By: T. O. Paul Harper, PhD and Randy K. Hardman, PhD
When a parent, teacher, or school counselor is faced with the need to give advice on ways to help an adolescent with slacking academic performance, it is important to consider if that student has an eating disorder. An eating disorder is born out of intense distorted thoughts and beliefs, and an individual with an eating disorder can distort messages meant to inform, console, educate, and advise into twisted self-contempt messages that promote further reliance upon the eating disorder and increased withdrawal from activities and friends. This is a process both frustrating and confusing to those who work with students with eating disorders and to the students themselves, fostering low self-esteem and a belief in their inability to perform. In order to undo this negative cycle in one who suffers with an eating disorder, it is important to understand what is happening to them and to provide opportunities to confront and counteract these negative and twisted beliefs. Academic performance and school activities are almost completely curtailed in the advanced stages of an eating disorder and will lead to massive disruption in a student’s educational advancement unless addressed in the appropriate manner. Traditionally, educational advancement in many who have suffered with serious eating disorders has been checked with periods of inactivity, hospital stay, setbacks, and disappointments, and in falling further and further behind in academic requirements for college. This does not need to be the case when the student is placed in the proper educational environment designed to address both the severe eating disorder and to foster continued educational advancement.
An Educational Profile of a Typical Eating Disorder Sufferer
An eating disorder sufferer is a contradiction in behaviors. An individual who is deeply entrenched in an eating disorder displays a set of characteristics diametrically opposed to her behavior when not suffering with the disorder. She becomes listless, withdrawn, emotionally numb, unexpressive, disinterested in activities, anti-social, and incapable of concentrating. Once she works through the eating disorder, she reverts quickly back to her real selve – sensitive, intelligent, outgoing, involved in many activities that reveal many talents, able to focus on multiple projects, and very giving and loving. Amy is a beautiful and gifted senior in high school. She is a cheerleader, the English Sterling Scholar from her school, writes beautiful poetry and stories, and is very active in school affairs. Amy has recovered from an eating disorder that completely disrupted her life. She writes,
Eating disorders are born, raised, and sustained by negativity; it is the bitterness I experienced with my eating disorder that allows me to appreciate and savor sweetness much more than I did before… Like any addict or substance abuser…I refused to think I had a problem. Not until I had been hospitalized for nearly three months…did I realize the horrific consequences brought about by my eating disorder. It had made me into the person I strived NEVER to become: I fought with my parents, I said things I will forever regret, I lied, I stole, I slipped in my studies, I isolated myself, twice I was tempted with suicide….ultimately, everything I had worked for and wanted was either gone or going as a result of my eating disorder. I lived in a grey haze which never cleared and allowed the little light left in my life to wane systematically.
The contrast between eating disorder behaviors and healthy behaviors is drastic and frightening. Parents who witness this transformation in their child’s behavior, from a bright, energetic, and outgoing person to someone with the exact opposite characteristics, react with a swift desire to alter the trend. Unfortunately, very often the tried and tested methods of eliminating suffering and changing undesirable behaviors are the very things that can make the disorder worse. Telling a daughter, “You are beautiful and don’t worry!”, usually is interpreted as, “She feels she needs to say that because I am so ugly,” and the command, “Eat all the food on your plate!” may be interpreted by the daughter as, “My parents want me to be fat and unpopular at school,” etc.
The School Environment
One of the most obvious evidences of something going wrong in the sufferer’s life is the impact the eating disorder has on school achievement. The sufferer’s normally high grades start to slip. She begins to withdraw from activities and becomes more antisocial. She loses interest in school subjects and extracurricular activities. She loses her ability to focus on important projects, papers, and tests. She becomes much more emotionally hypersensitive to what is going on around her and what others may be thinking about her.
I could not stay focused on my school studies. My concentration level was terrible and I could never read book assignments without my thoughts wandering. I was always too tired to stay awake, and more often than not my head was on the desk top sleeping. All of my energy went towards my eating disorder. It was first priority. (19-year old woman.) My concentration level decreased, I skipped classes, isolated myself from friends, and didn’t care about grades. I went from A’s and B’s to D’s and F’s. (High School Junior)
School can be a quick-paced, unrelenting, socially competitive, and strenuous environment. When you combine this with the changes that are taking place in the lives of young women, it becomes a potentially threatening and frightening place. If an individual starts to wonder and worry about their social and intellectual status, the school environment can become a very intimidating place. For an individual suffering from an eating disorder the school environment is filled with messages that can be twisted and confused within their negative self-judgment and criticisms. The whole experience can become too overwhelming to bear.
My anorexia destroyed my concentration, my drive, my love of school, and my performance in classes. Education no longer played a vital role in my life. My anorexia preoccupied and consumed all of my time, leaving little time for school and studies. Anxiety-producing stress only exacerbated my anorexia, which, in turn hindered my performance. (College Freshman)
Parents looking for the quickest and most logical means to alleviate the disruption of an eating disorder often encourage their eating-disordered child to become more involved and to work harder in their school setting to display their natural talents and abilities. The child unable to cope with the negativity she senses inside herself and all around her in school, reacts in the opposite manner and starts to withdraw and shut down even more. She knows what she feels and is confused about her inability to cope with the seemingly simple solutions her parents offer. She very naturally starts to believe that something is wrong with her, e.g., she is a social outcast, unable to fit in, or undeserving of good things.
Positive Strategies for Parents
Parents can help their daughters by doing the following:
- Do not treat this problem as just an academic issue, but rather recognize the emotional roots of anorexia and bulimia.
- Be open to feedback from teachers, counselors and others who can help.
- Educate yourself on the causes, impacts, and treatments of eating disorders through literature, books, seminars, and the Internet.
- Talk to your daughter about what is underneath the disordered eating behavior, do not just focus on the eating patterns.
- Recognize the need for proper assessment, dietary counseling, medical consultation and therapy treatments and options.
- Get involved in a parent support group.
- Talk about the issues and possible solutions to eating disorders with the whole family.
- Don’t be fooled by a daughter’s attempts to minimize and ignore the real problem, be firm about the need for recovery while being sensitive to not forcing the issues.
- Be a good role model around food, take care of yourself, don’t blame yourself, and be patient.
- Recognize that recovery takes time and do not place unrealistic demands for a quick fix of your daughter’s eating disorder.
High School Eating Disorder Research
In the past, approximately 1500 high school students in Utah and Nevada have filled out an eating survey (Foundation for Change Study, 2000) designed to assess eating disorder thoughts and behaviors. The results of the survey suggest that approximately 6% to 13% have already developed a diagnosable eating disorder; 30% to 35% have attitudes and beliefs about food and weight that fall into the abnormal ranges and that put them at risk for eventually developing an eating disorder. These findings document that there is a growing need for effective education and awareness programs on eating disorders in high school settings.
A Teacher’s Dilemma
It becomes important for teachers to understand the impact of anorexia and bulimia so they can pick up on the signs and consequences of eating disorders among their students. Since most students with anorexia and bulimia are very bright and talented it can be difficult for teachers to pick up students’ subtle changes in feelings and attitudes before their academic performance suffers. Consequently, knowing that approximately 2 out of 10 girls in any school class are at risk for developing an eating disorder presents a dilemma about when to raise concerns about anorexia and bulimia. Thus, it is helpful to raise the subject matter at different times throughout the year in general fashion. Doing this will encourage students struggling silently with the pressures and stresses of life and school to talk to you or a counselor in private before the eating disorder behaviors begin to disrupt academic performance. The fact that a teacher is willing to broach this subject in an open and general fashion can be perceived as a safe invitation for students afraid of negative consequences of an eating disorder to do something for themselves.
Another dilemma for teachers is often how to approach a student about a suspected eating disorder that is disrupting personal and academic performance. Most girls with eating disorders will deny, minimize, or lie about the problem when confronted directly. They often feel ashamed of who they are and their behaviors. It is important to not make direct accusations about concerns, but rather, gently talk about what you are seeing as a teacher and encourage them to talk to you, or someone else, when they feel more ready to do so. Raising the concern in their presence and then giving them room to come back to you, whether they are struggling with an eating disorder, depression or some other personal problem, will let them know that you have noticed, cared, and have offered a kind invitation for them to do something about it.
For the student more entrenched in the eating disorder, another dilemma for a teacher is whether to tell other school personnel or the parents about their concerns. Sometimes parents are the last to see the eating disorder because they want to believe their daughter’s responses to their questions. It is important to first talk to the student in private. Explain that you need to do something to help them rather than ignore or avoid the problem. Then give them some time to get back with you about who they are willing to let you talk to about the problem. For many girls with eating disorders it was the persistence and honesty of a significant other that led to their decision to seek treatment. For those girls who are too afraid or angry to admit to or address the eating disorder, it is very important to make more people aware of their problem, including the parents, so that teachers do not become silent collaborators of the disorder. The student may not be ready to change but they will know the secret is out.
Positive Strategies for Teachers
There are a number of things teachers can do to help their students:
- Encourage counselors in schools to start support groups for those who struggle with eating problems and body image concerns.
- Develop working relationships with counselors who can do one-on-one work with students and who can refer to outside
- Encourage the school to have assemblies or combined classes where outside professionals and recovered eating disorder
- sufferers can do presentations for the students.
- Provide materials and information on eating disorders that students can review on their own.
- Conduct a school wide awareness program during National Eating Disorder Awareness Week in the spring of each year.
- Be sensitive to the reality that eating disorders are about psychological and emotional pain and conflict and not about food and weight.
- Actively give invitations and encouragement to students to get help to overcome their eating fears, concerns, or disorders.
- Talk to other teachers informally to develop a network which can identify at-risk students and offer support to those identified students.
High school students suffering with an eating disorder can create an unusual challenge for any teacher, but the awareness of this illness can give a teacher increased opportunities to help these students.
The Educational Philosophy at Center for Change
A fundamental belief at Center for Change is that education is a basic right and opportunity for all human beings. Eating disorder sufferers are inhibited in their ability to take full advantage of academic education opportunities. An individual with an eating disorder can forfeit their right to an education because of a negative belief in their ability to do what is necessary to meet educational goals and cope with the educational environment. At Center for Change we recognize that fundamental to the gaining of an education is the ability to: (1) take advantage of educational opportunities, e.g., have appropriate social, coping, and learning skills, (2) maintain personal motivation for educational activities, e.g., learn to love education, and (3) believe in one’s personal ability to achieve educational goals, e.g., believe in one’s ability to cope with the environment in addition to meeting class requirements. We recognize the full negative impact of anorexia and bulimia on a young woman’s life and on her ability to fully function in an academic setting.
Center for Change incorporates an educational philosophy and program designed to help participants become able, motivated, and self-efficacious learners who can continue their academic educational development. The goals of the educational program are designed to augment the intensive care the Center utilizes to overcome an eating disorder, thus providing a powerful and synergistic therapeutic and academic experience.
The school at Center for Change will offer a complete academic curriculum for the high school student, grades eight through twelve, designed to move participants toward graduation and competency in university studies. Each student is given a complete battery of psychological, educational, and intelligence assessments designed to determine the most appropriate placement of students in our academic program. We are able to offer a unique set of core and elective courses that address the special challenges faced by students who suffer with eating disorders. We are committed to quality education, offered by certified teachers in an accredited academic institution. We are doing all we can to meet the above goals and provide the finest education available to our students.