Eating Disorders

Eating disorders are complex mental health issues. Anyone, of any age, gender or background can develop one. They can cause both serious psychological and physical harm and can be fatal.  Anorexia has the highest mortality rate of all mental illnesses. Young people are particularly at risk.

Approximately 1.25million people in the UK have an eating disorder. The National Institute for Health and Clinical Excellence estimates that around 11% of those affected by eating disorders are male (Beat Eating Disorders).

Adolescent men and women aged between 13 and 17 years old have a higher risk of developing an eating disorder (NICE 2017).

There’s no single identifiable cause for developing an eating disorder, rather a whole range of different contributing factors which may include genetic, psychological, environmental, social and biological influences. Young people might not have all the symptoms for any one eating disorder; it can take over the young person and their family’s lives. Having an eating disorder is not just about food, it can be a way of exercising control when feeling you have none. An eating disorder is not the same as changing your diet and worrying about the way you look. Eating disorders can be a way of coping with difficult feelings or situations that are making the person unhappy, angry, depressed, stressed or anxious. It  is not the fault of the person suffering, and no one chooses to have an eating disorder.

People with eating disorders are often secretive about their eating and may experience feelings of guilt and shame.

Bullying is a particular risk factor in the development of eating disorders. Even teasing or throwaway comments about someone’s size can have a negative effect on someone who is vulnerable to developing an eating disorder. Bullying also doesn’t have to be about weight and shape – any kind of bullying can lead to low self-esteem, a key feature of an eating disorder.

The three most common Eating Disorders include: Anorexia, Binge eating disorder and Bulimia.

Anorexia

Also referred to as anorexia nervosa, this is a serious mental health issue where people living with the condition are of a low body weight through reducing their food intake. People may also undertake lots of exercise in order to “burn off” the calories consumed. Restricting food intake and/or over-exercising can be harmful as it can make people very ill because they start to starve.

Many people with anorexia will often have a distorted image of their body and view themselves as fat when in reality they are underweight.

Binge Eating Disorder

When a person lives with a binge eating disorder, they will consume large quantities of food in a short space of time (bingeing), this can be very distressing as they often find it difficult to stop eating. Bingeing often involves eating faster than normal, eating large amounts of food when not feeling hungry, eating until being uncomfortably full or eating alone due to embarrassment at the amount of food being consumed.

People often experience feelings of guilt or even disgust at themselves, due to their lack of control either during or after a binge.

Bulimia

Bulimia – or bulimia nervosa – is where a person will consume large quantities of food (bingeing), followed by an attempt to compensate this by taking laxatives, vomiting, fasting or over-exercising in order to avoid gaining weight (known as purging).

Potential signs you may see in the school environment:

  • Avoiding meals/stating they have already eaten /are eating later
  • Isolating themselves from other pupils/anxiety around eating with others
  • Irritability
  • Increase in exercise levels/struggling to sit down in class/shaky legs
  • Obsessive/rigid behaviour/inflexible thinking styles
  • Reduced concentration if eating is restricted
  • Wearing loose clothing/wearing lots of layers
  • Perfectionist behaviour/setting high, unrealistic expectations for themselves
  • Excessive neatness in hand writing/anxiety regarding making errors in class and homework
  • Loss of confidence and self-esteem
  • Can be linked with other mental health conditions such as anxiety/OCD /mood problems
  • Dizziness/physical weakness
  • Feeling cold/wearing extra clothing irrespective of the weather
  • Hair loss and dry skin

What you can do?

  • Be very aware of the terminology you use to describe how someone looks, moving away from the body shaming culture.
  • Educate boys as well as girls about healthy eating, weight, size and shape, and how they communicate this.
  • Include topics relating to Eating Disorders in the school curriculum – PSHE, P.E, and Drama. Including emotional literacy, building resilience and positive body image into lessons is particularly useful.
  • It may be necessary to adapt the learning environment to accommodate reduced physical strength or issues with concentration.
  • Talk to the pupil about your concerns, be sensitive and speak to them in private so disruptions are minimised. This may be difficult as some young people may be in denial that they have a problem.
  • Explain the rational for information sharing with others i.e. parents and other professionals
  • Liaise with the local CAMHS team if a pupil is receiving treatment for an Eating Disorder in relation to school attendance/individual timetables.
  • If inpatient care is required provide a supportive transition/reintegrated plan for when the pupil is ready to be discharged.

Real Life Experience

If you would like to share your experiences of supporting a pupil with an eating disorder, please email tewv.vrc@nhs.net