Five Steps of Public School Eating Disorder Accommodations for Your Child
You’re doing everything you can to help your child: attending therapy, consulting with health professionals, making safe foods available, asking your family to stop commenting about body size, getting rid of the scale, and now there’s one big hurdle left: the school.
Public school in the United States includes health and physical fitness education. Unfortunately in some states that can include requirements like being weighed during gym class, assignments to keep a food journal of calories for health class, and being given a Body Mass Index (BMI) “report card” alongside academic grades.
To find out if your state does this, type into a search engine the name of your state and “school BMI requirements” or “student weight reporting.” For example, “West Virginia school BMI requirements” or “New York student weight reporting.”
Even if you live in a state without these criteria, attending public school can be a hotbed of eating disorder triggers. Here are five steps you can take to protect your child.
Talk to your child’s healthcare team
Make a list of accommodations
Prepare for the 504 Plan process
Meet with the school
Advocate when things go wrong
Step One: Talk to Your Child’s Healthcare Team
This is the first step because when you contact the school, they often will ask if you’ve already talked to your child’s healthcare team.
You may also live in a state or school district that requires medical documentation for certain types of health or academic accommodations so you will need to start with the healthcare team first.
Contact your child’s doctor or therapist and say:
“I’m requesting eating disorder accommodations for [child name] at their school. Have you ever had a patient go through that process before? If yes, do you have any recommendations?”
A local provider may have knowledge of who specifically at that school or school district office you should contact, what community resources are available, or suggestions for your specific child’s needs.
Step Two: Make a List of Accommodations
An accommodation is a modification or adjustment that will allow your child to attend school while protecting their recovery process. For example, if your child needs to carry safe foods at all times but their school doesn’t allow backpacks out at lunchtime, getting an exception to that rule would be an accommodation.
Not every child with an eating disorder will require every possible eating disorder recovery accommodation. The following list is a small sample of the numerous possibilities that exist.
Time off during school hours for therapy or medical appointments
Later start in the morning to allow more time for breakfast at home
Going to the lunchroom early to get through the line first
Leaving class to go call their parent/guardian as needed
Carrying safe snacks or being allowed to leave class to get a snack
Having a longer lunch period to allow more time to eat
Eating lunch with adult supervision such as the school nurse
Access to their cell phone to use a meal plan monitoring app
Teachers made aware of potentially triggering language like, “You look like you’ve lost weight!” or “You look much better today.”
Released from participating in Physical Education (PE) classes due to fatigue, dizziness, upset stomach, or other symptoms
Alternative classwork or homework to avoid assignments that involve calorie counting, logging meals, “good” or “bad” foods, being evaluated based on appearance, body size, food based activities, etc.
Extensions or exemptions on assignments due to missing school
Depending on your child’s age, you can involve them in this process. Write down what you think would be helpful and then say:
“I’ve made a list of possible ways we can make school easier for you. Would you read through it with me and tell me what you think?”
Step Three: Prepare for the 504 Plan Process
To implement and protect your child’s accommodations at a public school, you will need a 504 Plan.
Section 504 of the Rehabilitation Act of 1973 is a federal civil rights law that prohibits discrimination on the basis of disability in programs or activities that receive federal funding. Currently that includes virtually all public schools in the United States.
A disability is defined by the Americans with Disabilities Act (ADA) of 1990 as having a physical or mental impairment that substantially limits one or more major life activities.
Major life activities can include eating, learning, concentrating, thinking, caring for oneself, major bodily functions, and more. That is a long way to say: an eating disorder can qualify as a disability and your child’s right to an equal education is protected by federal law.
Because this is a legal process, you need to be prepared. Type into a search engine the name of your school district and 504 Plan. For example, “Washington County School District 504 Plan” in Utah brings up this page with forms and resources in English and Spanish.
Unfortunately not every school district is well organized online. You may need to contact your school district's 504 coordinator or your state’s board of education for more information.
Step Four: Meet with the School
Contact your child’s school and say:
“I’m requesting disability accommodations for my child with an eating disorder. Who do I need to speak to get the 504 Plan process started?”
Generally what happens next is a bunch of meetings and paperwork.
A group of people who know your student will be assembled into a 504 Team. This may include school administrators, counselors, 504 coordinators, teachers, school nurses, parents/guardians, and occasionally medical professionals or lawyers.
Going into that meeting with your child’s healthcare team on your side, a list of accommodations your child needs, and a knowledge of what your child’s legal rights are under Section 504 will be immensely helpful for the evaluation process.
Regrettably, whether or not getting your child a 504 Plan is easy or adversarial depends a lot who works for your specific school. There might be people who don’t think eating disorders are real, don’t believe your child needs certain accommodations, or are just overall unpleasant. Or they could all be absolutely lovely and supportive! If you know anyone local who has already gone through the 504 Plan process at your school, even if it’s not for eating disorder accommodations, talking to them will help you know what to expect in your situation.
Step Five: Advocate When Things Go Wrong
Now that all the meetings are over and the paperwork is complete, there is one final step: prepare yourself and your child for when things go wrong.
Your child might be exempt from food-based activities in their 504 Plan but their health class homework is to keep a food log for the week. What happens then!?
I’m Kami Orange and I’m a boundary coach with over 19 years of experience helping people say how they feel, ask for what they want, and set boundaries. My specialty is boundary phrases to help you prepare to say the thing in the moment it needs to be said.
The secret is figuring out before that moment what you want to say. Because the moment WILL happen when your child needs to self-advocate or you need to advocate for them.
Help your child memorize, practice, and use phrases like:
I need to go to the office now and call my mom.
I don’t feel good; I need to go see the school nurse.
I’m not okay. Will you please call my guardian for me?
I can’t do that. It’s in my 504 Plan. What should I do instead?
I have a 504 so I need [whatever their accommodation is, like ‘to leave early for lunch’].
You as the parent/guardian can memorize, practice, and use phrases like:
What happened in class today violated my child’s 504 Plan. What can we do to prevent that from happening again?
We need to have another meeting about my child’s 504 Plan. I know we made a plan involving P.E. class exemptions but it’s not working out as we hoped. When are you available to discuss this?
My son came home and told me he wasn’t allowed to sit out the gumdrop molecule building activity in science today. Being forced to touch and manipulate the candy was triggering for his orthorexia. Will you please talk to the science teacher about his 504 Plan and make sure she knows that he needs to leave if there’s a food-based activity?
There was an incident today I need you to be aware of. My daughter was surrounded by other girls during lunch chanting, “Skinny is as skinny eats!” It was horrible. I know she’s been eating with the other kids recently but for the next two weeks I would like her to eat in the office as outlined in her 504 Plan. Can she just go there right after homeroom?
The repeated issues with following my child’s 504 Plan is harming their eating disorder healing process. If this can’t be satisfactorily resolved, my next step will be contacting [person name/title].
There is a chain of command in public schools. You demonstrate good faith and will most likely have the best results if you escalate up that chain in order. There’s no need to skip right to the top to the most busy person when there are other people whose whole job role is to help assist you.
Your specific school district might be different but that typically looks like:
Your child self-advocates with their teacher. That resolves the issue.
If it doesn’t, your child talks to you, their parent/guardian.
You as the parent/guardian advocate for your child by talking to their teacher and that resolves the issue.
If it doesn’t, you talk to a school administrator like the vice principal and that resolves the issue.
If it doesn’t, you talk to the school district 504 coordinator and that resolves the issue.
If it doesn’t, you talk to the school district assistant superintendent for whatever level of school your child attends (elementary or secondary) and that resolves the issue.
If it doesn’t, you talk to the school district superintendent and that resolves the issue.
If it doesn’t, you seek legal counsel and proceed on their advice.
A 504 Plan is part of federal law. If you have to escalate up the chain of command to protect your child’s right to an equal education with accommodations for their eating disorder, do it.
