and early intervention can make a big difference to recovery outcomes. No matter the severity of your child’s eating disorder and symptoms, if school is getting in the way of recovery, triggering or worsening symptoms and mental health, and a factor in not getting more intensive treatment, then options should be explored with your family, your care team and/or medical team and the school. And the great news is that in the age of online everything, there are so many great options.
School options to explore while in eating disorder recovery:
Online courses
A private place for your child to have supervised meals while in school (ie the principal's office, etc.)
Reducing the course load
Taking some classes in person and some online
Summer school
Taking a semester off school
Seeking more academic support to alleviate pressure (i.e. more time for tests, extensions on some assignments, a private or quiet room to take tests, etc.)
The biggest concern we have heard vocalized by parents and caregivers around their child taking time off school is the mental health implications. The worry, understandably, is that time off school and away from peers will worsen mental health. In actuality, however, the risk of not getting care or adequate care or care of enough intensity is actually greater than the risk of taking time away from school. Remember that this is just a phase. This is a small moment in the big picture of time needed to get well. What is gained is time, not what is lost.
If you are a parent or caregiver of a school aged child struggling with an eating disorder, and are wondering what to do, how to support them best, and what next steps to take are… we are here! We offer free calls and truly encourage you to use this time to share, explore, ask questions and receive answers and support. No pressue, no obligations- if you need a place to land and ask questions and be guided on next steps, we encourage you to book a free call and connect.
