Eating Disorders are complex mental health illnesses that can affect people of any age gender or background. They appear to be increasing especially in young people and it is estimated that there is 1.25 million people with some form of eating disorder in the UK (BEAT 2019). There is no single cause for eating disorders and they can be hard to classify as a person may not have all of the symptoms that fit the diagnostic categories we have historically used.
Bullying and Eating Disorders
Bullying is of particular relevance to eating disorders as size and shape are common things for young people to focus on and feel vulnerable about. What might seem like minor teasing might have negative effect on people that are vulnerable to developing eating disorders as these comments can act as to reinforce negative beliefs they may already hold on their own size and weight. A young person does not need to be a particular size or shape for bullying to have an impact as many people with eating disorders have a distorted view of their physical bodies. All forms of bullying have an association with low self-esteem, which in turn is associated with vulnerabilities to the development of eating disorders.
What are the signs and symptoms of eating disorders?
Eating disorders are commonly thought of as clusters of symptoms that are commonly referred to as “types”. You may notice that there are lots of overlaps of symptoms between eating disorder types which highlights how fluid eating disorder types can be, someone may even oscillate between types during the course of their illness. As a teacher you only need to be aware of what eating disorders are and what support is appropriate for you to give in your role.
Eating Disorders in Children
Eating disorders can start emerging early, below are some characteristics of the different types of eating disorders.
It is useful to have some awareness around some of the signs of eating disorders. Often there is a focus on the physical signs of eating disorders, however more obvious changes in weight and appearance are more associated with more established eating disorders. For young people that might be developing an eating disorder is important to not simply rely on physical signs as the behavioural and psychological signs are often apparent in the earlier stages of illness.
Not being truthful about eating / weight
Avoiding eating with other people
Disappearing soon after eating (purging)
Buying lots of food
Excessive focus on body weight
Distorted perception of body shape / weight
Anxiety (around food / meal times)
Low confidence & self-esteem
Feelings of guilt & shame
Feelin out of control (especially with regards to food)
General poor mental health
Weight loss / Weight gain
Hair loss / poor skin condition
Feeling cold / low body temperature
Swelling of hands & feet
Damage to teeth
Again, there is a lot of overlap between signs of eating disorders and types of eating disorder. BEAT (A UK eating disorder charity) has a comprehensive list of signs and symptoms for each specific eating disorder type.
Teachers play an invaluable role in assisting with their pupils. Whilst we are preparing ourselves to help other we must also look after ourselves, we’ve got some advice and guidance on this in the teacher wellbeing section. As with all matters of mental health taking time to gain awareness of conditions like eating disorders helps to build confidence in what to do and how to support early intervention and prevention.
How to support
Eating disorders are serious mental health conditions that always need professional mental health support. Teachers therefore are only expected to be alert to the early signs of eating sign and try and facilitate further professional support.
Perhaps you notice a pattern of the signs mentioned above (for example maybe you notice they are avoiding mealtimes), then it is important to talk to them. Don’t be afraid to ask them if everything is ok and if anything is worrying them, these simple steps can often facilitate conversations that can lead to a young person receiving help. We’ve got some advice and guidance on regarding their mental health that can give you some ideas on how to go about this and we outline the some of the potential support pathways you can suggest in the support section here.
There are few things that are specific to eating disorders that can be helpful to consider when approaching someone you think may have one or be in the process of developing one;
What if they do not want any help?
None of us are able to solve every problem we face and sometimes a young person’s wellbeing becomes the most important focus. If you have serious concerns about a young person’s mental health you should contact your mental health representative in your school (sometimes this might be a headteacher or deputy head) or contact professional MH support.
What are eating disorders?
Eating Disorders are complex mental health illnesses that can affect people of any age gender or background. There is no single cause for eating disorders and they can be hard to classify as a person may not have all of the symptoms that fit the diagnostic categories we have historically used.
What are the signs and symptoms of eating disorders?
Behavioural: Not being truthful about eating / weight, Strict dieting, Counting calories, Avoiding eating with other people, Social withdrawal, Isolation, Mood swings, Disappearing soon after eating (purging) or Buying lots of food
Psychological: Excessive focus on body weight, Distorted perception of body shape / weight, Anxiety (around food / meal times), Low confidence & self-esteem, Feelings of guilt & shame, Feelin out of control (especially with regards to food), General poor mental health
Physical: Weight loss / Weight gain, Tiredness, Hair loss / poor skin condition, Stomach pains, Feeling cold / low body temperature, Swelling of hands & feet, Damage to teeth, Bloating, Constipation
How can teachers and schools support students with eating disorders?
Teaching health and nutrition in a way that is mindful that there may be class members who take it literally.
Being careful to ensure healthy eating messages are about achieving a healthy balance rather than inadvertently promoting a ban on sweets, cake, carbs and sugar.
Promoting body confidence and body diversity. Acknowledging that they are still growing and moving away from unhelpful or dangerous messages about BMI that do not take into account diversity, ethnicity, etc.
Promoting eating lunch. Consider initiatives that promote the fun, social advantages of eating lunch (e.g., “Let’s do lunch club”).
Promoting body acceptance between each other as a staff groups. Avoid corridor conversations often overheard by pupils that praise weight loss, will power to restrict food or dieting success.