Views & Opinion

Supporting children to learn about eating disorders Comment by Dr ASHA PATEL, CEO of education not-for-profit Innovating Minds

In 2019, a boy suffering from Arfid lost his sight. Many teachers will know about anorexia nervosa and, because of the publicity surrounding Princess Diana's eating disorders, bulimia is no longer a secret. But Arfid may be new to you. It stands for Avoidant Restrictive Food Intake Disorder and those who have it are exceptionally sensitive to the taste, texture, smell and appearance of certain types of food. The teenager, aged

19, could not tolerate the texture of fruit and vegetables and lived on a diet of chips, white bread, crisps and processed meat. At the age of 14, he was found to have vitamin B12 deficiency and given supplements, but he did not take them, nor change his diet. As a result, he developed nutritional optic neuropathy, became blind and had to leave the computer course he was doing at an FE college. 1.25 million people in the UK have an eating disorder and they can

affect people of any gender, race background or body type. Untreated, they can lead to serious mental illness which typically lasts for several years, and affects physical health, emotional well-being and the ability to function in education or the workplace. On average 21 people in the UK die each year from an eating disorder. Specialist services report increased rates of referrals of up to 73% since the pandemic began.

The three main types of eating disorders • Children with anorexia limit food intake; may have a distorted body image and see themselves as fatter than they are. They become consumed by their preoccupation with food and weight and can become very unwell

• Children with bulimia are overly preoccupied with food and get caught in a cycle of binge eating and then purging their body by laxative, vomiting or excessive amounts of exercise

• Children with a binge eating disorder eat excessive quantities of food in a short period of time and put on weight

Innovating Minds recently hosted An Introduction to Eating Disorders

on their platform EduPod and in the webinar clinical psychologist Dr Emma Clarkson dispelled some myths. Eating disorders are often portrayed in the media as a problem for adolescent girls. Teachers need to set aside this preconception because one in four of those with an eating disorder is male. Bulimia nervosa is diagnosed more often in females, but binge-eating disorder seems to affect similar numbers of boys and girls. Boys who are sports enthusiasts or who are aiming for a particular look, or who intend to go into careers such as acting, dancing, modelling or horse racing may be at more risk of developing an eating disorder, and one in every four diagnosed with anorexia nervosa is male.

20 An adolescent's size and shape changes so much that it can be hard to

spot the signs. A teacher noticed that Nick seemed to find it difficult to concentrate and was always tired; he wondered if he was taking drugs and decided to talk to him. It turned out that Nick wanted to go to college to be a dancer. He worried that he would not be good enough and was setting himself impossible goals with his eating and exercise. Another common misconception is that eating disorders can be caused

or exacerbated by controlling families. In fact, family and friends have little impact. Some believe that a child may have been teased about their weight and over-reacted. This may happen in a few cases but often it is not about food. Eating disorders, like self-harming, are about coping with unbearable emotions. These may be caused by trouble at home, bullying or extreme anxiety. Reports show that there is an increase in the number of girls in primary schools developing these conditions. When girls start to menstruate at a young age and are taller or bigger than other children in the class they may feel out of control and compensate by trying to make themselves smaller again. This is seen as a way of postponing their sexual /pubertal development.

What can schools do? Teachers are often advised to look out for children who seem to be experiencing a loss of self-esteem, but this is difficult to spot in most classrooms. Often it is a change in behaviour, increased secrecy and avoidance of others that indicate poor mental health but, in many cases, it is the sudden and severe weight loss or weight gain that teachers notice first.

• Promote well-being in your school. Help children to celebrate diversity and difference

• Discuss body image, healthy eating and size. It is important that children learn early that many of the images they see on screen and in the media are carefully contrived and unobtainable through diet, no matter how extreme

• Talk to child if you are concerned about weight loss, poor skin and hair condition and other changes that might indicate starvation or prolonged and repeating vomiting. It is common for the child to deny that there is a problem, but it is comforting for them to know you care

• If you are not comfortable having this conversation speak to your Mental Health Lead or designated Safeguarding Lead as soon as possible. They will be able to approach the student and family and advise on suitable next steps including signposting them to resources and sources of professional help

What should schools NOT do? • Get angry • Tell them to "just eat" • Look for blame • Talk about diets/weight loss • Lose sight of who they are as a person

For more information: Innovating Minds - to-eating-disorders orToolkit.pdf

June 2021

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