Worried about a pupil

While eating disorders can affect anyone of any age, young people are at particular risk. We know that the earlier an eating disorder is treated, the better chance someone has of fully recovering. Teachers and staff in schools and colleges are well placed to spot the early signs of an eating disorder, and educational establishments can take steps to address eating disorders at several levels with policies and practices, both in their curricula and with individuals at risk. Policies that address health and wellbeing, aim to prevent bullying, establish connections with health services, and set in place appropriate training and development for staff are strongly recommended.

Risk factors

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 transition from school to college or university is a time of heightened risk if someone has an eating disorder and also needs to be carefully managed. Moving on to college or university can bring new challenges above being away from home, making new friends and taking on new academic demands for someone with an eating disorder. Being away from family and familiar contacts can make it harder for anyone who is struggling more than usual with their eating disorder. New friends may not notice the warning signs, or know what to do. The added anxiety of being in an unfamiliar environment, with increased pressures for achievement can raise the risks. Cooking for yourself, or finding enough ‘safe’ foods served at the student catering can be difficult. Providing continuity of healthcare for someone receiving treatment is another concern, as new GPs and other health support workers become involved.

Signs to be aware of

You can read about the signs of individual eating disorders here. Beat also run interactive training courses for teachers at secondary/high school level to help them support pupils with eating disorders.

There are some signs that may become especially apparent in the school environment, which might include:

• Social isolation
• Avoiding eating around others
• Difficulty concentrating
• Tiredness
• Irritability
• Low confidence and self-esteem
• Anxiety
• Obsessive and/or rigid behaviour
• Perfectionism, including setting unreasonably high personal standards and increased concern about making errors
• Excessive neatness
• Decreasing handwriting size
• Self-harm
• Changes to weight – either gaining or losing weight, or experiencing fluctuating weight

Teachers may notice increased social isolation, and concentration levels will diminish if eating is very restricted. Higher functions such as abstract thought get ‘switched off’ if insufficient fuel is reaching the brain. Pupils may have high expectations of their academic performance, and examination success can be seriously compromised when someone has an eating disorder. Health must come first, and this can mean pupils being withdrawn from examinations in order to undergo treatment. The motivation of being well enough to continue with studies can help someone accept that treatment is necessary.

Addressing eating disorders

There are many areas of the curriculum where topics related to eating disorders can be included. Personal, Social Health and Economic Education (PSHE), media studies, physical education, drama and creative work all provide opportunities. Including emotional literacy, building resilience and positive body image into lessons is particularly useful, as is covering media literacy and the way images are digitally manipulated in advertising.

Individual pupils with eating disorders will require particular attention to their educational and pastoral needs. It may be necessary to adapt the learning environment to accommodate reduced physical strength or concentration span.

Liaison with healthcare teams if a pupil is receiving treatment is important. Most young people are treated in the community, remain at home, and continue to attend school throughout their treatment. If it is necessary for someone to be admitted to inpatient care, then plans need to be in place to reintegrate them when they are discharged and able to return to school. The multi-disciplinary teams involved in providing treatment should include educational staff.

Eating disorders also have a profound effect on the friends and family members of those with the serious mental illness. They may also be struggling as it will have a huge impact on their lives, both emotionally and in relation to friends, their ability to cope and perform at school and university. Both friends and family members of someone with an eating disorder will need support as well.