Better Learning Experiences

A Parent’s Perspective

This is part 3 of a three part interview series on eating disorders in schools. Sadie, a recent high school graduate (class of 2021), opened up about her experience of fighting a life threatening eating disorder while navigating school. Sadie suggested I speak with her mom, because she has a different and important perspective as well. Sadie was right; her mom offered great insight on working with the school and teachers as she helped Sadie flight her eating disorder. Here is our interview with Sadie’s mom. 

Question: Can you give us an overview of Sadie’s eating disorder during high school? 

Lara’s Answer: “The very intense struggle for Sadie began during her sophomore year. We noticed worrying behaviors that we later recognized as severe eating disorder behaviors, and she became severely malnourished, so much so that her brain was injured. It was life-threatening and very scary. She was diagnosed with an eating disorder, and in March of her sophomore year, it became clear that she needed to be pulled out of school to go into full-time, in-patient treatment because her eating disorder was only getting worse, and her life was at risk. She did not finish that school year; she stayed in treatment throughout the summer. 

Junior year was difficult. She had just gotten out of treatment, but there was a long road ahead of us. Sadie had doctors appointments, therapy appointments, and nutritionist appointments several times a week, which sometimes cut into school hours. She had to be supervised while she ate, she was picked up for lunch everyday. She had a reduced schedule that included only classes that were absolutely necessary. She took her math class online, so she could learn at her own pace. With a tremendous amount of effort and support Sadie made it through the whole school year. 

Senior year, Sadie had to play some catch-up with some of the classes she didn’t take the year prior. Sadie was continuing to heal and in stronger recovery as she began the school year. Sadie had a significant relapse midway through the year. It is not uncommon for people to relapse in their eating disorder recovery journey. Recovering from an eating disorder is never linear. It was a very difficult setback. We considered having Sadie return to residential treatment again, but ultimately, Sadie was able to stay in school. It was a very challenging time. Sadie needed a lot of support and she made it through, and graduated at the end of the school year.”

Question: Can you tell us about Sadie’s brain and capacity to learn as she was fighting her eating disorder? 

Lara’s Answer: “Sadie was having significant health consequences as a result of malnutrition. Her brain was damaged and was not working properly. She was constantly dizzy, nauseous, cold, and had extreme fatigue– when Sadie was picked up from school, she would fall asleep in the car within 15 seconds. She would speak, but her words didn’t make sense. She couldn’t remember things from one moment to the next. Her brain just stopped functioning. She was unable to put energy into anything academic. 

By coincidence, an appointment scheduled months prior to re-evaluate Sadie’s ADHD diagnosis as required for upcoming ACT and SAT testing occurred when she was very ill with the eating disorder.  The psychologist conducting the evaluation was the same who did her initial testing several years earlier.  He noted that even though he observed Sadie putting significant effort into the various tests, especially math computation, she could not arrive at the correct response. When the body is that malnourished, the brain is compromised. 

As we learned more about Sadie’s diagnosis and the effects of starvation, we were told to expect the healing process of the brain to take a couple of years with good nutrition.  We’ve also learned when teens and younger children have an eating disorder there are often developmental delays.  They can and will catch up developmentally, but it takes time and recovery.” 

Question: What did teachers and administration do that made things easier for Sadie? 

Lara’s Answer: “Sadie’s teachers, guidance counselor and the school administration were so, so wonderful and amazing. They were compassionate and made it clear that they wanted Sadie’s focus to be on recovery and they would support her recovery.  They were compassionate and supportive when Sadie had to leave school several weeks before the end of the school year for residential treatment out of state as a sophomore. They created a reduced schedule during her junior year that was unconventional but exactly what Sadie needed and continued to be supportive throughout her senior year. 

Her teachers were sensitive to the situation when talking to Sadie about academics; they led with the positives, acknowledged her effort, and were tactful and compassionate when suggesting ways to improve. It was empowering for Sadie. It was incredibly helpful that her teachers were not adversarial when she was struggling or needing accommodations. They trusted us and were very understanding when we asked for time off, extra help, and schedule changes.

We were able to work together for what was best for Sadie and I will forever be grateful to them.”

What tips do you have for educators who are working with students with eating disorders? 

Lara’s Answer: “First, eating disorders are a complex brain based disorder with a genetic component. Developing an eating disorder is not a choice.  Every teacher will have students who are  genetically predisposed to developing an eating disorder. You don’t know which students are predisposed, or who is already on their way to developing an eating disorder. So, all of this advice could really be applied to all students because eating disorders occur in all socio-economic levels, all races, genders, body types, sexuality and ages.

Eliminate all diet talk and all exercise talk when you are around your students. Comments like, “I can’t believe I just ate all that!” or  “I’ll have to run this off later,” or “I deserve to eat this!!” or “How many calories are in this?” or “This cookie is going straight to my thighs!” and “You’re lucky you can eat whatever you want!” are picked up by students. These types of comments are so harmful to students with eating disorders, and can even push genetically predisposed students into developing an eating disorder. 

Teacher’s should completely avoid commenting on what a student is eating, even in a joking way. No attention at all. Someone with an eating disorder or someone predisposed to develop an eating disorder will always hear the message in a way that is harmful, even life threatening. 

Food is medicine for students with eating disorders. Even if you mean no harm, well intended comments or attempted jokes are not appropriate or supportive.

Don’t talk about food habits and calories in class or with other faculty when students are in the vicinity.  In my experience, too often when people find out Sadie has an eating disorder, they like to talk about their own food habits, body, or insecurities and end up making comments that are harmful. 

Be mindful when a student experiences a drop in their grades or performance in class. That can be an indicator that something is going on. 

It was extremely helpful to have Sadie’s  guidance counselor as our point person to coordinate school support and accommodations.  We kept in regular contact and we gave approval for her to be in contact with Sadie’s therapist, dietician, and physician. This way, I didn’t have to have the same conversations with each teacher and senior administrators. It worked very well for us, and it may work well for other families and schools, too. Sadie’s guidance counselor seamlessly coordinated everything on the school’s end.”

Making Changes in Schools 

This is Part 2 of a three part interview series on eating disorders in schools. Sadie, a recent high school graduate (class of 2021), agreed to be interviewed on her experience with battling a life threatening eating disorder while she was attending high school. 

Eating disorders are the deadliest mental illnesses, second only to opioid overdose. Eating disorders are common, especially in the middle school, high school, and college age group. Teachers and other school staff are typically not specifically trained on how to approach or help students with eating disorders, but it’s very important to understand how we can help our students who are struggling with eating disorders. 

Sadie offers insight on how schools can help support students with eating disorders based on their personal experience. 

Question: What are the most helpful things your teachers did when you were struggling with your eating disorder? 

Sadie’s Answer: “I had to be pulled out of school to go into full time treatment for several months. When that happened, my teachers basically said, “I’ll take this stress away,” and excused me from my assignments. My school averaged my first semester grades with my current second semester grades and then froze my GPA, so nothing after that point counted towards my final grades. I could go into treatment without the extra burden of trying to work through school as well as fighting my eating disorder. I felt very seen because I was on an unfamiliar road, and it would have been way too much to be going into treatment and also doing exams and final projects.”

Question: Did anything your teachers said or did make things harder for you, in terms of your eating disorder? 

Sadie’s Answer: “I had a class in middle school called Changes and Choices, and one of the things we talked about was nutrition and health. It was focused on the negatives of food, and warning us against certain foods. I didn’t get nearly enough information to understand food the way I understand it now: food is fuel. All food is fuel. My teacher made a lot of comments about “good” food and “bad” food, and told us that we should all “eat healthy,” and told us never to eat cookies from the cafeteria. I have vivid, strong memories about comments like that and they stick with me. Everytime I went to get a cookie, I would hear her words always following me and influencing me. If I trace it back, that was when my eating disorder thoughts began. Small comments make a huge difference.”

Question: What advice do you have for teachers as they are talking to and teaching their students? 

Sadie’s Answer: “Be very careful with your words– they will stick with your students with eating disorders long after you say it. Either say nothing at all when it comes to food and bodies, or comment ONLY food positivity and body positivity. Food positivity is knowing that there are no “good” foods or “bad” foods– food is fuel to keep your body running. Keep to yourself about other people’s food choices– people can take comments the wrong way. “Food policing” (commenting about other people’s food choices) is inappropriate. Telling students never to eat cookies from the cafeteria is an example of that. 

This also includes teachers making comments about their own food choices and habits. I had a teacher who was very into working out, and talked a lot about her habits when it came to food and exercise. Maybe keep those comments to yourself. Students are listening and negative talk about yourself and your food choices might follow them.”

Question: What if a teacher is in charge of teaching a health class or nutrition class? What advice would you give them? 

Sadie’s Answer: “I had classes about calories, how much you should eat, and the various types of  “good” and “bad” foods. That was not helpful. It was harmful. Instead, you could teach your students that your body needs fuel to function. When you see food as fuel, your relationship with food slowly gets better; once you stop seeing food as “good” food vs. “bad” food, and you see that food is just food, you’ll have a healthier relationship with it. Food fuels your brain, your liver, your kidneys…everything! We all need fuel. Keep food talk neutral– just “your body breaks down food molecules to use as energy.” Teaching food and nutrition from that perspective would make a big difference.”

What changes could schools make to create a more positive environment for students with eating disorders? 

Sadie’s Answer: “Full body bathroom mirrors are hard. Sometimes people with body dysmorphia look at themselves and feel disgusted. You don’t want to feel like that at school, or ever. Also, sometimes I would go to the bathroom to purge, and I’d lock the main door to the bathroom so no one else could come in and hear. I know you can’t take the lock off the main door to the bathroom, but having an adult standing by the door would make it a lot harder to lock it and throw up in the bathroom. Also, taking down any posters in the cafeteria or gym that denote food as “good” and “bad.” Be mindful of what you put up on the walls. 

Also, lunch can be difficult. It would be nice to have an optional separate lunch space– a classroom would work great– for people who have eating disorders, supervised by someone who truly understands eating disorders. Maybe someone who had an eating disorder themselves, or has a child with an eating disorder, or is specifically trained in eating disorders. That person could lead a lunch group and help everyone take their mind off eating by playing games that make you use your brain. Thinking games help because they force you to stop overthinking your meal and think about something else. The supervisor should limit any talk of food– ESPECIALLY negative food talk. It would be a good escape from the stress of the cafeteria.” 

Thank you, Sadie, for the helpful insight on how schools can become safer places for students with eating disorders!

Part 1: Understanding Students with Eating Disorders

Some of your students, right now, have an eating disorder. Even more of your students have dangerous food habits. And most of your students have body image issues. These are facts, based on national statistics in the United States. 

9 out of every 100 people will have an eating disorder in their lifetime. 42% of first grade girls want to be thinner. 81% of ten year olds (both boys and girls) are afraid of being “fat.” 46% of 9-11 year olds are “on diets.” 35-57% of adolescent girls have been involved in crash dieting, fasting, self-induced vomiting, or laxatives. 91% of young women in universities attempt to control their weight with dieting. Whether we see it or not, eating disorders and disordered eating is all around us in our classrooms. 

To get a better idea of what it’s like to navigate school while struggling with an eating disorder, I interviewed a recent high school graduate named Sadie (class of 2021) on her experience with going to school while battling a life threatening eating disorder. 

Question: What is an eating disorder? 

Sadie’s Answer: “It’s an unhealthy obsession with food. It’s using food to cope with how you are feeling. You cannot control all of the things in your life, but you can control what you eat, how you exercise and have control over your body. I want to emphasize the “control” aspect of eating disorders. Lots of people with eating disorders are perfectionists and it’s very important to them to have control over their bodies, their eating, and their habits.”

Question: What is it like to battle an eating disorder? 

Sadie’s Answer: “The only word I can think of is AWFUL. I wouldn’t wish it on my worst enemy. It’s awful. It has so much control over you, and even if you really, really want to get help, you feel like you can’t, you’re trapped. It’s like being in one of those soundproof foam rooms, and the people you love are right outside. You are looking for the door to get out, but you can’t find it. And maybe you even find the door but there is no doorknob. Or you finally find the door and the door knob but it’s locked and you don’t have the key. Trying to recover feels like that. At the end of each day, you are just so tired. You face your biggest fear six times a day (eating), and you’re also trying to navigate the world and school while you do it. Eating disorders are addictive, and it’s exhausting to move away from it.”

Question: Describe your school experience as you juggled your eating disorder and schoolwork. 

Sadie’s Answer: “Basically there was no school experience– my eating disorder messed with my memory. I went to Chile on a school trip, but I can’t remember it other than what I ate. It was hard to even try at school because I was so preoccupied by my eating disorder because nothing else mattered to me when I was very sick. 

I took chemistry when I was the most sick– it was so hard, I barely passed the class. My chemistry class was sometimes right before or right after lunch, which meant that I would have urges to workout, run, or purge throughout class. It was hard to focus on learning chemistry. In other classes, I would read cookbooks and look at pictures of food on my computer. It was incredibly difficult to think about anything else other than food.”

Question: What was it like to take a test while you were sick? 

Sadie’s Answer: “I had a science test one morning that I really tried to study and prepare for. Before school, I had to eat breakfast (something that is very hard). I had oatmeal, but I was so anxious about it that I threw it up in the car. It got all over me. I told my teacher that I had a hard morning and I asked to take the test at another time, but I was told I had to take the test that class period. I felt awful taking the test, and I couldn’t focus at all. I smelled bad, I was trying to comprend breakfast, thinking “I ate so much” and “I didn’t need to eat that much,” and “I have to eat lunch soon, now I am anxious about both meals,” and all the while I am trying to take my science test. It’s really hard.” 

Question: What do you wish your teachers knew when you were very sick with your eating disorder in high school? 

Sadie’s Answer: “I wish they knew that I was trying my best. I knew I was trying my best, but I couldn’t do my best. All of my energy was going into my eating disorder and my behaviors. I really wanted to keep my grades up and I really wanted to be a good student, I just didn’t have the tools or the energy to do that at the time. I was going through something so hard, but I worried my teachers just thought I was lazy. I was trying my best.”

How did your teachers and school respond when they were told about your eating disorder? 

Sadie’s Answer: “Before we even told anyone at school, one of my teachers emailed my mom. He said “Sadie is going through something, and I can tell that something is wrong. I think something might be going on.” I remember that. I appreciated it because it went beyond a quick conversation in the hallway and never followed up. He saw that I was really struggling and reached out to help. Actually, most of my teachers were willing to work with me and take things off my plate, especially when I left school to go to treatment. I wasn’t able to do anything other than fight my eating disorder, so that was really helpful.”

Thank you, Sadie, for the eye-opening insight on what it’s like to be a student with an eating disorder at school. Teachers are always trying to better understand our students, and Sadie’s story can help all educators as they teach, help, and support their students with eating disorders.