Advocates are pushing for school-based initiatives to raise awareness about the dangers of eating disorders, which kill more Americans than any other psychiatric illness.
“Educators have a real opportunity to disseminate healthful messages and address issues that are impairing the quality of life of many students,” says Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Obesity at the University of Connecticut and co-author of a study that found strong public support for school-based strategies that address eating disorders and weight stigmatization.
Lynn Grefe, president of the National Eating Disorders Association in New York, believes schools need to take a more active role to address eating disorders by reaching out to students in grades five through 12.
“There’s no doubt there’s plenty of disordered eating and dangerous dieting going on in schools,” Grefe says. “Kids are more afraid of being fat than they are of war and terrorism.”
An estimated 30 million Americans will have a diagnosed eating disorder such as anorexia, bulimia and binge eating disorder at some point in their life, reports NEDA, which is sponsoring its 28th annual National Eating Disorders Awareness Week from Feb. 22 to 28 to bring attention to the needs of people with eating disorders and their families.
Experts across the country report seeing eating disorders diagnosed earlier in life, with children as young as 10 years old seeking treatment. Other youngsters are struggling with disordered eating, which refers to harmful habits (such as restricting food intake) that can lead to a diagnosed eating disorder.
“It’s a pressing public health issue,” Puhl says. “These are serious psychiatric disorders that can lead to death.”
Some schools are already taking a proactive approach. At Brooklyn Lab School in Brooklyn, New York, a group of 10th graders are participating in the Body Project, a national prevention program designed to help adolescent girls and young women resist sociocultural pressures to be thin.
“Kids can get caught up in these messages,” says Sukhee Ramawickrama, the school’s HealthCorps coordinator and Body Project co-teacher. “They forget about the healthy image of how they should look and feel, versus how they are being told to look and feel.”
But the Brooklyn Lab School is the exception to the rule. “We could really put a dent into eating disorders if more schools took action,” Grefe says.
Here are three school-based initiatives identified by the Rudd Center study and eating disorder experts that could help prevent and identify eating disorders.
Educating School Personnel
Training teachers, coaches, nurses and other school staff to spot the warning signs of eating disorders is “crucial because we know that early intervention is key,” says Tiffany Phillips, clinical program manager of the Renfrew Center of Nashville in Brentwood, Tennessee, which treats females ages 13 and older.
School personnel benefit from understanding that eating disorders impact girls and boys from all social, economic and cultural backgrounds, notes Phillips, and not everyone with an eating disorder has the thin appearance typical of anorexics. “People with eating disorders come in all different sizes and shapes,” she says.
Typical warning signs include skipping lunch, eating in secrecy, frequently using the bathroom after meals, excessive talk about dieting and negative body image, fluctuating weight, mood swings, changes in school attendance and wearing baggy clothes to hide body size. Other trouble signs including knuckle abrasions (known as “Russell’s signs”) caused by bite marks during self-induced vomiting, as well as “chipmunk cheeks” caused by swollen salivary glands due to constant binging and purging.
Coaches are in a unique position to notice student athletes who may be at risk for an eating disorder because they feel pressure to maintain a certain body type or weight to excel in wrestling, gymnastics, football, track, rowing and other sport, experts said.
“Being involved in sports is fantastic for a kid’s self esteem,” Phillips says. “But some kids get the message that lower body weight and lower body fat percentages might make them better performers. Coaches can provide sound nutrition advice.”
School districts that want to educate teachers, coaches and other staff about eating disorders can find valuable resources on the NEDA website, as well as the site for the National Association of Anorexia Nervosa and Associated Disorders.
Enhancing the Health Curriculum
Expanding the health curriculum to include content about eating disorders can provide students with critical information, notes Sara Niego, medical director of the Eating Disorders Program at Hartford Hospital’s Institute for Living in Connecticut, which treats females and males of all ages.
“Even a well-intentioned health class about can backfire,” Niego says. “We’ve seen students whose eating disorders were triggered by a health class that focused on the consequences of being overweight. Kids didn’t get the message that they should be healthy. Instead, they began restricting food and dieting, which is the entrée to eating disorders.”
Schools that focus on body mass index — an indicator of fat based on height and weight — only increase student anxiety. “People can have a high BMI for many reasons,” Niego says. “It’s a misleading number that doesn’t give you the whole picture. But students take away the message that they are not worthy or good enough.”
Weight-Related Anti-Bullying Policies
Adopting and strengthening anti-bullying policies at school to include weight-based teasing can help raise awareness. “School-based anti-bullying polices vary, and many don’t address weight-based bullying as a legitimate form of bullying,” Puhl says.
Forty-nine states (Montana is the exception) have anti-bullying laws. But only three states (Maine, New Hampshire and New York) include weight or physical appearance, “even though weight is one of the primary reasons kids are bullied in school,” she says.
Looking Ahead
NEDA supports the use of screening tools administered by school nurses or pediatricians to identify students who may be at risk for an eating disorder. But most school districts are hesitant to get involved. One exception is Virginia, which in 2013 passed a law requiring schools to annually provide information about eating disorders to parents of students in grades five through 12. The state must also develop a toolkit to guide schools that opt to conduct eating disorder screenings.
“It’s progress,” Grefe says. “But we need to see these measures across the country.”
More from U.S. News
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Tackling Eating Disorders With School-Based Initiatives originally appeared on usnews.com
