Contributor: Lauren Seicke, LGPC, at The Center for Eating Disorders at Sheppard Pratt
As children and adolescents begin a new school year, it is normal to feel the “back-to-school jitters.” And this year, the normal anxiety that accompanies the beginning of a new season may be exacerbated by the uncertainties of the COVID-19 pandemic. For individuals who struggle with an eating disorder, feelings of anxiety may make them desire to seize control where they can, and engage in maladaptive coping strategies, such as the urge to act on eating disorder symptoms.
That said, if we can help children and adolescents navigate their normal back-to-school anxiety, returning to in-school learning will likely have a positive impact. For example, the school schedule offers structure. Socialization happens “IRL”—in real life, instead of in the curated world of social media. And there are additional caring adults, such as teachers, school counselors, and coaches to help parents notice when a child doesn’t seem like their typical self. The school environment can still include negative factors, such as bullying and comparisons to others. But these factors already existed on social media, and hopefully can be better monitored by the adults in the school environment.
Because unfortunately, the social isolation during the pandemic has been difficult for individuals who struggle with an eating disorder. In fact, a study published in the International Journal of Eating Disorders reported that 70% of patients who have a diagnosed eating disorder reported an increase in eating and weight concerns, drive for exercise, or isolation and loneliness. The study also reported that during the early months of the pandemic, in-person therapy and visits to the general practitioner decreased by 37% and 46%, respectively. During the pandemic, many children and adolescents were at home, without a structured schedule, with access to food or other triggers, and isolated from support networks.
Further, social media use increased during the pandemic. This 24/7 access to the negative, inauthentic world that can exist on social media can foster fake, elusive standards of beauty that are impossible to achieve. In fact, a recent study by Wilksch et al. noted a marked correlation between social media use and disordered thoughts and behaviors related to eating.
As children return to school, parents and caring adults should be aware of several important warning signs that indicate an individual may have an eating disorder.
First, is the individual isolating themselves from others? When a student pulls away from peers and the adults in their life, this could be a sign of an eating disorder. They may also disengage from activities they previously enjoyed.
Individuals with an eating disorder may also wear clothes that are bulky or a few sizes too large to hide a body that they feel is too big, or disguise excessive weight loss or gain.
Take notice if they are they restricting what they eat, or purging when the feel they ate too much. This can be tough to determine. A teen might claim they can’t come to dinner because they have too much homework. Or in the lunchroom cafeteria, they claim they actually already finished their lunch, when they really threw it in the trash. One sign that they are engaging in this behavior is if they always go to the bathroom right before or after a meal. Going before a meal might mean they are “body checking,” or looking at their body to decide if they “deserve” a meal. Going after a meal may mean they are purging the food they just ate.
Next, check their hygiene. Not caring for their appearance and body is another sign that the eating disorder has taken over, and the child or teen is no longer caring about anything except obeying the demands of their disordered thinking.
And finally, do they seem irritable? Individuals who routinely do not give their bodies the fuel and nutrients it needs will understandably become very irritable.
How to Help
There are a lot of ways parents, teachers, and supportive adults in the school environment can help someone with an eating disorder get help and begin a path toward recovery.
Be empathetic. This can be hard, especially when an adolescent with an eating disorder can be quite irritable. But the more adults can try understand the child and become educated about the eating disorder and really “walk in their shoes,” the better they will become at supporting them.
Foster healthy communication. Actively listen to the child, then repeat what they have said to validate them and make sure they know they were heard before responding. Then, lead with “I” statements. For example, instead of saying, “You make me so mad when you don’t eat!” say, “I feel worried for you when you won’t eat, and that fear makes me angry.”
Utilize all resources available. The school setting has numerous trained, caring adults available to support the student. These include teachers, administrators, counselors, coaches and even other peers. This is especially helpful for parents, as parenting a child with an eating disorder can be extremely taxing. Having an external person for the child to talk to can really take a lot of pressure off of the family. That said, sometimes the school environment does not have the level of specialized care needed to help someone with an eating disorder get on a path to recovery, so parents should also consider finding professional individual and family therapy.
Create an environment that celebrates all bodies and their uniqueness! The adolescent years are especially tough, as children go through the natural changes of puberty. Schools can help students foster body positivity through classroom lessons about these changes, small group “lunch bunches” with the school counselor to help shy kids foster friendships, and a culture that celebrates uniqueness. Parents, too, should lead by example. Kids watch when parents express distaste for their own bodies, or criticize others.
Healthy School Days
After so many months of isolation and virtual learning, the return to school should be a very positive change for most students. Therefore, the importance of schools creating a positive and safe space for kids cannot be overstated. This fall, instead of getting back-to-school jitters, children and parents should recognize the valuable resources that schools have available for individuals who struggle with an eating disorder.
Resources:[1.] Schlegl, Sandra, PhD; Maier, Julia, MSc; Meule, Adrian, PhD; Voderholzer, Ulrich, MD. (August 2020) Eating disorders in times of the COVID-19 pandemic—Results from an online survey of patients with anorexia nervosa. International Journal of Eating Disorders. https://onlinelibrary.wiley.com/doi/10.1002/eat.23374 [2.] Wilksch, Simon; O’Shea, Anne; Ho, Phoebe; Byrne, Sue; Wade, Tracey. (Jan. 2020) The relationship between social media use and disordered eating in young adolescents. https://pubmed.ncbi.nlm.nih.gov/31797420/
About the Author:
Lauren Seicke, LGPC, is a therapist with Sheppard Pratt Center for Eating Disorders. In this role, she provides individual and group therapy to patients of all ages. Lauren Seicke has worked with individuals with various mental illnesses and emotional difficulties. Lauren graduated from Johns Hopkins University with her clinical counseling degree. She is motivated by improving the lives of her patients through treatment utilizing Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. Previously, Lauren was a school counselor in a Title 1 school and has worked on the Neurobehavioral Unit at Kennedy Krieger Institute. Her professional interests include fostering change through mental health treatment for all ages and her efforts to make mental health support more accessible in her private practice which she enjoys in the evenings.
The Center for Eating Disorders at Sheppard Pratt provides treatment for adults and adolescents with complex eating disorders. We call eating disorders “complex” because each disorder has its own unique set of causes, symptoms, and health risks, and every individual may experience the illness and the recovery process differently.
Everything we do is guided by our extensive experience and the latest research into the biological, psychological, and social factors of anorexia nervosa, bulimia nervosa, and binge eating disorder.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published September 15, 2020, on EatingDisorderHope.com
Reviewed & Approved on September 15, 2020, by Jacquelyn Ekern MS, LPC