Eating Disorder Strategies

What it is

An area of student need involving a self-imposed restricted diet or refusal to eat and/or compensation actions after eating to avoid gaining weight or excessive eating.

Diagnosed conditions of eating disorders include:

Anorexia Nervosa: Self-restriction of calories leading to low body weight, impaired physical development and/or physical health and persistent behaviour to avoid weight gain, with intense fear of gaining weight and distorted body image.

Bulimia Nervosa: Recurrent episodes, at least once a week for three months, of binge eating (consuming very large amounts of food in a relatively short period of time), that feels “out of control” with inappropriate compensatory acts to prevent weight gain (vomiting, misuse of laxatives, diuretics, or other medications, fasting or excessive exercise).

Binge Eating Disorder: Recurrent episodes, at least once a week for three months, of binge eating without compensatory actions, but with three (or more) of the following: 1. Eating more quickly than normal. 2. Eating until uncomfortably full. 3. Eating large amounts when not feeling physically hungry. 4. Eating alone due to embarrassment of quantity. 5. Feelings of self disgust, depression or guilt after binging.

Other Specified Feeding or Eating Disorder: Atypical anorexia nervosa, bulimia nervosa and/or binge eating disorder if not all the criteria are met.

Strategies

• Develop a positive and warm rapport with the student.
• Avoid making comments on body image or appearance as these could be taken the wrong way.
• Normalize healthy eating as it comes up in classroom discussions.
• Be in frequent contact with parents and enlist of school supports (Child and Youth Worker, Social Worker, Counselor, etc.).
• Be flexible with work completion and memory, which can be negatively impacted by restricted food/starvation.
• Be aware of increased risk taking behaviours and report to parents and school team.
• In a private setting, discuss your concerns with the students in a supportive and non-punitive way. Ask the student for ways that you can help.
• Consider developing an IEP Alternative Program Plan and set goals with the student and IEP team.
• Consider the development of and IEP Transition Plan to help reduce stress.
• Consider the development of an IEP with Accommodations for any instructional, environmental and/or assessment accommodations that may be helpful to reduce stress from the student.
• Provide resources to the student and parent on eating disorders and counseling options (school and/or community).
• Teach media literacy, focusing on realistic body images.
• Supervise eating in communication/consultation with parents/guardians.
Teaching Strategies

Instructional

• Offer preferred students to partner with for group activities
• Reduce number of expectations
• Advance notice of changes to routine
• Provide 1:1 check in’s to ensure understanding of instructions
• Provide support to attain necessary resources for a task
• Provide examples/exemplars
• Provide prompts to being and stay on task
• Chunk tasks into parts
• Provide frequent positive feedback

Environmental

• Prearrange a safe location in the school for the student to go if/when feeling unable to eat in front of peers
• Offer preferred seating near supportive peers
• Allow to eat during class times
• Support healthy eating
• Monitor peer interactions to ensure positive comments on body image

Assessment

• Consult with parents/guardians and support staff on what is reasonable to expect from the student during this time
• Give advance notice for tests/assignments/presentations/projects
• Provide a study sheet/materials to prepare for assessment
• Reduce number of items/quantity to be assessed
• Prompts to return the student’s attention to the task
• Check in’s to ensure understanding of the questions/task
• Breaks during the assessment, allow student to eat
• Extended time limits
• Presentations made to just the teacher and/or small group instead of full class
• Use other methods of assessment that are less stressful to the student (oral discussion, project)



Resources
Student Needs IPRC Exceptionalites Diagnosed Conditions