What Health Class Left Out: It’s Time to Talk About Eating Disorders in Sex Ed
Imagine sitting through lesson after lesson on contraception, sexually transmitted infections, and puberty — but never hearing that your mental health is just as vital as your physical health. Imagine never being told that hating your own body can hurt you as deeply as any infection and sometimes even more. This is the reality in most middle and high school health classes today: we are taught how to care for our bodies, but not how to live inside them. Sexual health education must include body image and eating disorders as an essential part of curricula.
When I was 19, I was diagnosed with anorexia. I was a college athlete at the time, feeling overwhelmed and consumed by thoughts about food, weight, and my body. When I was in middle and high school, I remember my health class vividly, where my friends and I uncomfortably learned about how to put a condom on a banana, all the different STIs we could get, how pregnancy happens, and the variety of birth control methods to choose from. I was fortunate to go to a New Jersey public school that cared about teaching these topics, but a lot was missing. One of those major missing pieces was mental health. It wasn’t until I was diagnosed with anorexia and several other mental illnesses at 19 that I finally realized the thoughts spinning through my head every moment of every day were not a universal experience.
So, other people aren’t always thinking about food? Other people don’t feel they need to control and count everything they eat? I was shocked.
I was able to make a full recovery, and turn my eating disorder experience into passion and drive. Then, I began asking hard questions: “Why didn’t I know about anorexia sooner?” “Why hadn’t anyone told me?” I felt angry that at 19, I was only just starting to learn and wanted to do more to change that for others. For me, education was the answer.
Education and discussions on body image, eating disorders, and mental health are a necessity in middle and high school health classes. They should be incorporated into all sex education curricula. As a sex educator, I see up close how most health classes discuss the bare minimum of information and are surface-level. Topics can vary widely and can include nutrition, exercise, drug and alcohol use, and sexual health. If there is sex and/or health education in schools, it tends to focus on abstinence, which is encouraging young people to not have sex at all. According to SIECUS, 30 states and the District of Columbia require sex education by law or by proxy via enforced state standards. Some students only get health class for a few weeks or less out of the entire year and that experience is negative — don’t do drugs, don’t have sex, and don’t eat food that’s “bad” for you. Young people are suffocated on all sides by the things they shouldn’t do. This is not an effective way to support our young people; they deserve more.
Education about eating disorders is often overlooked in the U.S. education system, which is exceedingly dangerous, given how common eating disorders and body image issues are among students.
According to Harvard School of Public Health, at least one in 10 people in the U.S. will be diagnosed with an eating disorder in their lifetime — that’s nearly 30 million people. Studies have also shown that approximately 50% of preadolescent girls and 30% of preadolescent boys dislike their bodies. LGBTQIA+ youth also see higher rates of disordered eating compared to their cisgender and heterosexual counterparts. Penn Medicine has determined that transgender and gender nonconforming individuals are at least four times as likely to struggle with an eating disorder than their cisgender peers.
A 2019 study found that Latine, Black/African American, and Asian American people are more likely to engage in disordered eating behaviors compared to their white counterparts. However, BIPOC are also less likely to receive a diagnosis and treatment. A specific study on Black women found that they are 25% less likely to be diagnosed with an eating disorder than white women when they have the same eating disorder behaviors. Furthermore, a 2018 study shows that by age five, children already express concerns about their weight and body shape. For too many, those concerns become lifelong struggles — and not all young people have equal access to help. As education continues to ignore these topics, societal messages seep in and are very hard to remove.
Body image and sexual health are strongly connected, and eating disorders deserve space in the standard sexual health curriculum.
Our bodies allow us not only to have sex, but also to be sexual if and when we choose. Our bodies change throughout our sexual lifespan. Many bodies may also experience the impacts of getting a sexually transmitted infection, using birth control, getting pregnant, and/or giving birth. Some people who experience sexual assault or intimate partner violence also experience eating disorders and body image struggles. According to the National Sexual Violence Resource Center (NSVRC), “controlling behaviors around food and exercise may suppress difficult emotions and provide a temporary sense of control” for victims and survivors.
To successfully integrate body image and eating disorder education into sexual health education, there is much work to be done. We have seen several US states working to include education on body image and preventing eating disorders. Just this year, in 2025, the state of New York introduced Senate Bill S5198, mandating that all schools incorporate age-appropriate instruction on eating disorder prevention into their health education programs for students in grades 6–12. However, more work must be done through advocacy and policy. We can all play a role and make our voices heard.
I am 25 now, and sometimes I think about how different my life would be if I had learned about eating disorders and body image in my middle and high school health classes. I wonder what could have changed had I known the warning signs, and had I known it was okay to ask for help when I saw them. I wonder if I could have shown my friends more compassion when they looked in the mirror and told me how much they hated how their stomachs looked in their new jeans. I wonder what the future could be for young people if we start to make these changes in our education systems now. Every young person deserves access to information about their bodies and their mental health, and to know their body is okay just the way it is. I don’t want to keep wondering what could have been, but instead, start creating what can be.
