Eating disorders are serious mental health conditions that can affect people of all ages, genders, ethnicities, classes, body shapes, and sizes. While there are many reasons someone might develop an eating disorder, disordered eating behaviours are often used to cope with difficult emotions and situations. Early identification of eating disorder symptoms is crucial in helping young people and their families access timely, evidence-based treatment, leading to better recovery rates and overall well-being.
What to look out for:
- Changes in appearance or clothing: Have they lost or gained weight? Is their uniform noticeably baggier or tighter than usual?
- Changes in eating habits: Are they eating alone, skipping meals, avoiding lunch areas, or restricting certain food groups?
- Physical complaints: Do they report feeling faint, dizzy, fatigued, constipated, bloated or cold hands? Have they mentioned trouble with hair loss, sleeping or losing their period? Does their face appear swollen?
- Behaviour around the bathroom or mirrors: Have they been using the bathroom more frequently, possibly to make themselves sick or due to drinking excessive amounts of water. Do they frequently check their appearance in mirrors?
- Changes in activity levels: Are they exercising more during lunch or break times? Do they seem restless, often standing up or walking around?
- Increased focus on body or food: Are they talking more about their body, appearance, or food?
- Social withdrawal: Are they isolating themselves from friends?
- Academic impact: Do they appear to struggle to concentrate? Are their grades slipping? Are they missing more school than usual?
- Concerns from others: Are other people expressing concern about this young person?
What to do next:
- If you notice signs of an eating disorder, share your concerns with your line manager and relevant staff on a ‘need to know’ basis.
- Address concerns directly with the young person; do not be surprised or deterred if the problem is denied – be vigilant and monitor the situation.
- Check if the young person’s parents are aware and if they’ve arranged a GP visit. If not, ask if the young person can inform them or if you can help. The school health nurse can assist if needed.
- Be aware of the need for confidentiality and the situations in which it may be overridden. Parents should be informed at an early stage.
- The family should be encouraged to take the young person to the GP for a medical check-up. The check up with the GP may also lead to referral to mental health services. School nurses are also able to make a referral to CAMHS.
- If parents deny the issue, remain curious about their reasons, consult the local policy and discuss with the relevant care team within the school.
- The Access and Waiting Time Standard for Children and Young People with Eating Disorders (1) requires treatment to begin within 4 weeks for routine cases and 1 week for urgent cases, after first contact with a healthcare professional.
Ideas of what to say:
- “You can speak to me confidentially, but the school is responsible for keeping your parent(s) informed about serious issues”,
- “I have noticed that you have not been quite yourself recently, is there a problem? You seem to be very sad/unhappy this term.”,
- “Would it help if I spoke to your parents, or if we did it together? Or, would you like me to write to them?”
- “Could we ask your parents to come into school? Would you like to be with us when we talk to them?”
What not to say:
- “You look as though you have put on weight”, “You look well” or “you look better” can be misinterpreted as “you look fatter”
- Do not comment on the amount or type of food being eaten, comments such as “You have eaten all your food, well done” are unlikely to be taken as encouragement.
- It is generally best to avoid any comments about eating, weight or shape.
For more information on eating disorders and training for school professionals, visit Beat or consult your local CAMHS team.
This resource has been written by the Oxford Child and Adolescent Eating Disorder Service, under the guidance of Dr. Jasmin White, Clinical Psychologist. (1) The Access and Waiting Time Standard for Children and Young People with Eating Disorders
