For all of you who are going back to school – middle school, high school, college – there are some challenges that you may face. You want to be “armed” for these challenges and not let them hurt your recovery. For those of you who are parents of children, adolescents, or young adults with eating disorders, the following information will be helpful for you as well.
Summer, for many individuals, is a time of less structure, less pressure, and less exposure to the stress from peers. For students, it may involve a summer job, camp, vacation, a summer class or two, or just relaxing with friends and family. Then, toward the end of August and the beginning of September, all that swiftly changes. Academic and social pressures begin again. Perhaps there is a change of school entirely, such as the change from middle school to high school, or high school to college. College students may leave home for the first time or begin living in an apartment, dorm, fraternity or sorority house.
Whichever the case is, transition back to school is a time of challenges for many students. It is especially challenging for those with eating disorders.
Structure, on the one hand, is very good for people with eating disorders. Getting back to the structure of a school day where there are specific times for specific academic and extracurricular activities, can be very comforting. The distractions that school provides, as well as the focus on new subjects, sports, and other skills, can also take the focus off the eating disorder and provide the sufferer with some relief.
On the other hand, going back to school can elicit some unforeseen stressors that can exacerbate an existing eating disorder. First and foremost, the anticipation of school (or leaving home to go away to college) will undoubtedly create anxiety. The fear of the unknown is a powerful source of anxiety. Social anxiety can also escalate. Anxiety can also relate to academics, lockers, teachers, making friends, and living arrangements (at college). And, of course, there is tremendous anxiety related to body image, clothing, and food. I’ll highlight some of the specific stressors in my next few posts, and try to offer some solutions. Ultimately, it is important to be acutely aware that “back to school” time is a transition that individuals with eating disorders may struggle with. The issues are very real and must be handled with care and sensitivity.
The first topic I will discuss is “the lunch table” at school.
A number of my student clients are fearful of the lunch table. If you are a parent, you may be thinking “What types of stress could the lunch table create?”
Stressors that middle school and high school clients experience at the lunch table are:
- What should they put their lunch in – paper bag or lunch box (more typical in middle school)? Believe it or not, this decision causes an enormous amount of stress. They fear that if they put their lunch in the “wrong” container, they will get made fun of.
- Should they bring lunch, or buy lunch? This decision is stressful because they want to feel comfortable with what they eat for lunch, yet if their friends are buying lunch, they want to fit in. Also, there are usually lines of students waiting to buy lunch. Standing on line may be uncomfortable for the eating disordered student, as well as waiting on line creates a shorter amount of actual eating time. This can be challenging for the student who takes a bit longer to eat.
- If they bring lunch, what should it be and how much should they bring? Many individuals in recovery are on a meal plan that requires specific amounts of food that must be eaten at each meal. There is an enormous amount of conversation that occurs at the lunch table regarding what everyone eats. When a student eats anything that appears “different” in the eyes of anyone else at the lunch table, there is the potential for unwelcomed attention on the sufferer and their food choices. This is especially challenging when the sufferer is eating “more” than the others at the table.
- For female students especially, there is excessive “diet talk” at the lunch table. Comments such as “I am not eating carbs anymore.” Or “I only eat XX amount of calories a day.” Or “I have to lose XX pounds by Thanksgiving.” Or “I only eat pretzels at lunch.” This talk can trigger someone with an eating disorder, even when they are doing well.
- During the first few days of school, one of the biggest stressors my student clients experience regarding the lunch table is “where do I sit?” When an individual with an eating disorder has social anxiety and/or has only a few friends, and there is no comfortable person for him/her to sit with at lunch, he/she may experience an enormous amount of anxiety and may try to skip the lunch room altogether.
What are the ways to cope with these lunch table stressors?
- As far as the container you bring your food in, for the first few days, bring it in a paper bag (unless you know that the other students are using lunch boxes). Look around and see what everyone else brings their lunch in, and then you can re-assess whether the bag is the best choice or a lunch box. I’ve never heard of anyone getting teased about bringing lunch in a plain brown bag. Remember though, if you don’t have an ice pack in the bag, you shouldn’t bring anything that is perishable (lunch meats, fish, dairy, etc).
- Regarding bringing or buying lunch is concerned, keep your recovery at the top of your priority list when making this decision. If you feel most comfortable bringing lunch in order to meet your recovery goals, then bring lunch. As time goes by, and you can see what is on the school lunch menu, and you have seen how long it takes other students to get their lunch, then you can decide if you want to change your mind and buy lunch.
- You need to bring to lunch the amount of food that will carry you through until the next time you can eat (after school snack), or the amount of food that you and your treatment team have deemed necessary for your recovery. If you bring too little, you may struggle later, as you will be too hungry. This is true, no matter what type of eating disorder you have. In terms of what to bring for lunch, you want to bring the types of food that meet your nutritional requirements and foods that you like. If you need a supplement at lunch, you can bring it in a sports-type of bottle so that it appears like a sports drink. Try to bring foods that are “common” so as not to draw attention to your eating. I want to add here, that I understand this advice may cause some controversy. I’d love to say to my student clients to bring whatever they want to the lunch room regardless of what anyone might say, but I also want to protect them from any unwanted attention and comments. I had a male middle school client who brought tuna for lunch once and everyone at the table said “Ewww! That smells!” He threw his lunch away and ate none of it. A female high school client brought stuffed grape leaves to lunch and the others at the table commented on how “gross” they looked. She didn’t eat them and was too uncomfortable to sit at the lunch table again. Instead she ate in the nurse’s office. You have to bring foods you like, but if there are foods that are pretty common looking, you will go unnoticed. These might be foods like peanut butter and jelly sandwiches or other sandwiches, yogurt, cheese sticks, pretzels, fruit, cookies, salads with chicken and cheese, granola bars, etc.
- When other girls start talking about their diets, you can try your best to ignore the conversation, start a separate conversation with the person sitting next to you, or change the topic altogether. Try to sit next to a “safe” person that you can rely on to help you out. If you are being too triggered, find an excuse to leave the lunch table (and take your remaining food with you). Unfortunately, diet talk is a pastime for so many people. You will likely not be able to escape it very easily. Also, many teens “talk” about their latest and greatest diets, but most of them don’t act on them. You must do your best to tune the “diet talk” out. Remember, in recovery, you have to stay focused on your needs, not the behaviors of others.
- Get as much information as possible in advance of the first day of school about who you know that will be in your lunch period. Ask them to meet you outside the lunch room before lunch starts so you can walk in together. Ask them to sit next to you as well. If you don’t know who will be in your lunch period, try to find a fairly empty table and bring a book with you. If you have a book to read, you might feel a bit more comfortable. While you are sitting there, try to look around for someone you know and then move to their table if there are empty seats. If there is someone else in the lunch room that seems like they are sitting by him/herself, you could try sitting at that table. He/she might be relieved to have someone sit with him/her. Or, if you are feeling courageous, you might try to use the lunch period to meet new people and sit with people you don’t know.
Remember also to talk to your family, friends, and/or treatment team about the anxiety you might feel about “back to school”. They will surely understand and might offer some great support.
Stay tuned for more posts regarding “back to school.”
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