Eating disorders recovery - how to handle a rough patch

If it looks like things are taking a turn for the worse, address matters head-on as quickly as possible, whilst remaining sensitive and supportive.

The pupil must not be made to feel that they’ve failed

More than likely they’ll be beating themselves up and be feeling deeply upset that they’re letting everyone around them down. This is a heavy burden to bear and you should aim not to exacerbate it by encouraging feelings of guilt. Instead, help the student to realise that this is simply a setback and nothing more… a detour rather than the end of the line.

Explore what has triggered the current difficulties

It won’t always be possible to isolate the source of a setback but in many instances it may be that a particular incident has caused the current difficulties, perhaps something someone has said or done. It is entirely likely that the offending action or comment was not intended to cause any offence or upset – sometimes even comments which are meant as compliments or to boost confidence can be misinterpreted and can trigger a setback. For instance the pupil who is told they are ‘looking well’ who interprets this to mean they’re ‘looking fat’. The pupil needs to feel able to share any difficulties such as this in confidence so similar situations can be avoided moving forward Read the rest of this entry »

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Talking to parents about eating disorders on the phone

It’s always preferable to inform a parent of their child’s eating disorder in a face-to-face meeting where you can read and respond to body language. However, it’s not always possible and you may end up having to have the conversation on the phone. In which case the following points are worth bearing in mind:

 

Choose the most appropriate parent

Ask the pupil which of their parents would be better to speak to. They are likely to have a good idea about which of their parents is most likely to supportive, understanding and comfortable discussing such a sensitive issue.

 

Plan what to say

Make a list of the points you want to cover beforehand – it can be very easy to become flustered on the phone if the conversation is difficult, or to fail to mention certain things if the conversation goes off in a different direction than you’d planned for.

 

Call at a good time

Pre-arrange a good time to call so that both you and the parent have time to talk. This is not a conversation that can be rushed. Read the rest of this entry »

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What not to say to recovering anorexics

This can be adapted to help you adopt the correct approach when talking to pupils recovering from bulimia or binge eating disorder as well. A great degree of sensitivity is needed when interacting with a young person recovering from any form of eating disorder. Their self-esteem is very low and they are in a very vulnerable position where they will believe and blow out of all proportion even the slightest negative comment (or even positive comments which they may reinterpret as negative). Here are some key flashpoints to avoid.

Avoid commenting on the pupil’s appearance

During the recovery process, it can be very easy for eating-disordered thoughts to be triggered by someone saying or doing the wrong thing, even if they mean well. Almost any comment on appearance can be reinterpreted by the pupil as, ‘You’re fat’.

Well-meaning comments such as. ‘You’re looking healthy’; ‘It’s great to see some colour in your cheeks’; ‘You must feel better now you have more energy’ are all open to misinterpretation. It’s best to avoid any comment at all on a pupil’s appearance.

Consider lesson content

It’s also important to be sensitive to tasks in class that may be difficult for the recovering pupil and to consider altering your scheme of work as necessary. Any tasks involving food, healthy eating and exercise, weighing or measuring the body in any way, or discussion of eating disorders are best avoided. If this is not possible, show the pupil all of the materials beforehand and allow them to opt out if they prefer. Read the rest of this entry »

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Tackling the eating disorders taboo in school

Many school staff that I’ve worked with have told me that in their school eating disorders were a taboo topic either because the school was loathe to admit there was a problem or because they’re worried that talking about eating disorders will lead to an epidemic. Other staff simply feel uncomfortable or out of their depth when talking about mental health issues.

We must get more comfortable talking about eating disorders

In order to effectively support young people with eating disorders at your school, it’s important that the taboo is tackled. We simply must get more comfortable talking about eating disorders, not doing so can cost lives as I discovered when talking to a PE teacher:

“…Everything came to a head one day when she collapsed at school. She was rushed to hospital but there was nothing they could do. She died of a heart attack. It turned out that there were five or six members of staff, myself included, who’d been worried about her but we all assumed that someone else was taking care of it – it wasn’t exactly the kind of thing we discussed in the staffroom. We’ve since created a policy and we now routinely discuss children whose mental health is a cause for concern.”

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Teaching pupils about eating disorders

Teaching pupils about eating disorders won’t mean they develop one

There is a much perpetrated myth that teaching young people about eating disorders will make them many times more likely to develop one. This simply isn’t true. Eating disorders are highly complex mental health illnesses and not something which will simply develop overnight as a result of a PSHE lesson. Teaching young people (and their teachers) about eating disorders may make the incidence of eating disorders appear to increase within your school, but that is because cases which may have previously gone unrecognised may now be picked up. That is a good thing as it means these young people who had previously slipped below the radar are now receiving much needed support.

Pupils will realise you are knowledgeable and think it’s an important topic

A key benefit of taking the time to teach your students about eating disorders is that this will make them realise that you think eating disorders are an important topic, and one that concerns you. It will also help them to realise that you are knowledgeable on the topic as long as you have prepared appropriately. Read the rest of this entry »

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Overcoming pupil objections to informing parents about their eating disorder

A good relationship with parents can make a huge difference when you’re supporting a pupil with an eating disorder. The pupil, their parents and the school should all be working together towards the common goal of helping the pupil to recover. However, pupils are often reluctant for their parents to be informed and involved for a variety of reasons.

 

Listen carefully to objections

In most instances, it is important to overcome the pupil’s objections so that parents can be involved in their recovery, however, it is important to listen carefully to their objections before dismissing them because very occasionally they may present a valid reason why a parent should not be informed. For instance, their eating disorder may be in response to abuse they are suffering at home. Here are some suggestions for overcoming common objections you’re likely to face:

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Healthy weight loss can put young people at risk of anorexia

There are a wide range of risk factors for eating disorders including social, personality and family factors that I’ve discussed before, but I’ve not discussed one of the most obvious ones. Weight loss. You might think that weight loss is a symptom of rather than a precursor to anorexia and in many cases you’d be absolutely right. But it is also not uncommon for healthy weight loss to go on to trigger an eating disorder.

Diets can go too far

As you’ll be well aware, it is very common for young people to diet. Occasionally a young person will successfully stick to a diet and may end up taking their diet too far which can result in the development of an eating disorder.

Positive feedback

One of the reasons that diets occasionally get taken too far and go beyond healthy weight loss is because of the positive feedback that dieters receive. Particularly if they were noticeably overweight to start with they are likely to receive a large amount of positive feedback from family and peers about their new healthier appearance. Read the rest of this entry »

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Weight change – the ultimate eating disorder warning sign

The most clearly evident warning sign of most eating disorders is a change in weight. Young people should be growing and steadily gaining weight until they reach their adult height and weight. It is relatively unusual for a young person to deviate from this course unless physical illness, an eating disorder or occasionally a healthy weight loss / gain programme is followed by the pupil. You should be hyper-vigilant to unusual changes in weight.

 

Weight gain

Young people will tend to steadily gain weight as their height increases. However, if you notice that a pupil is gaining weight more rapidly than their peers then it is worth taking note of whether they are exhibiting other binge eating disorder warning signs.

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Mealtimes: 10 ideas for supporting recovering anorexics

Parents and teachers of young people recovering from an eating disorder often find themselves in a situation where they want to offer support at mealtimes, but they don’t know how best to help. It will depend entirely on the individual and, as long as they are well enough, you should always be guided by the young person in question, but here are ten suggestions to help you on your way.

 

Think about meal timings and locations

The school lunch hall or cafeteria can be a difficult place for a recovering anorexic to spend time in. You should never insist that their meals are taken there, even if it is your school’s usual policy. Perhaps your school has more than one lunch sitting and the pupil would feel okay in the cafeteria at a time when their peers aren’t there, or perhaps you should find somewhere different altogether such as a classroom.

Trust them to keep their own food diary

Many recovering anorexics are expected to keep a food diary. It can be very tempting to complete this on their behalf because you know what they have eaten and are keen to ensure that it is recorded accurately. However, it can be an important show of trust to allow the pupil to complete their own food diary. Of course, if you have reason to suspect it is wildly inaccurate then consider again!

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5 useful phrases when talking to someone with an eating disorder

It can be difficult to know what to say when you’re talking to someone with an eating disorder, especially if you’re discussing the eating disorder itself. Many of us fear that using the wrong words will make things worse and it’s common to shy away from saying much at all. But if you put yourself in the shoes of the sufferer you’ll realise that would make for a lonely existence. There are things that you can say that are useful. Here are a few…

“How can I help you?”

It’s really, really hard to know how to help someone with an eating disorder. Maybe you’ve been wracking your brain to no avail. Well here’s a secret… the best way to find out is to ask them. This can be a real conversation starter and you’ll be amazed at some of the suggestions you’ll get back, anything from, “Sit with me when I eat, but please don’t talk” to “Don’t pretend there’s nothing wrong with me” to “Just keep asking, it’s helpful to know you care.” Don’t ask unless you’re genuinely willing to help and support though. Read the rest of this entry »

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