Priory’s Dr Hayley van Zwanenberg (MBBS, MRCPsych, MMedSci) advises that all secondary schools in the West Midlands should introduce compulsory lessons about eating disorders and their potentially long-term health effects - and offer lessons to parents too. The move could reduce the 1,500 children and young people in West Midlands with an eating disorder and help “smash the shame barrier” around seeking help, said Dr van Zwanenberg.
The child and adolescent psychiatrist, from Priory Hospital Woodbourne in Edgbaston, said parents often sought help only when their child’s eating disorder was entrenched, and the child had become seriously ill.
She said: "Too often, young people are being referred for specialist input at dangerously low weights, and their eating issues are not being addressed at an early stage when they are easier to treat.”
“Schools are in an ideal position to be offering preventative work, and some independent schools are accessing Priory medical staff for support with this. If young people are supported to develop a good sense of self-worth, and personal identity, they will be more successful at managing not only their mental wellbeing but their emotional and physical health too. Education can be so valuable in schools if accurate information is delivered in the right way.”
The effects of eating disorders
The effects of anorexia nervosa
Anorexia nervosa has the highest mortality rate of any psychiatric disorder, with more patients dying from anorexia than from depression, or schizophrenia, or any other mental disorder.
Dr van Zwanenberg said: “We need lessons where pupils discuss self-esteem, perfectionism, risks of dieting, and how to take a stand against peer pressure - and strategies to challenge the thin ideal and to understand how ‘disordered eating’ can impact on physical health for years to come.”
Priory Hospital Woodbourne offers outpatient treatment for children and adolescents from five to 18 years, including access to psychology and psychotherapy for those suffering from eating disorders. The team provides parenting advice and liaises with schools and other professionals involved in the young person's care.
Eating disorders impact physical as well as psychological development. Anorexia can lead to infertility and loss of menstrual periods, brittle bones (osteoporosis), extreme fatigue and exhaustion, and chemical changes in the brain - making rational decisions and concentration difficult.
The effects of bulimia nervosa
Bulimia nervosa is an eating disorder characterised by binge eating, often causes sufferers to eat three or four times the usual amount of food. This is followed by self-induced vomiting or taking laxatives.
Long-term term effects include problems with vital internal organs due to lack of essential minerals, gastrointestinal complications, damage to tooth enamel, a painful throat and damaged vocal chords and swollen cheeks.
Dr van Zwanenberg’s comments come as mental health charities said all schools needed professional mental health services on site.
Almost two thirds (64%) of primary schools in England do not have a counsellor based on-site, and the majority (59%) of those that do, provide counselling on-site for one day a week or less, according to children’s mental health charity Place2Be and National Association of Head Teachers.
One in five children will experience a mental health difficulty at least once in their first 11 years, and many adults with lifetime mental health issues can trace the symptoms back to childhood. Head teachers in schools across England have raised pupil wellbeing and mental health as one of their top concerns.
Dr van Zwanenberg said primary school children should be taught about good health and positive body images, while lessons on eating disorders should start in secondary school.
“When education is on offer to young people about body image, and the risks that come with pursuing the Western ideal of the ‘thin’ body, it does not create or exacerbate eating issues, but can be part of a preventative package. It can also enable those in the early stages of eating issues to seek and access help because they will feel there is less stigma in doing so.”
This page was reviewed by Dr Van Zwanenberg (MBBS, MRCPsych, MMedSci) Consultant Child and Adolescent Psychiatrist at Priory's Woodbourne Hospital