How Schools Can Help Prevent Eating Disorders
Written by Rithika Ramkumar
What are Eating Disorders?
Eating disorders are a part of every school health curriculum, but most people have a misconstrued perception of what an eating disorder is. It’s easy to think about avid calorie counters and offensive comments about people “needing to eat a burger every now and then,” but eating disorders are far more pervasive and subtle than people think; people with eating disorders range from dangerously underweight to overweight, from athletic to couch potatoes. Moreover, eating disorders are not a lifestyle. They’re not a diet people undertake. Eating disorders are medical conditions, first and foremost.
The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Anorexia nervosa is characterized by severe avoidance or restriction of food. People with anorexia may weight themselves repeatedly, and usually have a inflated sense of their own weight, even when dangerously underweight. There are two subtypes of anorexia:
Restrictive: “people severely limit the amount and type of food they consume,” (Eating Disorders).
Binge-Purge: people restrict their food, but may also go through phases of binge eating and purging, where a person may eat excessive quantities of food but then “rid” themselves of it by vomiting, laxatives, or diuretics.
Anorexia can be fatal.
Another type of eating disorder is bulimia nervosa, wherein people eat excessively but then feel the need to “rid” themselves of the food, similar to the binge-purge subtype of anorexia. They may also exercise excessively or fast as a “solution” to the binge episodes (“Eating Disorders”).
The third type of eating disorder is binge-eating disorder. It is the most prevalent eating disorder in the US (“Eating Disorders”), characterized by excessive amounts of eating. However, unlike bulimia or anorexia, the binge episodes are not followed by purging episodes.
What Does This Have To Do With Schools?
Eating disorders are the third most diagnosed chronic illness in teens. The NIMH reports that 13% of adolescents will develop an eating disorder by the age of 20. Females are roughly twice as likely to struggle with an eating disorder (Rienecke, 8). Eating disorders run rampant through youth populations, and for this reason, schools need to be on the lookout for concerning behaviors; furthermore, they should be prepared with the resources and knowledge to help students who struggle with eating disorders.
What Can Schools Do, Then?
The first step--and arguably the most important step--to prevention and treatment is teaching teachers and peers to recognize the warning signs. Below are lists of early signs for...
Anorexia Nervosa
Having an intense fear of weight-gain or being overweight
Calorie counting
Preoccupation with body image, such as shape and/or size
Skipping meals
Declining meals
Refusing to eat with others
Distorted body image
Stringent food rules or restrictions
Irritability
Insomnia
Dry skin/hair
Extreme weight loss
Knuckle scarring or teeth sensitivity (from purging)
Bulimia Nervosa
Distorted body image
Preoccupation with body image, such as shape and/or size
Hiding food
Eating in secret
Expressing shame for eating
Frequently using the bathroom around mealtimes (immediately before or after)
Possessing diuretics or laxatives
Compulsive or excessive exercise (especially if exercise occurs despite weather or injury limitations)
Drinking excessive amounts of water
Knuckle scarring or teeth sensitivity (from purging)
Binge-Eating Disorder
Eating in secret
Hiding food
Eating beyond comfort (past the point of fullness or until uncomfortable)
Eating quickly
Low self-worth
Depressive symptoms
Weight fluctuations
(Rittenhouse; “Eating Disorders”).
Additionally, there is evidence that population-screening (where students, as a collective, are screened--typically through medical questionnaires) to identify students at risk or struggling. This seems logical, given that eating disorder behaviors should be caught as early as possible. In one study, around 15% of girls and 4% of boys at a high school reported behaviors that indicated the likelihood of eating disorders. Overall, 25% of girls and 11% of boys reported behaviors severe enough to warrant a clinical evaluation. Of those students, few reported receiving treatment (Austin). Medical questionnaires implemented by school nurses, psychiatrists, counselors, or other medical personnel can greatly help catch eating disorders at their early stages and prevent disorders from progressing to, in the worst case scenario, death.
Additionally, simply working preventative measures into school curriculums would be helpful. In environments of high competition such as sports or rigorous academics, coaches and teachers have a unique opportunity to connect with students. Teaching body positivity or mindfulness can be helpful, especially because eating disorders can stem from past traumas or low-self esteem (“How Teachers”). Teaching students to be aware and take care of themselves can prevent mental health struggles from devolving into eating disorders before it even happens. Inviting counselors or dieticians into classrooms or locker rooms can connect students to resources that they may be in dire need of.
What Now?
Eating disorders are shamefully prevalent in our society. From social media to societal pressures to peer pressure, it’s not hard to see where someone may grow a distorted perception of their body and their worth. It’s important to be supportive of those who may struggle with an eating disorder.
It may seem illogical to you; how can someone think of themselves like that? However, to a person struggling with an eating disorder, those thoughts may be the most rational, logical things in the world.
Sources
Austin, S Bryn et al. "Screening high school students for eating disorders: results of a national initiative." Preventing chronic disease vol. 5,4 (2008): A114.
"Eating Disorders." National Institute of Mental Health (NIMH), National Institutes of Health (NIH), www.nimh.nih.gov/health/topics/eating-disorders. Accessed 30 Jan. 2023.
"How Teachers and Coaches Can Help in Preventing Eating Disorders." Center for Discovery: Eating Disorder Treatment, Center for Discovery, centerfordiscovery.com/blog/teachers-coaches-can-help-prevent-eating-disorders/. Accessed 30 Jan. 2023.
Rienecke, Renee. "Family-based Treatment of Eating Disorders in Adolescents: Current Insights." Adolescent Health, Medicine and Therapeutics, vols. Volume 8, June 2017, pp. 69-79, https://doi.org/10.2147%2FAHMT.S115775. Accessed 30 Jan. 2023.
Rittenhouse, Margot. "Eating Disorders in Teens." Edited by Jacquelyn Ekern. Eating Disorder Hope, 4 Aug. 2021, www.eatingdisorderhope.com/risk-groups/eating-disorders-teens. Accessed 30 Jan. 2023.
Understanding Eating Disorders in College. Best Colleges, Red Ventures, www.bestcolleges.com/resources/eating-disorders/. Accessed 30 Jan. 2023.