Final/Summative Assignment

Brandy Chevalier

Student #060923

04:757 Education of Children with Behavioural Disorders II

Mary-Anne Ploshynsky

August, 2012

Eating Disorders

Introduction• Eating disorders are

constantly glamorized by the media

• People who have high social status are portrayed to have obsessions with slenderness as well (Kauffman & Landrum, 2013)

(upside of inertia, 2010)

• Anorexia Nervosa and Bulimia Nervosa demand the most attention from society (Macera & Mizes, 2006; Wilson, Becker & Heffernan, 2003)

• Anorexia and bulimia are considered to be predominantly a problem of adolescent females (Robb & Dadson, 2002).(Eating Disorder Community, 2012)

Anorexia Nervosa• Obsession with low body

weight• Fear of gaining weight• Extremely anxious about

getting “fat”• Go to extreme lengths to

achieve a low body weight• Females suffer more often

from anorexia nervosa in comparison to males at a rate of 3:1

(Kauffman & Landrum, 2013)(Helm, 2009)

Bulimia Nervosa• Binge eating followed

by an offsetting behavior

• Offsetting behaviors include self-induced vomiting, use of laxatives/enemas or extra exercise

• Binges are often kept secret(Kauffman & Landrum,

2013)(Heart, 2010)

Psychological and Behavioral Signs of Anorexia and Bulimia

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders IV (2000), anorexia nervosa and bulimia nervosa can manifest in the following psychological ways, which varies from one patient to the next:

• May withdraw socially, be irritable, have insomnia, and experience reduced libido

• Most people with eating disorders suffer severe forms of anxiety

• People with eating disorders are often perfectionists

• People suffering from anorexia nervosa are often obsessed with food, they may collect recipes or hoard food

• People with anorexia are often uncomfortable eating in public

Physical Symptoms Anorexia & Bulimia• Emaciation• Amenorrhea • Hyperactivity

• Wear layers of bulky clothing• Appear to be younger than their actual age

• Atrophied breasts• Dry skin with a yellow tinge

• Lanugo • Bulimics often have scarred fingers, tooth decay, extreme

oral sensitivity(HealthCommunities.com, 2011)

Anorexia & Bulimia IndicationsMany signs point towards a risk of developing an eating

disorder. Parents, health care providers, teachers and coaches should look for the following, especially in

teenagers:• Weighing 15% below normal• Eating in secret (bulimia)

• Vomiting after eating (bulimia)• Using medications, laxatives or diet pills (bulimia)

• Chewing and then spitting out food• Experiencing amenorrhea

• Having fear of gaining weight• Being uncomfortable with comments regarding weight

(HealthCommunities.com, 2011)

• Weighing oneself often• Experiencing mood changes after

eating/weighing• Feeling dissatisfied with body• Feeling fat even though they are

thin• Feeling loss of control when eating• Being uncomfortable eating in

front of others(HealthCommunities.com, 2011)

Anorexia & Bulimia Indications

Continued….

Eating Disorder Signs and Symptoms Specific to a School Setting

Throughout the adolescent years, individuals experience sudden variations in both their height and their weight. Girls can gain an average of 40 pounds from age 11 to 14. Educators should be concerned about the student who appears to be “perfect” or strives for perfection. Be concerned and speak with an expert if a student consistently shows one or more of the signs/symptoms listed on the following slides.

(NEDA Toolkit for Educators, 2012)http://www.nationaleatingdisorders.org/uploads/

file/ETK%20A05%20signs%20symptoms.pdf

Emotional• Expresses body image complaints/concerns: too

fat; unable to accept compliments; mood affected by perceived appearance; compares self to others; refers to self negatively; overestimates body size

• Talks about dieting• Is overweight but eats small portions in front of

others• Is sad/depressed/anxious/feeling worthless• Is target of weight/body bullying• Spends increasing periods of time alone• Is obsessed with maintaining low weight• Reluctant to ask for help

(NEDA Toolkit for Educators, 2012)http://www.nationaleatingdisorders.org/uploads/file/

ETK%20A05%20signs%20symptoms.pdf

Physical• Sudden weight

loss/gain/fluctuation• Abdominal pain• Feeling full/bloated• Feeling faint/cold/tired• Dry hair/skin• Dehydration• Blue hands/feet• Lanugo hair

(NEDA Toolkit for Educators, 2012)http://www.nationaleatingdisorders.org/uploads/

file/ETK%20A05%20signs%20symptoms.pdf

Behavioral• Diets; pretends to eat; throws away food;

skips meals• Exercises for long• Constantly talks about food• Frequent trips to bathroom• Wears baggy clothes• Fatigued• Dizzy• Avoids cafeteria• Shows some type of compulsive behavior

(NEDA Toolkit for Educators, 2012)http://www.nationaleatingdisorders.org/uploads/file/ETK%20A05%20signs

%20symptoms.pdf

“Don’ts” for Educators Concerned About a Person

with an Eating Disorder1. Keep focus on reality; that eating disorders result

in:

-Inefficiency

-Misery

-Alienation

-Disturbance of the self and others

2. Don’t oversimplify.

3. Don’t imply that bulimia nervosa isless serious than anorexia nervosa.

4. Don’t be judgmental

5. Don’t give advice about weight loss, exercise, or appearance.

6. Don’t confront the person as part of a group of people,

7. Don’t diagnose

8. Don’t become the person’s therapist, savior, or victim.

9. Don’t get into an argument or battle of wills. If the person denies having a problem, simply and calmly:

-Repeat what you have observed-Repeat your concern about their health

and well-being-Repeat your conviction that the

circumstances should be evaluated by a counselor or therapist

-End the conversation if it is going nowhere

-Take any actions necessary for you to carry out your responsibilities or to protect yourself

-If possible, leave the door open for further conversations

10. Don’t be inactive during an emergency: If the person is throwing up several times per day, or passing out, or complaining of chest pain, or is suicidal, get professional help immediately

(Levine & Smolak, 2005)

“The Female Athlete Triad (FAT) is a state of imbalance between diet equilibrium, hormone regulation and bone density. And with only one of these slightly out of sync the others will try to adjust often creating a weakness such as going into a state of amenorrhea (menstruation ceases) or getting bone stresses.”

All information on this slide retrieved on August 9, 2012 from http://frostysfootsteps.wordpress.com/2011/07/05/female-athlete-triad-fat/

Preventing Eating Disorders in Athletes

The following are tips for coaches who deal with adolescents at a risk of developing an eating disorder.1. Take warning signs of eating disorders seriously 2. Refer athletes who are chronically dieting to a health

professional 3. Do not weigh athletes 4. Don’t assume reducing body fat or weight will

enhance performance5. Instruct other coaches and trainers to recognize signs

and symptoms of eating disorders and understand their role in prevention.

6. Provide athletes with accurate information regarding weight, weight loss, body composition, nutrition, and sport performance to reduce misinformation and to challenge unhealthy practices

7. Emphasize the health risks of low weight8. Understand why weight is such a sensitive and

personal issue for women. Eliminate derogatory comments or behaviors about weight – no matter how slight.

9. Do not remove athletic participation if an athlete is found to have eating problems, unless warranted by a medical condition

10.Coaches and trainers should explore their own values and attitudes regarding weight, dieting, and body image, and how their values and attitudes may inadvertently affect their athletes.

(Kratina, 2005)

Educational professionals in contact with adolescents who are highly susceptible to

acquiring an eating disorder need to be aware of the signs and symptoms of both anorexia

nervosa and bulimia nervosa. They must also be aware that the body image ideals that they have set for themselves are evident to their

students as are their biases and assumptions that they make relating to appearances. When suspecting that a student is suffering from an

eating disorder, educational professionals need to be present for their student while ensuring that they are following necessary professional

conduct required of their job and refer that student to a medical professional when it

becomes evident that the situation requires medical attention.

ReferencesAmerican Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed,

text). American Psychiatric Publishing.

Eating Disorder Community. (2012). Life with an eating disorder. Retrieved August 9, 2012 from

http://www.flickr.com/photos/prettythin/6761603239/

HealthCommunities.com (2011). Eating disorders. Retrieved August 9, 2012 from

http://www.healthcommunities.com/eating-disorders/anorexia-bulimia-symptoms.shtml

Heart, A. (2010). Self: and you’re my obsession, I love you to the bones. Retrieved August 9, 2012 from

http://www.flickr.com/photos/soundlessfall/4713541894/

Helm, D. (2009). Comparison. Retrieved August 9, 2012 from

http://www.flickr.com/photos/daniellehelm/3963668758/

Kauffman, J.M., & Landrum, T.J. (2013). Characteristics of emotional and behavioral disorders of

children and youth (10th ed.). (pp 281-283). Upper Saddle River: Pearson.

Kratina, K. (2005). Tips for coaches: Preventing eating disorders in athletes. Retrieved August 9, 2012

from http://www.nationaleatingdisorders.org/nedaDir/files/documents/ handouts/TipCoach.pdf

Levine, M. & Smolka, L. (2005). The role of the educator: Some “don’ts” for educators and others

concerned about a person with an eating disorder. Retrieved August 9,2012 from

http://www.nationaleatingdisorders.org/uploads/file/information- resources/The%20Role%20of

%20the%20Educator- Some%20Don'ts%20for%20Educators%20and%20Others.pdf

Macera, M.H., & Mizes, J.S. (2006). Eating disorders. In M. Hersen (Ed.), Clinician’s handbook of child

behavioral assessment (pp. 437-457). Boston: Academic.

National Eating Disorders Association. (2012). Information and Resources. Retrieved August 9, 2012 from

http://www.nationaleatingdisorders.org/information-resources/

Robb, A.S., & Dadson, M.J. (2002). Eating disorders in males. Child and adolescent psychiatric clinics of north

america, 11, 399-418.

Upside of inertia. (2010). Masters-apprentice. Retrieved August 9, 2012 from

http://www.flickr.com/photos/53748207@N08/5233947439

Wilson, G.T., Becker, C.B., & Heffernan, K. (2003). Eating disorders. In E.J. Mash & R.A. Barkley

(eds.).Child psychopathology (2nd ed., pp 687-715). New York: Guilford