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Dying to Fit In: When School Stresses Trigger Eating Disorders

By Hugh C. McBride

With such a great degree of attention being focused on the obesity epidemic among America’s youth in recent years, parents and students might be forgiven for thinking that the “freshman fifteen” and other similar gains are the only serious weight-related challenges facing them and their families.

But as young people across the country return to the classroom, many high school and college students may experience back-to-school stressors that lead to unhealthy, and in some cases life-threatening, weight losses.

According to the National Eating Disorders Association, cases of eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating have been on the rise for nearly a century, with school-aged young women and men bearing the brunt of these conditions:

• An estimated 10 million women and one million men are afflicted with an eating disorder.

• Eighty percent of Americans say they are unhappy with their appearance.

• More than half of all teenage girls and almost one-third of teenage boys engage in unhealthy weight control behaviors such as skipping meals, refusing to eat, smoking cigarettes, vomiting, and taking laxatives.

• More than 80 percent of U.S. 10-year-olds who participated in a 1991 study said they were afraid of being fat.

• Forty percent of newly diagnosed cases of anorexia involve female patients between the ages of 15 and 19.

• The prevalence of anorexia in women ages 15 to 19 has increased every decade since 1930.

• The rate of bulimia in girls and women ages 10 to 39 increased by 300 percent between 1988 and 1993.

Many Causes

Eating disorders are intensely personal conditions that may be preceded, triggered, or exacerbated by a number of events and experiences. For example, some students starve themselves in response to stresses or traumatic events; others binge and purge because they believe it will help them “improve” their appearance; and still others end up with eating disorders as a result of trying to enhance their athletic ability.

The following are three of the many experiences that have preceded the development of eating disorders by some young men and women:

Teasing & Taunting – Angelique, the recovered anorexic who runs the eating disorder blog “Breaking the Mirror,” attributes her condition to a misguided attempt to put an end to middle-school torment.

“I didn’t set out to become anorexic; I just wanted to never be called ‘fat’ in school again,” Angelique wrote on her blog. After she lost some weight on a 1,200-calorie-a-day diet, she cut her intake in half, then reduced it even more. Though inflicting considerable damage upon herself, Angelique recalled, she reveled in the positive responses she received.

“When eighth grade started, everyone began telling me that I looked good,” she wrote. “Teachers even noticed the weight loss and never seemed to worry about it. And I began starving myself in earnest, delighting in the attention from my peers and authority figures.”

New School Stress – Though Angelique’s anorexia occurred because she wanted to alter her environment, Ohio State University professor Dr. Lisa Werner told the school’s student newspaper that change can also be the cause of disordered eating.

“Change is stressful. Leaving home for college is perceived as so, and it can lead to an eating disorder,” Werner told The Lantern reporter Christine Dumford. “Students may feel that they do not have a lot of control over anything in their lives, but they feel they can take control of their bodies.”

Competition – Some highly competitive athletes in “aesthetic” sports such as gymnastics, diving, and bodybuilding may be driven into disordered eating by compulsions to achieve the “perfect” look. Within the classroom itself, a different type of competition may have a similar outcome.

Researchers with the University of Western Sydney (Australia) have determined that schools that emphasize competition and discipline can inadvertently be encouraging disordered eating by students.

“When the culture and practices of schools focus excessively on competition and individual achievement, it can encourage a drive for perfection,” Christine Halse, the associate professor who led the UWS study, said in an Oct. 2, 2007 press release on the school’s website. “This drive for perfection is a key feature of anorexia, and for vulnerable individuals it can extend to other areas of daily life.”

Advice for Parents

It is virtually impossible to predict a student’s likelihood of developing an eating disorder, but parents can increase their children’s odds of staying healthy by monitoring their behavior, keeping the lines of communication open, and getting help when they suspect a problem.

In addition to dramatic changes in body weight, the following signs could indicate that a student is struggling with an eating disorder:

• He constantly makes excuses to skip meals. When he does sit down at the table, he eats very little.

• She follows a highly regimented and restricted diet, allowing herself small portions of limited types of food according to a strict meal schedule.

• He demonstrates an unhealthy focus on how much he weighs.

• He becomes obsessed with exercise, and becomes hostile, defensive, or withdrawn when questioned about his eating or exercise habits.

• She starts wearing oversized, baggy clothes to hide her body, and becomes withdrawn and secretive about how she spends her time.

• Her skin becomes unusually dry; the hair on his head becomes thin and brittle; and soft, downy hairs begin to grow on his torso, arms, and legs.

• She seems unusually fatigued or lethargic, and complains of being cold even in warm rooms.

• She seems to be increasingly stressed about school, appears to be fixated on achieving perfection, and becomes unduly frustrated with even the slightest setbacks, failures, or personal shortcomings.

Some students who develop eating disorders are able to be treated on an outpatient basis, while others require hospitalization or a stay in a residential treatment facility. Parents who are concerned about their children’s eating habits should consult with their family physician, contact a school counselor, or seek assistance from a mental health professional.

[This article originally appeared on the Aspen Education Group website.]