Education Professionals

Education professionals are ideally positioned to detect early signs and symptoms of eating issues and disorders.

Educators, teachers and trainers therefore play an important role in helping to prevent eating issues from developing further, resulting in better long term outcomes for treatment.

Recognise the warning signs

People with eating disorders may display a combination of symptoms or they can show only one symptom. In some cases, they may not show any signs or symptoms at all. They may make significant efforts to conceal their behaviour or they may not even recognise that there is anything wrong or that their eating habits have become ‘disordered’.

Warning signs that can signal the onset or the presence of an eating disorder include:

Physical warning signs

• Rapid weight loss or frequent changes in weight

• Loss of or disturbance of menstrual periods in girls and women

• Fainting or dizziness

• Lethargy and low energy

• Swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath which can be signs of vomiting

• Feeling cold most of the time, even in warm weather

Psychological warning signs

Psychological warning signs can be difficult to detect. They usually only come to light through changes in behaviour or through discussion and conversation. Psychological warning signs may include:

• Preoccupation with eating, food, body shape and weight

• Feeling anxious around meal times

• Feeling ‘out of control’ around food

• Having a distorted body image

• Feeling obsessed with body shape, weight and appearance

• ‘Black and white’ thinking (e.g. rigid thoughts about food being ‘good’ or ‘bad’)

• Changes in emotional and psychological state (e.g. depression, stress, anxiety, irritability, low self-esteem)

• Using food for comfort (e.g. eating as a way to deal with boredom, stress or depression)

• Using food as self-punishment (e.g. not eating for emotional reasons like depression/ stress)

Behavioural warning signs

Behavioural symptoms are commonly present in those with eating disorders. While you may recognise some of these symptoms in someone you care about, these signs can still be concealed and may be difficult to detect.

• Dieting behaviour

• Eating in private and avoiding meals with other people

• Evidence of binge eating (e.g. disappearance or hoarding of food)

• Frequent trips to the bathroom during or shortly after meals

• Vomiting or using laxatives, enemas or diuretics

• Changes in clothing style (e.g. wearing baggy clothes)

• Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)

• Making lists of good or bad foods

• Suddenly disliking food they have always enjoyed in the past

• Obsessive rituals around food preparation and eating (e.g. eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time everyday)

• Extreme sensitivity to comments about body shape, weight, eating and exercise habits

• Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)

 

Understand who is most at risk

Eating disorders can occur in people of all ages and genders, across all socioeconomic groups, and from any cultural background. There are many risk factors that increase the likelihood that a person will experience an eating disorder at some point in their life. Knowing who is most at risk of developing an eating disorder can help educators, teachers and trainers know who will benefit most from preventative interventions.

High risk groups that you may be in contact with as an educator

• Adolescents

• Women, particularly during key transition periods, for instance from school to adult life

• Athletes

• People with a family history of eating disorders 

• People who are interested in weight loss

• Young people with Diabetes or Polycystic Ovary Syndrome

For more information, see the NEDC booklet: Eating Disorders in Schools: Prevention, Early Identification and Response.

Eating disorders in males

While eating disorders are often portrayed as illnesses that only affect females, large population studies suggest that up to a quarter of people suffering with anorexia nervosa or bulimia nervosa are male, and almost an equal number of males and females suffer with binge eating disorder. We also know that underdiagnosis and cultural stigma mean that the actual proportion of males with eating disorders could be much higher.

One unique difference between males and females with eating disorders is that men often engage in compulsive exercise as a compensatory behaviour, typically with the aim of achieving a more muscular, and not just slender, body type. Compulsive exercise describes a rigid, driven urge to exercise and is a serious health concern. 

To find out more, see the NEDC fact sheet Eating Disorders in Males.

Screening 

Screening questions may help people to identify and talk about their body dissatisfaction or disordered eating with a health professional leading to earlier access to treatment.

Screening for eating disorders 

  • Eating disorders are complex illnesses with serious consequences for health and quality of life
  • Early detection and intervention can reduce the severity and impact of the illness
  • High risk groups can be identified
  • Screening tests are available

For more information, please contact the NEDC

 

KEY STEPS: What to do if you suspect someone has an eating disorder

Be familiar with Mental Health First Aid

The Mental Health First Aid guidelines for eating disorders provide evidence based recommendations about how to help a person developing or experiencing an eating disorder.

Be prepared

While there is no 'right' or 'wrong' way to talk to someone with an eating disorder, there are some important steps you can take to be prepared. 

For more information, see the NEDC booklet: Eating Disorders in Schools: Prevention, Early Identification and Response.

Express your care and concern

The first steps toward treatment and recovery from an eating disorder are often very hard to take. However, if you suspect that someone has an eating disorder it is important that they seek help immediately.

The sooner a person starts treatment for an eating disorder, the shorter the recovery process will be. Seeking help at the first warning sign is much more effective than waiting until the illness is in full swing.

Some helpful tips could include:

• Help them to feel it is safe to talk to you

• Give them time to talk about their feelings

Some things to avoid:

• Avoid putting the focus on food - try talking about how the person is feeling instead

• Avoid taking on the role of a therapist - you do not need to have all the answers, rather it is most important to listen and create a space for them to talk

For a more extensive list of tips and important things to avoid, see the NEDC booklet: Eating Disorders in Schools: Prevention, Early Identification and Response.

Seek help early

The importance of seeking help early cannot be overstated. The earlier an intervention occurs, the shorter the duration of the eating disorder, and the greater the likelihood of full recovery, especially in children and younger adolescents.

You can help by remaining supportive, positive and encouraging. 

Carers also have access to specialised services for support and advice. You can access these here. 

In a school context: Involve the family whenever possible

Decisions about when to pass confidential information about a student’s health and wellbeing on to the student’s parents can be complicated as not all schools are covered by the same legislation or guidelines. Teachers should refer to their own school’s privacy policy and codes of practice to inform their decisions about communicating with parents.

From a recovery perspective there are many potential benefits of involving the family of a student with an eating disorder. Family and friends play a crucial role in the care, support and recovery of people with eating disorders. Clinical guidelines for best practice in managing eating disorders encourage the inclusion of families at each stage of treatment for adolescents with eating disorders, from the initial assessment to providing recovery support.

For more specific suggestions on correct procedures for contacting parents with regards to student welfare issues, see the NEDC booklet: Eating Disorders in Schools: Prevention, Early Identification and Response.

In a school context: Establish a support network

A student places a huge amount of trust in a teacher by disclosing a mental health issue and so it is important to respect that trust and respond appropriately to any such disclosure. One element of an appropriate response is the need to respect the confidentiality of the student.

Always be upfront and honest about your duty of care and any responsibility you may have to report issues to other members of staff, the student’s family or any external authorities. Ideally you should obtain the student's permission to pass their information on, but if this is not possible be clear about who you are going to tell and why. Try to minimise the number of people who are told to show the student you are trustworthy and are respecting their privacy.

For more specific information on following school policy and confidentiality, see the NEDC resource: Eating Disorders in Schools: Prevention, Early Identification and Response.

For friends and family

Friends and siblings of a person with an eating disorder may need support in adjusting to the situation and their role in supporting their friend or sibling. Friends of a person with an eating disorder can become confused about their own body image and ideas about diet and exercise.

For specific ideas and tools of how to care for your friend or sibling with an eating disorder, see: 

8 Tips for Dealing with an Eating Disorder and Eating Disorders 101

 

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