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Eating Disorders

Accommodation and Compliance: Eating Disorders

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About Eating Disorders

A significant number of men and women experience a eating disorders at some time during their lives. Many cases are probably not reported. Many more people may not meet the criteria for an eating disorder diagnosis, but have difficulty around dissatisfaction with their bodies and distorted beliefs and behaviors about eating. Eating disorders are characterized by a continual disturbance of eating or eating-related behavior that results in changes in eating patterns that significantly impairs physical and mental health. Although there are many eating disorders, JAN hears about those that are most prevalent:

  • Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by restriction of energy intake (food consumption) and excessive weight loss. Symptoms include resistance to maintaining body weight at or above a minimally normal weight for age and height; intense fear of weight gain; disturbance in the experience of body weight or shape; undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight; and loss of menstrual periods in girls and women post-puberty.  Anorexia nervosa typically appears in early to mid-adolescence and it has one of the highest death rates of any mental health condition.
  • Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors designed to undo or compensate for the effects of binge eating. Its presence is indicated by regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior; regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise; and extreme concern with body weight and shape. Bulimia nervosa is frequently associated with symptoms of depression and changes in social adjustment.
  • Binge eating disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating. It is characterized by frequent episodes of eating large quantities of food in short periods of time; feeling out of control over eating behavior during the episode; and feeling depressed, guilty, or disgusted by the behavior. Behavioral indicators of BED include eating when not hungry, eating alone because of embarrassment over quantities consumed and eating until uncomfortably full. BED is often associated with symptoms of depression.

JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations. 

Eating Disorders and the Americans with Disabilities Act

The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Eating Disorders

People with eating disorders may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with eating disorders will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  6. Do supervisory personnel and employees need training?

Key Accommodations:

Malnutrition: For individuals with eating disorders, having accommodations to help manage malnutrition can be helpful. 

Accommodation Ideas:

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

Events Regarding Eating Disorders

Other Information Regarding Eating Disorders