Returning to School After Eating Disorder Treatment: Helping Children & Teens Adjust

Children and teens with eating disorders may need to take time away from school so they can focus on eating disorder treatment and recovery. This can be a very difficult decision, both for the child and for the child's family/support system. Many parents and caregivers wonder if taking the child out of school is the right thing to do. By working closely with the treatment team, the family can determine what will work best to help the child get the care they need.

Can't my child stay in school?

Removing a child or teen from the school setting can be a painful decision, particularly when the child is excelling in academics, involved in clubs or activities, or if school-based social relationships are helping the child. The reality is that, sometimes, it is important to step away - temporarily - from the stressors and social pressures associated with school. The reason? We can best heal when we focus all of our attention and energy on eating disorder recovery.

All child and adolescent patients at Eating Recovery Center work with educational specialists regularly while in treatment. Learn more about our approach to educational support here. Supporting families and young patients, our educational specialists provide help with:

• Homework
• Support for 504 accommodations and related issues
• Communication with teachers and administrators at school, and more

Is the child doing well at school?

When it comes to eating disorders, we find that some young people aren't functioning very well in the school environment, after all. Eating disorders are associated with a number of symptoms that can make it hard to thrive in school. Eating disorder symptoms related to school include:

• Having trouble concentrating
• Feeling tired
• Perfectionist tendencies
• Social withdrawal
• School refusal

But what about the child who has made a great deal of progress in treatment and appears to be ready to return to the school setting? This can be a challenging and confusing time for families and students as they evaluate when and how to return to school after eating disorder treatment.

Families can consider a number of the following questions and strategies when making the decision to return to school.

Is the child ready to return to school?

This is one of the most important questions — and the first question that families might ask themselves and their treatment team. Some of the important signs that a child or adolescent may be ready to return to school include the following:

• They are completing meals regularly with minimal or no prompting or support
• They have demonstrated the ability to use skills to avoid engaging in behaviors like purging or compulsive exercise
• They are demonstrating increased honesty and openness about eating disorder behaviors and urges
• Their ability to concentrate has returned, and they are not consumed with eating disorder-related thoughts most of the time
• Their ability to tolerate changes in schedule, available food options, and other unexpected events allows them to make flexible adjustments when needed

Who will support the child when they return to school?

It’s important to connect with the student’s school counselor and other support staff to ensure that they are aware of your child’s specific challenges. It can be helpful for your student to know that at least one adult at school will be a helpful resource should challenges arise.

Before your child returns to school, discuss the best way to approach the counselors and support staff. You’ll also want to decide if, and how, you want your child to contact you during the day, if needed.

If your child is a patient at Eating Recovery Center, we will also be part of the support system in helping the child return to school. Our educational specialists will be here to work with you and can act as a liaison.

Who will oversee the child’s nutrition at school?

The transition back to the school environment can be challenging. New situations, relationships, and food choices abound. Let's say your child has been in treatment for anorexia or another eating disorder. It can be helpful, well ahead of the transition, to decide how nutrition will be managed. This can help your child prevent challenges from escalating. Some possible strategies include:

• Eating with a school staff member, perhaps having meals in a counselor or nurse’s office with supervision
• Sharing meals with a parent during the early days of reintegration
• Eating with peers and using other strategies to assist in accountability, like looking for signs of anorexia behaviors in the school setting (these can be identified with help from the treatment team and family members)

The type of support that is best for your child will depend on a combination of their individual challenges and the available options.

Is it possible for the child to return to school slowly?

Whenever possible, help your children acclimate slowly to the school environment. Consider the following as you prepare for the return to school:

1. Start by attending a few hours of school in the morning.
2. Go home for lunch.
3. Check in with your treatment team later that day.

By starting with half days, the student has the opportunity to get their feet wet in readjusting to the (many) stressors of school, without needing to stress about meals at school.

Next, the student can attend the school day through lunch and then check in with the treatment team. Over time, you can gradually increase exposure to the various challenges the school day provides with an ample amount of support, structure, and monitoring. 

Can the child participate in extra-curricular activities?

Reintegration into school doesn’t necessarily mean that your child is ready to be back, full throttle, in the pace of an average student’s life. Families and caregivers need to carefully consider if their child will be participating in activities outside of school. If you are facing this decision, consider the following:

• How well is your child balancing his/her nutritional and psychological needs with the adjustment to school?
• Is your child able to complete their school work without becoming overwhelmed?
• Is your child physically ready to engage in activities?

When it comes to participation in sports or other more physically engaging activities, families need to even more carefully consider readiness and are encouraged to consult with their child’s treatment team. Prerequisites for engagement in physical activities include a period of stability in weight, vitals, and other physical markers of well-being (e.g. if menses has returned).

Final thoughts

It is understandable that school reintegration can feel like an overwhelming process to all involved. But, with thoughtful consideration and regular consultation with your child’s treatment team, it can be a rewarding opportunity for your child to build back a life worth living. Please let us know if you have any questions or would like to learn more about educational support with eating disorder treatment. Call 866-622-5914 to learn more.

Read These Next:

• Can My Child Stay in School While in Eating Disorder Treatment?
• Your Child's First Week Home After Treatment
• Eating Disorders and Summer Camp: Making the Tough Decision
• How Eating Disorders Affect Families: Steps for Self-Care
• Educational Support at Eating Recovery Center: A Guide for Families