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Get Ahead Kids - Vol. 5, No. 5 - September/October 2013

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A Lesson for Teachers in Addressing the Eating Disorder Bully

By June Alexander

Today, I would recognise the signs: the 11 year old girl in the grade six class spending her entire recess and lunch-break running in the schoolyard and doing circuits in the gym; every day, exercising more; the same girl continuing to get top marks with her school work, always punctual, eager to please, but becoming withdrawn; her bubbly personality disappearing; she is not eating her lunch - she offers it to her playmates. She keeps only the apple and eats this very, very slowly, one nibble at a time.

Today I would recognise these as symptoms of anorexia nervosa, as this child was me.

Teachers are in a prime position to be among the first people to notice a child developing an eating disorder. I certainly wish my teacher had recognised the symptoms and intervened.

But that was 50 years ago. Today, I like to think that all teachers are aware of the signs of anorexia nervosa, and that they know how to respond. Sometimes, friends of the child notice the symptoms, and confide in the teacher. Or perhaps the coach or dance instructor may notice behavioral changes.

How the teacher responds - how they offer support - can greatly influence what happens next. Clues on what to say, and when to say it, are provided in my latest book: 'Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends.'

This updated eating disorder classic includes information for teachers and others whose daily work involves the care of children.

Teachers often want to help when they suspect a child is suffering symptoms of anorexia nervosa, but don't know when to say something, what to say, or how to say it. They might even decide that it is better to say nothing than to say the wrong thing. This just goes to show how important it is for school staff to be educated and informed about eating disorders - so that they feel confident and more able to help.

A teacher's attitude and response can greatly influence whether the illness is 'nipped in the bud' and stopped in its tracks, or gathers pace and becomes entrenched.

Teachers are well placed to spot the early signs of anorexia nervosa, enabling early diagnosis, early intervention and a far better prognosis. A child may feel more comfortable talking about food difficulties with a teacher rather than someone in their immediate family.

The school can provide a bridge between the child, their family and other care providers to ensure the best possible outcome.

School Specific Warning Signs

Some anorexia nervosa warning signs are more easily noticed at school. Observing me at age 11, the teacher would have ticked a box in each of the following:

  • Weight loss (not because I did not want to eat, but was afraid to eat)
  • Avoidance of PE or swimming (because it involved undressing)
  • Excessive exercise (I felt driven to do more each day)
  • Busy during lunch breaks (to avoid questions like 'why aren't you eating?')
  • Wearing extra clothing (to keep warm and hide the body)
  • Perfectionism (important to get everything right to avoid anxiety)
  • Inability to focus in class (when the brain is starved, concentration is more difficult)
  • Loss of friends (because food thoughts increasingly dominate thinking time)

When a Child is Causing Concern

When a teacher suspects a child may be suffering from anorexia nervosa, they need to tell the person responsible for pastoral care within the school.

They may already be aware of the problem, or they may enlist your help.

Creating Opportunities for Confiding

A child feels more comfortable when they 'make the first move' with regards to talking about their eating disorder as this helps them to feel in control of the situation.

To facilitate this, a teacher can create situations for one on one time such as suggesting they stay after class to discuss their homework.

Often, a child with an eating disorder feels scared and alone, and during the early stages may welcome the chance to offload to someone.
Remain calm and don't judge. Encourage the child to share their fears with questions such as: 'You don't seem quite yourself lately, how can I help you?'

Avoid talking about food or weight directly as this is likely to frighten the
child. Take this first meeting gently and accept that you are unlikely to get to the crux of the issue immediately.

Focus on listening to the child. Work on building a trusting relationship and ensure that they know when and where they can talk to you further about what's on their mind.

This article was originally posted on the National Eating Disorders Association blog. For more information, see Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends. Pooky Knightsmith writes the chapter 'Guidelines for School Staff'.

About June Alexander

June grew up on a family dairy farm in Victoria in the 1950s. As one of two daughters, she was her father's shadow on the farm. Her mother called her 'Tim'. She attended a one-room primary school. Around puberty she began to experience what today would be called a body image problem. In grade six, she developed anorexia nervosa, a severe psychiatric illness that would challenge and shape her life. A love of the written word became her tool for survival.

A journalist since the age of 18, June worked for many years on rural and suburban newspapers as senior writer, editor and newspaper columnist. In the past three years, she has written and edited three books about eating disorders: "My Kid Is Back - Empowering Parents to Beat Anorexia Nervosa" (collaborator, Prof. Daniel Le Grange); "A Girl Called Tim - Escape from an Eating Disorder Hell"; and textbook "A Collaborative Approach to Eating Disorders" (co-author, Prof. Janet Treasure).

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