Eating Disorder Protocol

Grinnell College has coordinated wellness services designed to serve students dealing with anorexia, bulimia or with other forms of disordered eating. We utilize a team approach as this is considered the best practice for treatment of eating-related concerns on college and university campuses. The team consists of representatives from the fields of medicine, psychology, exercise and nutrition who work collaboratively with the student toward stated goals.

What is disordered eating?

Disordered eating is the overarching term used to refer to wide variety of problematic behaviors relating to weight, eating habits, exercise, and/or body image. These types of behaviors may include restricting intake of food, rapidly consuming large quantities of food in an uncontrolled or compulsive manner (binging), over-exercising, frequently checking one’s body size in the mirror, etc. These behaviors are often accompanied by critical thoughts about oneself and negative emotions such as sadness, guilt, or anxiety. For more information about types of disordered eating or how to recognize the signs and symptoms, read National Eating Disorder Association's information on eating disorders.

Treatment Team

Grinnell offers a team approach to working with enrolled students experiencing disordered eating to assist them in their recovery efforts. A comprehensive team approach is the most beneficial to students because it maximizes services and support, through coordinated care, with the goal of students regaining wellness and remaining in school. Once a student presents to a Team member for an initial assessment, the Team member will work with the student to identify what goals the student would like to work toward. Then, with the student’s consent, the Team as a whole will meet to discuss treatment options, course of treatment, and recommendations for continued care, taking into account the student’s individual goals. The Team will work collaboratively with the student to come up with a plan for continued care and will assess progress toward the agreed upon goals throughout the duration of treatment. The Team may revise the plan for care and/or the goals for treatment based on the continued assessment of progress. All members of the Team maintain confidentiality of information about the student and treatment, except in cases when it rises to the level of imminent risk to self, in which case emergency personnel and College administration may become involved.

Team Membership (minimum):

Mental Health representative

Nursing Staff representative

Nutrition/Dietician representative*

These three people would meet on a regular basis, perhaps monthly. The Team would bring in others on an as-needed basis. Ideally the Team will also include (1) both therapeutic/psychiatric and nursing staff from Student Health and Counseling Services, and (2) the Wellness Coordinator , and possibly (3) a local medical provider/physician. If student is an athlete, the Team will also include an Athletic Trainer, who may consult with the Coach and the Athletic Department’s physician (please see the Athletic Department protocol in the Student Athlete Handbook for more information about the role of these individuals on the Treatment Team and additional requirements for participation in varsity sports). If student is involved in an activity/performance related to an academic department (e.g., Theatre/Dance), the Department Chair will be consulted.

Identification and Referral

Any student concerned about his/her/hir own eating patterns, weight, or related issues can consult with the Treatment Team by initiating contact with a member of the Team:

Mental Health Representative: 
Stephanie Brown, Ph.D. (641-269-3230)
Lead Psychologist and Director, Student Health and Counseling Services 

Nursing Staff Representative:
Deb Shill, RN, (641-269-3230)
Lead Nurse and Student Health Services Coordinator, Student Health and Counseling Services 

Nutrition/Dietician Representative*:

TBD 

Frequently, members of the Grinnell community will have a concern about a particular student. Whether faculty, staff or a student, this individual can consult with a Team member. This Team member will discuss the signs and symptoms noticed, give advice about how to talk to the student of concern and discuss how to refer him or her for an assessment if indicated. The College considers this a best practice for referral of a student.

If the concerned party is uncomfortable approaching the student of concern about a referral for an assessment, or their efforts have been unsuccessful, a Team member, likely a Student Health and Counseling Services staff member, may intervene on his/her/hir behalf. If the Student Health and Counseling Services staff member is able to verify and document these concerns, and it indicates a potential significant risk to self, the Director will notify the student that there is a concern for the student’s health and safety. The Director will then ask the student to schedule an appointment for an evaluation with a member of the Treatment Team.

If the student about whom there is a concern is unresponsive, or if it is determined during this process that there is a significant and immediate risk to self, the Treatment Team will consult directly with Administration, as described below. 

Administrative Consultation and Review

College officials may be involved in situations where a College decision needs to be made, such as addressing self-injurious behavior (e.g., mandating a medical and/or psychological assessment).  After consultation with the Treatment team, College officials may, for example: (1) refer students to the Treatment Team, (2) make a student’s enrollment contingent on following the recommendations of the Treatment Team if the student continues to be at risk to self, and/or (3) make decisions if the student has not scheduled an appointment, as described above, in a reasonable time period. 

Membership for Administrative Review and Consultation Team may include:

Dean of Students

Another Student Affairs dean (as deemed appropriate)

Residence Life Coordinator

An Athletic Director (if a student is a student-athlete)

The first priority for anyone at the College is the student’s wellbeing and, additionally, keeping the student enrolled (if appropriate).  However, if a student is: (a) disruptive to the community; (b) there is continued evidence of self-harm behaviors; and/or (c) there are other violations of College policy, College officials may make decisions about the student’s eligibility for continued enrollment (e.g., medical leave of absence, interim suspension).

*A search for a dietician/nutritionist with this expertise is currently underway at the time of publication.