During my first year as a high school counselor, a parent came to speak to me about her daughter. The student was a bright and beautiful young lady with a bubbly personality who I had the pleasure of meeting prior to her mother’s visit.  Although she was thin (she was a dancer), I hadn’t noticed just had thin she had become in the last month.  In that meeting, mom shared with me her concerns about her daughter’s well being and how she had just been diagnosed with Anorexia Nervosa.  During our time together, we discussed a safety plan for her at school, particularly during lunchtime.  For a year, my office would be a place where this student could visit, eat, talk, and even rest.  Although I was not a specialist in eating disorders, I knew what this family was experiencing.  Unfortunately, my family had dealt with the painful reality of an eating disorder by one of my sisters. Though I could not make her symptoms go away or “talk” her out of her feelings about herself, just being there was powerful.

As a school counselor, you may or may not work with a student who has an eating disorder.   Regardless, being aware of the symptoms of an eating disorder is an important step in assisting students in their road to recovery. In 2010, Lynn Shellcross wrote an article about the growing problem of eating disorders among elementary school aged children.  When eating disorders are not identified early in students, they have the potential of growing into high school students who are at risk for serious illness and even death. Shellcross referenced researchers who found it imperative that counselors, whether school, mental health, college, or family, have an understanding of the deadliness of eating disorders. In order to understand eating disorders, counselors must be aware that it is not about food, but the student’s inability to control the world around them.  Students who suffer from an eating disorder often present in our office with anxiety and go to great links to hide their disorder.  Having knowledge about eating disorders and the importance of early detection is important in identifying students who may be suffering from this mental health issue.

What is an Eating Disorder?

According to the National Eating Disorders Association, eating disorders are “serious but treatable illnesses with medical and psychiatric aspects.”  The DSM-5 recognizes several types of eating disorders in their diagnosis including: Anorexia Nervosa, Bulimia, Binge Eating Disorder, and Other Specified Feeding or Eating Disorder (OSFED). Although people with eating disorders concentrate on food and weight, the reality is that eating disorders often coexist with depression, anxiety, and obsessive compulsive disorder. According to the Academy for Eating Disorders, there are nine truths people, particularly school staff, should know about eating disorders. 

These truths include:

Although a student may look healthy, he or she may be extremely ill.
Parents are not to blame, and should be considered allies in recovery.
An eating disorder diagnosis is a health crisis that disrupts daily life functioning (including academic success).
Having an eating disorder is not a choice, but is a serious “biologically influenced illness.” Eating disorders affect students of “all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.”
Eating disorders increase the risk for both suicide and death due to medical complications.
Biology and environmental factors can enhance the development of eating disorders.
Biology alone does not predict the development eating disorders.
Early detection and intervention are important for full recovery!

See Kati Morton’s videos about the different types of eating disorders.

Recognizing an Eating Disorder

Since school staff are with students at least seven hours a day, we are at an advantage of identifying when a student is experiencing a mental or physical illness.  In fact, early detection of an eating disorder is the first step to treatment and healing. So, who are the students we should be most concerned about having an eating disorder?  According to the BodyWise Eating Disorder Booklet, there are signs that educators should be aware of in adolescents who are at risk for developing an eating disorder (students experiencing these signs may or may not have an eating disorder).

Be aware of the following students:

  •  complain about their bodies being too fat even if they appear to be normal weight or thin
  •  talk about being on a diet or avoiding certain foods because they are too fattening
  •  overweight and appear sad
  •  teased about their weight
  •  obsessed about maintaining a low weight to enhance their performance in sports, modeling, or dancing

 Other signs and symptoms include:

Physical                                                       Emotional                                            Behavioral

Weight loss or fluctuation                      Complaints about being too fat               Constant dieting
Constantly feeling faint, tired, or cold   Comments about feeling worthless         Constant exercising
Dry hair/skin                                          Frequently going to the bathroom           Perfectionism

Not only is early detection important for the student to get treatment, but it is important to prevent a student from academic failure.  According to the National Eating Disorders Association, an eating disorder can profoundly impact a student’s cognitive function and the ability to learn. Some of the impacts on their ability to learn include:

  • low iron levels which decrease memory function
  • irritability caused by headaches, lethargy, or nausea
  • reduction in concentration and focus due to constant dieting
  • obsessive thoughts with grades due to perfectionist tendencies
  • withdrawal, apathy, and social isolation from feelings of self worthlessness
  • increased absenteeism as a result of physical illness

If this is the first time you have considered learning more or promoting eating disorders awareness, this post may have some helpful information for you!

National Eating Disorder Awareness Week

This week is National Eating Disorders Awareness Week. Both the National Eating Disorders Association (NEDA) and Anorexia Nervosa & Associated Disorders have created booklets with guidelines for teachers, school nurses, school psychologists, coaches, and counselors who work with students identified as having an eating disorder, their friends, and their parents. In addition to promoting awareness, NEDA and ANRED are encouraging early detection for students through a three minute screening and self help screening.

Want to get involved?  Check out these events.

February 22nd – Google Hangout-Early Intervention and Eating Disorders (2 PM EST)

February 22nd- Twitter Chat-Awareness to Action 8 PM EST)

February 23rd – Twitter Chat-Getting Healthy: The Many Faces of Eating Disorder Recovery

February 24th-Day of Action-Promoting Education Regarding Eating Disorders

Need more information? Check out these additional resources.

Booklets & Pamphlets for Educators
NEDA Educator Booklet
ANAD School Guidelines 
National Institute of Mental Health Brochure on Eating Disorders (Downloadable)

Guidelines for School Counselors
Cutting, Eating Disorders and Confidentiality

Facts and Webinars About Eating Disorders
Anorexia Fact sheet 
Binge Eating Disorder Fact Sheet
Athletes and Eating Disorders
Fast Facts on Eating Disorders
Kati Morton’s Videos on Eating Disorders
Webinars on Eating Disorders
The Truth About Eating Disorders
NEDIC Webinars

What Does Recovery Look Like Webinar

Referral Information 

Eating Disorder Referral Information (US)
Eating Disorder Information (UK)

Websites and Associations
Academy for Eating Disorders Facebook Page
Eating Disorder Foundation
International Association of Eating Disorders Professionals Foundation – Offers courses and certifications in eating disorder education. 
EDAC  – Eating Disorders Association of Canada
ANZAED –  Australia and New Zealand Academy for Eating Disorders
Eating Disorders Hope
Teens Health

Chats and Conferences
Twitter Chat – March 9th-12:00 PM-Treatment and Recovery
ANAD Eating Disorder Conference – September 9, 2016
International Conference on Eating Disorders  – May 5-7, 2016, San Francisco, CA

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