Specific Considerations for Educators

Appearance-based bullying and bullying of any kind can lead to low self-esteem and body dissatisfaction – key predictors of eating disorder development. Seemingly “minor” teasing and throwaway comments about someone’s appearance can profoundly and negatively affect someone who is vulnerable to developing an eating disorder. These micro levels of discrimination and exclusion can perpetuate broader experiences of discrimination, oppression, and trauma, which only increase the risk of eating disorder development. 

Life transitions can be times of heightened stress, especially if someone is already struggling. For some people entering college or university, the challenges of living away from home are compounded with a high-pressure academic and social environment. Being away from family, familiar loved ones, and their existing support system can amplify isolation and stress. New friends may not notice the warning signs or know what to do. For those already receiving treatment, the transition can disrupt and prevent continuity of care as new providers may be introduced. Students experiencing economic insecurity may struggle to nourish themselves, especially if they have to cook for oneself, which takes time, energy, and money; they may feel the need to prioritize working part-time or skipping meals to make ends meet. Access to food can also be challenging; for example, school catering – for those with meal plans – may not offer enough “safe” foods. Fundamentally, as students embark on finding their identity, these environmental factors can all contribute to the development or exacerbation of an eating disorder. 

Here are some signs may become especially apparent in the school environment:

• Mood swings
• Obsessive and ritualistic behaviours around food
• Perfectionism (e.g., towards school work, extracurriculars, self-identity)
• Social isolation and/or wanting to eat alone
• Depression
• Anxiety
• Constant trips to the washroom
• Body-checking behaviours (e.g. mirror gazing)
• Fidgeting and difficulty staying seated
• Trouble with school, such as declining attendance, grades, and ability to concentrate during class
• Pale or sickly pallor
• Baggy clothes
• Lightheadedness and a tendency to fall (lack of balance)
• Weight fluctuations
• Wearing inappropriate clothing for the season (e.g. heavy clothing in the summer)

Some students may exhibit multiple signs which suggest further assessment and approaching the student with respectful curiosity may be warranted. Keep in mind that these signs do not necessarily indicate someone is affected by an eating disorder nor does an individual have to experience all of these in order to be impacted. Disordered eating commonly co-occurs with other mental health and neurological conditions, so staying vigilant about the student’s physical, emotional, and social well-being will be critical for early intervention. 

Restricted eating negatively affects cognitive functioning; ability to concentrate and skills like abstract and critical thinking may diminish or appear absent. Emotion regulation also becomes more challenging, and preoccupation with food, weight, or shape may lead to social withdrawal and avoidance. There is a lot of stigma and shame in the eating disorder experience; ensuring that the school environment and classroom are judgment-free spaces with a zero tolerance policy for discrimination and harassment can strengthen help-seeking.

• Speak with the student privately and in a confidential space, as they may feel attacked, cornered, or embarrassed in a group setting.
  
  
• Avoid solely focusing on physical and appearance-based changes. Express your concerns about their overall health and well-being. Use clear and simple language.
  • “I noticed you haven’t been hanging out with your friends as much lately and appear to be somewhat withdrawn.”
  • “You appear to be quite tired lately and your energy level seems to be lower than usual.”
    
    
• It is unhelpful to make judgemental comments, such as, “What you are doing to your body is not only harmful but stupid as well. You should know better.” Instead, reassure them that they have done nothing wrong and emphasize that you are not judging them.
  • “You’re not in trouble. I’m not judging you or blaming you. I am asking you these questions because I’m worried about you. I wanted to hear from your perspective and experience rather than make assumptions.”
    
    
• After sharing your concerns, give the student the opportunity to absorb and process your comments.
  • “I know this is a lot of information. I’m going to pause for a moment to let you take this all in.”
  • “There’s no pressure to make a decision or talk about next steps right now. You can think about this and we can come back in the afternoon to chat.”
    
    
• Ask for their thoughts, feelings and reactions.
  • “How do you feel about what I’ve said today?”
  • “Have you noticed any of the changes I’ve shared with you today?”
    
    
• Often, people with eating disorders are hesitant to change their behaviours. It can be easier to focus on some of the intersecting concerns and side effects of the eating disorder that they may be more willing to acknowledge and tackle (e.g., depression, social isolation, anxiety, insomnia, fatigue, feeling cold). This can open the door to conversation that can be connected to the eating disorder.
  
  
• You are not the student’s therapist or confidante. After the student shares their thoughts with you, explain to them that you are obliged to inform their parents and the school team (i.e. principal, health services, etc.) about your concerns.
  • It’s normal for the student to be afraid of what this change means. Reassure them that you’ll be with them throughout this process and that you can support them in preparing for a conversation with their family and/or the school team.
  • This might include letting them know about resources like NEDIC’s helpline services wherein they could learn more about treatment, possible changes to expect, how to express what’s working for them and what’s not, etc.
    
    
• Avoid arguing with the student if they deny that there is anything wrong. Be transparent about protocol and the steps you’ll take to ensure their safety. Gently encourage them to think about the conversation and what you, the school, or their family can do to help make this process as comfortable as possible.
  
  
• As a strong social network at school is an invaluable resource for a student who is healing from an eating disorder, prioritize their full recovery and communicate to them that if they need to miss school to receive treatment, you will help minimize disruptions. Students who value being in school may find it helpful to hear encouraging words that reinforce that treatment and focusing on their well-being will enable them to enjoy a positive school experience.

Young people under age 18 and receiving treatment for their eating disorder often have caregivers directly involved in their care. Consult any relevant school policies around supporting a student experiencing an illness and/or engage in a conversation with any school- or board-level supports (e.g., school leadership and administration, school counsellors, board social workers, mental health leads); this can be helpful in ensuring everyone involved at school is on the same page with supporting the affected student. In some instances, a student’s treatment team might provide information and resources that can help you meet the student’s new learning needs or accommodate changes in their physical strength and concentration. Check if it’s within the scope of the school team’s roles and capacity and communicate any need for additional family- or community-based support. For post-secondary students especially, faculty and staff may find it prudent to ensure the student has access to financial and/or housing support if needed. 

Suggestions for academic support:

• Modify the expectations for missed schoolwork. Focus on helping the student achieve only the essential learning outcomes.
• Encourage them to let their teachers know in advance about absences due to medical appointments. This helps ensure accommodations can be made with their workload and/or deadlines.
• Be flexible and compassionate when considering deadline extensions and assignment adaptations. Fighting an eating disorder is demanding, both emotionally and physically.
• Avoid exposing the student to curriculum content, activities, and discussions that draw attention to weight or body image as this may trigger eating disordered thoughts.

Suggestions for social/emotional support:

• Those with eating disorders tend to experience low self-esteem and to engage in unhelpful self-comparisons. Don’t make comments or comparisons about appearance or academic/athletic achievement. While well intended, even positive comments relating to these topics can trigger disordered thoughts and feelings.
• Normalize regular counselling appointments that they may have and check in with them periodically. This can help reduce anxiety relating to their recovery, and make it easier to ask for more support when they need it.
• Proactive measures must be in place to safeguard against bullying, harassment, and gossip. Students with an eating disorder likely already have experiences of discrimination and oppression. They are likely already worried about being dismissed or framed as someone who “just wants attention”. Perpetuation of these beliefs can be invalidating and make the eating disorder worse.
• For students returning after being absent for a significant period of time, it’s helpful to establish as much normalcy as possible. While expectations of educators may shift, such as providing adapted assignments or meal support, a student should be held to the same expectations for standards of behaviour as other students. For example, it is not helpful to make exceptions for certain behaviours, like making excessive, unnecessary trips to the washroom.

Remember that eating disorders also profoundly impact family members and friends supporting a loved one. Students who are caring for or supporting a sibling/family member/friend with an eating disorder may themselves experience difficulties functioning at school due to the stress, and may require additional psychosocial and academic support.

A whole-school approach focuses on optimizing the school environment and ranges from broader policy and curriculum considerations to supporting the interpersonal relations between students, educators, and caregivers. 

Some examples of policy and curriculum focused prevention-based strategies:

• Critically reflecting on access to food within the school and at home, as well as the language we use to talk about food (in studies, in cafeterias, etc.)
• Removing diet culture-fuelled and eating disorder-sensitive activities from curriculum (e.g. counting calories or tracking food/exercise regime for math/science/health studies, weighing students for physical education, etc.)
• Incorporating emotional literacy and building resilience into lesson plans for courses like media studies, health and physical education, drama and creative work, social studies, languages, etc.
• Enforcing zero-tolerance policy for bullying, harassment, and discrimination; and creating positive spaces (e.g., racialized, queer, neurodivergent, (dis)ability, etc.)
  
  

At NEDIC, we believe in the importance of collaborating with students, educators, caregivers, and parents to build understanding of body image, self-esteem, media literacy, body-based bullying, and constructive approaches to food. By targeting all elements of a school environment, this provides individuals with strategies to navigate conversations about weight, food, and shape both within the classroom and beyond. A whole-school approach to eating disorder prevention strives to disseminate community resources to better support students who may be struggling with eating disorders, disordered eating, and/or body image preoccupation. Overall, when students, teachers, caregivers, and parents are on the same page, we can create safer spaces for young people to learn and grow. Our mission is for young people to feel respected and accepted in all environments, with key values of body inclusivity, celebration, and embracement. 

NEDIC’s community education programming is delivered to over 20,000 people across Canada every year. Our vision is to have home, school, youth-facing, and healthcare environments that are body-inclusive, where people feel accepted and respected. Our sessions blend best practices in health and education policy to increase your confidence in navigating the vast array of information around food, weight, exercise, and health in a non-discriminatory manner. 

Visit our community education page for details about our programming for students, educators, support staff, and caregivers.

Beyond Images and Au dela de l'image are free, in-class self-esteem and body image curriculum available to Grades 4-8 educators across Canada. Now available in English and French, it includes lesson objectives and plans, contemporary mixed media examples, student worksheets, evaluation rubrics, and backgrounders/tip sheets. Visit here to learn more.