Eating Disorders

Well-Being & Mental Health

Overview

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact an individual's health, emotions and ability to function.


Most eating disorders involve focusing too much on weight, body shape and food, which leads to dangerous eating behaviors. These behaviors can significantly impact the body's ability to get adequate nutrition. Eating disorders can harm the heart, digestive system, bones, teeth and mouth, and lead to other diseases.


Eating disorders often develop in teens and young adults, although they can develop later in life as well.


The most common eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge-Eating Disorder.

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Anorexia Nervosa

Anorexia nervosa is the best known of the three disorders and is the inability to maintain body weight at or above the normal weight range for height. People suffering from this disorder are chronically underweight, yet still harbour anxieties about becoming fat. They have an intense and irrational fear of being overweight or even a normal weight. Starving is seen as essential to maintaining competence and self-esteem.


Anorexia nervosa has serious health consequences. In adults, it has one of the highest mortality rates of any psychiatric disorder. One in ten patients will either commit suicide or die as a result of malnutrition. Commonly, the disorder surfaces during adolescence when the body’s nutritional demands are high. Adolescents with anorexia frequently encounter problems with menstruation, a weakened immune system, stomach and heart problems, and chemical imbalances in the brain which can increase depression and anxiety levels.


Anorexia nervosa is a complex eating disorder with three key features:

  • Refusal to maintain a healthy body weight
  • An intense fear of gaining weight
  • A distorted body image


For individuals with anorexia nervosa, thoughts about dieting, food, and their body may take up most of their day—leaving little time for friends, family, and other activities. Life becomes a relentless pursuit of thinness and going to extremes to lose weight.


While people with anorexia often deny having a problem, the truth is that anorexia is a serious and potentially deadly eating disorder.

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Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating, followed by frantic efforts to avoid gaining weight. It affects women and men of all ages.


During an average binge, individuals may consume 3,000 to 5,000 calories in one short hour. Afterwards, he or she may attempt to “undo” the binge by taking laxatives, inducing vomiting, or over exercising.


People with bulimia tend to be average to over weight because of their episodes of intense eating. They may also suffer both the physical and mental effects of chronically poor nutrition, including stomach and cardiovascular problems, damage to the immune system and depression. They are also at risk for rupture of the esophagus, inflamed throat, enamel erosion and gum disease.


It is important to note that bulimia doesn’t necessarily involve purging by throwing up or using laxatives, enemas, or diuretics. If an individual makes up for binges by fasting, exercising to excess, or going on crash diets, this also qualifies as bulimia.

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Binge-Eating Disorder

Binge eating disorder is characterized by compulsive overeating in which people consume huge amounts of food while feeling out of control and powerless to stop. A binge eating episode typically lasts around two hours, but some people binge on and off all day long. Binge eaters often eat even when they’re not hungry and continue eating long after they’re full. They may also gorge themselves as fast as they can while barely registering what they’re eating or tasting.


Binge eating disorder is much more widespread than either bulimia or anorexia. Males, people from lower socioeconomic backgrounds and people of a wide range of ages are just as likely as middle class, adolescent females to develop this disorder.


The key features of binge eating disorder are:

  • Frequent episodes of uncontrollable binge eating
  • Feeling extremely distressed or upset during or after bingeing
  • Unlike bulimia, there are no regular attempts to “make up” for the binges through vomiting, fasting, or over-exercising


People with binge eating disorder struggle with feelings of guilt, disgust, and depression. They worry about what the compulsive eating will do to their bodies and beat themselves up for their lack of self-control.

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Supporting Students With Eating Disorders

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Only a fully trained therapist should attempt to counsel someone suffering from these disorders. Teachers, however, are in a position to spot the warning signs of eating disorders. As caring and informed adults, who see the students on a daily basis, teachers may also play a preventive role by leading classroom exercises that discuss issues such as nutrition, body image and self-esteem. As well, teachers can help create school and classroom environments that are particularly sensitive to the needs of students with eating disorders.


Once teachers are familiar with the characteristics or “warning signs” that indicate eating disorders, they are more likely to notice when students exhibit worrisome eating behaviours. A physical education teacher may notice that one girl’s weight constantly fluctuates, while an art teacher might encounter an underweight boy whose work often portrays images of food or weight loss.


The real question is, what should a teacher do with information about a potential eating disorder? The following three-step strategy is intended to help teachers act on their concerns.

#1 Keep Clear Records

There is a chance that the student, and even parents, will react negatively to any suggestion that there is an eating disorder. Denial that there is a problem is often the first response of students with eating disorders and their families, and any suggestion that there is a problem may be rejected.


Concerned teachers are advised to keep clear, concise notes of the incidents that have led them to suspect that a student has a problem. These notes should focus on specific observed behaviours. Teachers should not attempt to “diagnose,” but their careful observations may assist clinicians in the diagnostic process.

#2 Consult with Other Professionals

Since eating disorders generally emerge during the secondary school years, it is often difficult for a single teacher to identify potential danger signs. If teachers have a concern, they may want to compare notes with other teachers. It is important that teachers also share any concerns of this nature with the school counsellor and, perhaps, an administrator.


In many cases, the counsellor may already be aware of the problem and will be able to offer the teacher support and advice. The school counsellor is in the best position to deal with the student and family, and should be able to direct them to the most appropriate community and medical resources.


It is suggested that school counselling offices maintain resource material on eating disorders as well as information on support services available in the community.

#3 Develop Ongoing Support Strategies

Many students undergoing treatment for eating disorders continue with their normal school routines without teachers or classmates realizing that there is a problem. In more severe cases, however, the disorders may be disruptive to their lives at school. When these students are in school, they will benefit from receiving extra social/emotional supports.


It is helpful to ensure that there is an ongoing communication strategy in place in the school to allow for the flow of information from counsellors and administrators to teachers, and back. School-based team meetings may be an appropriate forum for information sharing.

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