Teachers and staff in schools and colleges are well placed to spot the early signs of an eating disorder because
daily contact with young people at the ages of greatest risk. Educational establishments can take steps to address eating disorders at several levels with policies and practices; in their curricula and with individuals at risk.

Policies that address health and wellbeing; aim to prevent bullying; establish liaison with health services and set in place appropriate training and development for staff are strongly recommended. A useful model policy for use in schools and colleges has been developed as part of an Institute of Psychiatry programme.
Bullying and eating disorders

Bullying is a particular risk factor in the development of eating disorders since it lowers self esteem and low self esteem is a key feature of an eating disorder. Bullying doesn’t have to be about weight and shape to have this effect, but if it is, the effect is more marked. Fat teasing sounds harmless but it isn’t and needs to be stopped, promptly.

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. Beat works with the Dove Self Esteem Programme to deliver free self esteem workshops to schools which you might find useful. The workshops aim to strengthen body confidence and build resilience to social pressures about size, shape and weight.

Individual pupils with eating disorders will require particular attention to their educational and pastoral needs. Adapting the learning environment to accommodate their reduced concentration spans or physical strength may be necessary. People with eating disorders can have a strong drive for perfectionism and this can be evident in their academic work – with excessive neatness, increased anxiety about making errors and a tendency to become inflexible in thinking. Handwriting sometimes decreases in size to minute proportions.
Signs to be aware of

Teachers may notice increased social isolation and concentration levels will diminish if eating is very restricted. The brain requires a minimum of 500 calories a day and higher functions such as abstract thought get ‘switched off’ if insufficient fuel is reaching them. 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 intensive treatment. The motivation of being well enough to take exams can help someone accept that treatment is necessary.

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.

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.

Eating disorders also have a profound affect on the friends and family members of those with the serious mental illness. They too 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 will need support as well.

Understanding Eating Disorders for Schools has been specifically developed for teachers, staff, parents and students who want to update their skills and knowledge and ensure that their school is active in the prevention, detection and support of students.