Back-to-School Time and Eating Disorders

Struggling with eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) is hard enough. But the experience can be even more difficult while navigating the social and academic pressures of school.

A majority of people struggling with BN and AN experience their first symptoms while still teenagers, meaning their conditions develop while they’re starting college, finishing high school, or even navigating middle school. [1]

But understanding the risk factors—and options for help—that school brings to the picture can help you or a loved one better manage these scenarios and learn more about treatment.

Eating Disorder Risk Factors at School

School can be a stressful environment, even in the best of times. And for those struggling with an eating disorder—or at a higher risk of developing one—there can be some aspects of the educational experience that can be particularly triggering.

Stress

The way people deal with stress can have an impact on their chances of developing disordered eating behaviors. Stress at school can come from many areas, including pressure to get good grades, complete assignments, keep up with friends and social activities, or feel the need to “fit in.”

Certain types of coping mechanisms, which are established through a combination of environmental and genetic factors, have been more closely associated with eating disorder symptoms, including both disordered eating habits and distorted body image. [2,3]

A tendency toward overcompensatory coping mechanisms, when a person tries to “make up” for perceived shortcomings by focusing on perceived strengths, and avoidant coping mechanisms, when a person tries to actively avoid or deny negative experiences, have been particularly tied to the maintenance of common eating disorders. [3]

People who utilize surrender-style coping mechanisms, where they come to accept poor treatment or emotionally detach to deal with it, are also at an elevated risk. [3]

Social Influences

While eating disorders are increasingly being found to have genetic and biological causes, environmental factors can still play a role in their development or maintenance.

Negative peer pressure within a friend or social group has been connected with a higher risk for developing disordered eating behaviors, especially among adolescents and especially among girls. [4]

Weight-related teasing, in particular, was found to have a strong connection to developing eating disorders, along with “likability,” or the idea that being thin will help students be more well-liked. [4]

Sports

Many studies have also found student-athletes to be particularly vulnerable to eating disorders. One analysis found that as many as 22.7% of student-athlete participants were considered at risk for developing an eating disorder. [5]

Still, other analyses have shown that certain sports or types of sports may be especially dangerous, especially those that focus on achieving a certain body weight, such as wrestling, or those that favor athletes with certain body types, such as gymnastics or dancing. [6]

Athletes have also been shown to be at higher risk for exercise dependency, which is associated with many eating disorders. [5] Aside from the training needed for their particular sport, athletes may use excessive exercise to lose weight, gain weight, or otherwise work to achieve a specific body type.

How Can an Eating Disorder Affect School Performance?

Whether someone is struggling with a restrictive food intake disorder, where they eat less than their body needs or a disorder that involves eating more than what their body needs, the behavior can lead to malnutrition. The issue can have many consequences on academic performance.

Nutritional deficiencies have been tied to: [7]

• Impaired academic achievement
• Issues with cognitive development
• Neurodevelopmental problems

Many people associate malnutrition with people in lower-weight bodies, but the sickness can happen in people of all body weights, shapes, and sizes. It simply means that the body is not getting enough of the nutrients it needs, and even when people are experiencing binge eating, they may not be eating healthy or nutritionally balanced foods.

The mental fixation on body weight, appearance, food, and eating that’s involved in most eating disorders can also distract someone from schoolwork or other aspects of school. Eating disorders are also frequently tied to mood disorders—especially depression—which can interfere with someone’s performance at school. [8]

Eating Disorder Warning Signs

Eating disorders are dangerous and potentially even deadly mental health conditions, and the pressures of school may trigger their symptoms.

If you or a loved one are experiencing these thoughts or behaviors, it may be time to seek out help: [9]

• Frequently fluctuating weight, including weight loss or weight gain
• Intense fear of gaining weight
• Fixation on food, eating, or nutrition
• Distorted body image (usually believing one is in a larger body than they are)
• Sense of self-worth that’s strongly tied to physical appearance
• Strange rituals around food or eating
• Avoiding events or situations that involve food
• Social isolation or withdrawal
• Frequently leaving directly after a meal, especially to go to the bathroom
• An extreme or rigid workout schedule, which doesn’t change even with injury or illness
• An extreme or rigid eating schedule

How to Find Help for Eating Disorders

If you or a loved one are struggling with an eating disorder, it’s important to seek out treatment. Asking for help can feel scary or intimidating, but there are a number of resources that are designed to help those with AN, BN, BED, and other eating disorders get the treatment they need.

If you’re at school, you can speak to your guidance counselor, school nurse, or a trusted teacher about your concerns. Some schools, especially colleges and universities, also offer on-campus help centers specifically for eating disorders or may employ an eating disorder specialist.

Several eating disorder hotlines also exist, allowing callers to anonymously seek information about eating disorders, nearby treatment options, and more. You can also consult your primary care physician or therapist, as these experts can give you an official diagnosis or help you determine your next best steps.

But regardless of where you look for help, the most important thing is seeking it. It’s often the first step on the road to recovery.

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Updated August 12, 2024.