Understanding Eating Disorders in the School Setting

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1 Understanding Eating Disorders in the School Setting Let s Talk Eating Disorders Educational Program Funded by the Government of Newfoundland and Labrador Department of Health and Community Services

2 Eating Disorder Foundation of Newfoundland and Labrador The Eating Disorder Foundation of Newfoundland and Labrador (EDFNL) is the only leadership advocacy group dedicated to promoting research and providing public support services and information about matters related to eating disorders, including information on available treatment services for individuals and families who experience disordered eating.

3 What is the Definition of an Eating Disorder An eating disorder is a coping strategy that an individual uses to deal with deeper problems. It is a complex situation in which food, eating and body image difficulties become the language through which a person s concerns about themselves are expressed. Eating disorders are usually characterized by an intense fear of weight gain, feelings of ineffectiveness and low self-esteem. Eating disorders are serious health disorders in which a person may experience emotional, psychological and social difficulties as well as physical complications.

4 Why should your school be concerned about eating Disorders? Approximately 8000 individuals in Newfoundland and Labrador experience some form of disordered eating or are at risk of having an eating disorder 10-15% of adolescents are affected (ages 13-22) There is significant irreversible health complications if not treated early Mortality rate can be as high as 20% if not treated early Eating disorders exist in all age, racial and ethnic groups. You cannot tell if someone has an eating disorder just by looking at them. ED rates in NL are higher than PEI, NB, MB, SK, AB, BC and the same as ON, QC, and NS

5 Types of Eating Disorders Anorexia Nervosa Bulimia Nervosa Eating Disorder Not Otherwise Specified (EDNOS)

6 Anorexia Nervosa a self-starvation disorder. The individual experiencing Anorexia Nervosa ignores hunger, restricts the amounts and kinds of food eaten to such an extent that starvation is a very real possibility as is death. 6

7 Bulimia Nervosa A binge-purge disorder The individual who is experiencing bulimia nervosa gorges (binges) on enormous amounts of food, sometimes thousands of calories at one time The individual will then get rid of the food(purges) by vomiting, excessive use of laxatives, or other means. Bulimia is also dangerous to a person s physical and mental health.

8 Eating Disorders Not Otherwise Specified - EDNOS There is a range of other disordered eating patterns that do not fall into the specific categories. These conditions are still serious and interventions and attention are still required. EDNOS or other Eating Disorders may include: Those who have some, but not all of the characteristics of an eating disorder. For example, people who severely restrict food intake but do not meet the full criteria for anorexia nervosa Those who binge and purge irregularly, such as at times of stress People who experience disordered eating or any subclinical symptoms

9 Some Causes of an Eating Disorder Biological can run in families genetic factors. Low self-esteem and negative body image. Inability to cope with emotions identity concerns. Society reinforces the idea to be happy, successful and healthy we must be thin. Adolescents, in particular, are most vulnerable influence of peers, role models, the school climate and media. Body harassment (comments, teasing and bullying about body size and body differences)

10 Some Causes of an Eating Disorder Sexual and physical abuse and controlling relationships. High achievers tend to be perfectionists. (Honor Roll) Can be a coping strategy used to deal with deeper problems. High-risk activities/sports, where judgments of performance and success are based on body size and shape. Family issues the person suffering from an eating disorder has difficulty coping with.

11 Not just girls and women Males with disordered eating/eating disorders has increased from original research estimate of 10% to recent research of 20-25%

12 Warning signs specific to a school setting Change in attitude/performance Express body image complaints/concerns Appears sad/depressed/anxious Talks about dieting/avoids nutritious foods because they are fattening Is the target of body or weight bullying Spends increasing amount of time alone or isolated Obsessed with maintaining low weight to enhance performance in activities like sport, dance, acting or modeling

13 .Warning signs specific to a school setting Reluctant to ask for help Wearing baggy clothes/change in clothing style Frequent trips to the bathroom Facets left on in washroom Difficulty with friends and relationships Frequent excuses not to eat

14 Educating about Eating Disorders Age appropriate education should include: Factors that can contribute to eating disorders (adolescents/adults, not children) Risks associated with eating disorders (adolescents /adults, not children) Media Literacy (all ages) Strategies that promote positive image and self esteem (all ages) Vitality message (all ages) Positive attitudes toward food and body (all ages) 2010 Eating Disorder Interprofessional Community Capacity Building Team

15 Vitality Message "Enjoy eating well, being active and feeling good about yourself 2010 Eating Disorder Interprofessional Community Capacity Building Team

16 Educating about Eating Disorders Education should NOT: Encourage Discussion about eating disorder attitudes, beliefs and behaviours Inadvertently provide direct instruction Glamorize or normalize eating disorder behaviour Contribute to fear of food: good food/bad food 2010 Eating Disorder Interprofessional Community Capacity Building Team

17 Guidelines for talking about Eating Disorders in the classroom? Don t avoid questions - this may reinforce the mystery that sometimes exists around them If questions are asked by students focus discussions on aspects of the issue, not just on the extreme consequences of the disorder. You do not want to create a how to discussion Avoid being overly focused on food, as eating disorders are more complicated than a food issue Encourage, normalize and promote help seeking for emotional issues. (ex. Talk about everyone's need for help at different times in their lives.)

18 Guidelines for talking about Eating Disorders in the classroom? Conduct information sessions and discussions about mental illness in general Be mindful of language that may ostracise or blame people who experience mental health concerns (ex. Referring to a person as someone who is experiencing bulimia nervosa rather to them as bulimic Be aware of your own personal issues and attitudes around body image, healthy eating, weight loss dieting, people who are overweight and people with eating disorders (ex. Staff participating in Biggest Loser Competitions) Avoid all body measurement exercises in the classroom, gymnasium or school environment

19 Provincial Treatment Facilities

20 Renata Elizabeth Withers Center for Hope Clinic Provincial Mandate announced in 2006 Wellness Model (promotion, prevention and early intervention) Treats and supports outpatients and families (holistic approach) Serves adolescents and adults 18+ Referrals from family doctor or similar healthcare professional mandatory Provides continuity in treatment and support services e.g. relapses Will provide 3 meals, 2 snacks per day (food therapy) Intensive group/individual therapy Close liaison with Child Health and Adult Medicine Program Admission for medical stabilization Staff of 10 to 12 Interdisciplinary professionals

21 Janeway Adolescent Medicine Provincial Program Interdisciplinary team including: medicine, psychology, social work, dietician, nurse practitioner Children & Adolescents up to age 18 Family Support Programs In patient beds, out patient program Referral to Specialists Continuity referrals to the HOPE Program Relapse Services

22 Across Newfoundland and Labrador. Treatment and support services are available at Regional Health authorities across the province

23 Prognosis of Eating Disorders Important note: All of these numbers improve with prevention, early detection and treatment 45-50% improve to good health, good outcome 25-30% struggle to keep themselves out of hospital & often have irreversible complications, chronic fluctuating course 25% poor outcomes, Up to 20% mortality irreversible complications universal multisystem organ failure and death

24 Support and Educational services across the province Eating Disorder Foundation of Newfoundland and Labrador Only established leadership advocacy group dedicated to eating disorders in NL Body Image Network Developed curriculum for grades 2 & 4 across Province Addresses wellness, self esteem, positive body image, positive lifestyle etc. Great toolkits developed for students of all levels visit website Parents of Hope Monthly support group for parents facilitated by a parent and healthcare professional Must complete a Bridge to Hope Program Eating Disorder Interprofessional Community Capacity Building Team Team of professional who have travelled across NL for a two day workshop to train various medical and counselling professionals. They have developed a great training manual for professionals

25 Eating Disorder Foundation of Newfoundland and Labrador The Foundation provides many programs and services for families, individuals and communities across NL. Advocacy Education Awareness Family Support Resource Centre Primary contact for families

26 Our Progress to Date Public awareness about eating disorders has increased Families and individuals are seeking and receiving treatment The Foundation s advocacy and education role is working across the province and country HOPE Program The Foundation has given several presentations to various schools and service groups across the province First class resource centre Eating Disorder Interprofessional Community Capacity Building Team Body Image Network

27 We believe Education is the long term solution in the prevention of eating disorders. We need your help to spread our important message

28 Important websites Eating Disorder Foundation of Newfoundland and Labrador Body Image Network National Eating Disorder Information Centre Teachers guide to teaching students with Mental Disorders Educator and Coaches Tool Kit - National Eating Disorder Association Healthy Weight Network

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