and its effects on the classroom
disorders have become increasingly prevalent throughout the past few
Eating disorders have serious social, psychological, and physical
These disorders primarily affect adolescents, but adults are affected
Anorexia affects the 7 to 26 age range. Children have lower levels of
and their bodies crave nutrition therefore, they can suffer from
more quickly than an adult with this disorder. This paper will discuss
prevalence, characteristics, classroom issues, and possible treatments
What is Anorexia Nervosa?
An overview/definition of this
Nervosa is a psychological disorder usually occurring in young women
characterized by an abnormal fear of becoming obese, a distorted
persistent unwillingness to eat, and severe weight loss. It is often
accompanied by self-induced vomiting, excessive exercise, malnutrition,
and other physiological changes (Dictionary.com).
Criteria for Anorexia
to maintain weight at or above a minimally normal weight for age and height (e.g.,weight loss leading to
maintenance of body weight less than 85% of t hat
expected; or failure to make expected weight gain during period of
growth, eating to body weight less than 85% of
fear of gaining weight of becoming fat, even though underweight.
Disturbance in the way in which one’s body weight or shape is
experienced, undue influence of
body weight or shape on
self-evaluation, or denial of the seriousness
of the current low body
4. In postmenarcheal females, amenorrhea, i.e.,
the absence of at lease three consecutive
menstrual cycle. (A woman is considered to have amenorrhea if her periods occur only following
hormone, e.g., estrogen administration) (DSM-IV criteria).
current episode of anorexia nervosa, the person has
not regularly engaged in binge-eating or purging
(i.e., self-induced vomiting
misuse of laxative, diuretics, or enemas).
type: During the current episode of anorexia nervosa, the person
regularly engaged in bing-eating or purging behaviors (i.e.,
vomiting or the misuse of laxative, diuretics or enemas).
are mostly affected
by eating disorders? Statistics:
It is not a
new concept that eating disorders occur during childhood. It has been
that eating disorders occur just before puberty in both sexes. Many
adolescents with A.N. have shown that females make up for 90-95% of all
patients. It has been reported that the overall sex ratio of girls to
9.5 to 1 (Watkins, 2002). It has been found that 85% of women who have
developed A.N. range from the ages of 13 to 20. This disorder primarily
adolescents from age 7 to over 26 years old (Phelps, 1991).>
For the past
few decades A.N. has been considered a disorder of the Western culture.
also been confined to white, middle-class women. This is because of the
ideas of slimness and beauty that are portrayed in the media and then
throughout society. This is being blamed on the change in the way women
perceive their bodies. Women today strive to be thin.
that only Western cultures suffer from A.N. is no longer valid. Studies
non-Western culture, have found evidence of A.N. throughout Hong Kong, Taiwan,
There has also been research done which concluded that A.N. has also
evident in Scotland,
and there has been an increasing number of A.N. cases reported amongst
women, a variety of ethnic groups, and those of different socioeconomic
Some characteristic of
Nervosa is a condition that can be characterized by the denial of food,
and significant weight loss and amenorrhea, and is commonly found in
women (Simpson, 2002). There are signs that you can look for from a
suffering from A.N. These signs are not part of diagnosis, but
that identify signs of A.N. to help you detect early on-set aid in
refusal is the number one sign to look for in someone with Anorexia
person can refuse to maintain normal body weight for their age and
means that there will be minimal to no growth during the expected
person will fear weight gain because they believe it will lead to
even though severely underweight.
females deprive themselves of food, there is an absence of monthly
is referred to as amenorrhea.
if an out of control personality. Starving oneself gives them a sense
control over one aspect of their life.
physical symptoms to look for; Dry skin, constipation, weak finger and
nails, swelling of the hands and feet (edema), and possibility of
hair loss, skin abnormalities, lethargy, and teeth discoloration
the person(s) experiencing anorexia can show signs that are the
opposite. For example, they can be an overachiever, outgoing, a
very well behaved, and compliant. This is not always the case, but it
possibility. A person experiencing this disorder begins to lose
normal daily activities that once were enjoyable. The new focus is on
exercise, schoolwork, and strict ‘dieting’. Since A.N. has an effect on
nutrition, they are not receiving enough energy to maintain good
health. As a
result of all the heavy activity and overload in schoolwork, there is a
level of academic achievement from lack of energy (Phelps, 1991).
How does this disorder
impact the classroom?
classroom, a student suffering from A.N. feels as if he or she is in
control of completely out of control. The empowerment of control or
of control tend to lead the adolescent to be a hard working,
perfectionist, introverted, and compliant. Because the student does not
signs of distress in an educational setting makes it difficult for
recognize treatment issues. This is typically why A.N. and other eating
disorders go unnoticed in the school setting. It could be apparent that
student is showing physical characteristics if A.N., but he or she
signs of distress and is not disruptive. This student is trying to be
stereotypically perfect student. This is not suggesting that every good
has A.N. It is simply stating that a student with A.N. is trying to
complete control and by focusing on schoolwork distracts the student as
teachers (Phelps, 1991).
these students become withdrawn socially, and lose interest in once
activities. When individuals starve themselves, they do not have the
nutrition or energy level to complete everyday tasks. Therefore, they
show signs of impaired concentration and alertness. This eventually
a lower level of academic achievement.
classroom, there are some other signs/mood fluctuations in which the
Treatment issues as they
relate to the classroom
The School Counselors Role:
treatment of Anorexia Nervosa involves many aspects. Medical
personal management, behavioral management, and family therapy (Halmi,
These are the important multidimensional aspects, which are mostly
new current treatment procedures that can prove to benefit the school
psychologist. The first approach is aimed at targeting specific
towards ones weight, body shape, starvation, and eating habits. The
counselor has a responsibility to recognize and identify the symptoms
Anorexia in a school setting. The counselor needs to assess the
determine whether assistance will be successful in a school setting.
because the counselor deals with not only that one student but other
as well. He or she needs to determine if they have the needed amount of
and attention to assist the anorexic through recovery. IF the counselor
it possible, their next objective is to help the student/anorexic
their potentially life threatening behavior (Omizo, 1992). Then the
is going to help the individual steer towards rehabilitating their
to a healthy nutritional state. This will aid the anorexic in becoming
nutritionally balanced and hopefully lead to long-term recovery. The
psychologist will receive positive results by enforcing positive
anorexic and the school counselor receive a desirable outcome during
recovery process, support group participation complements individual
In addition to the support group meetings, it could be crucial for
support groups as well. For example, the anorexic should have a support
of anorexics, peers, and family members. Peers and family members help
create a loving support system for these patients. The child with
craves love, affection, and attention while going through recovery.
by having a strong support group with love from the school counselor,
and peers, the child has a greater chance for full recovery (Omizo,
for the Anorexic:
therapy and family treatment are two completely different approaches.
therapies target families as the problem. It finds that family as the
the problem for the anorexic. On the other hand, family treatment
techniques in which the family makes changes and provides support
assist their child in the recovery process. Family treatment does not
family as the source of the problems. It is the most important once the
anorexic achieves weight gain. This occurs because once the anorexic
eating properly; the family has less stress and their mood changes.
even begin various strategies to test the child by allowing them to
their own food, eat snacks without observation, and even make their own
choices. Once the adolescent can manage his/her own meals, the family
enter the last phase of family treatment. This phase focuses on how
affected the adolescent’s development. This includes development
mentally, socially, and sexually. This helps all involved to reorganize
lives back to normal. Yes, the parents should help the adolescent to
recovery, but keeping anorexia as the focus is not healthy for the
well being. This phase helps the family to set new boundaries around
of recovery (Lock, 2002).
It is widely
known and accepted that Anorexia Nervosa occurs in adolescents. A.N.
characteristics in children are similar to those in adults. The
between the two are important to recognize because children have lower
of body fat, and tend to suffer from starvation drastically quicker
adults. Therefore, identifying characteristics for early detection in
adolescents is more crucial. To aid in the diagnosis of A.N., teachers
always be aware that A.N. can go undetected without proper
showing awareness, this possibly fatal illness can be reversed at an
There is more research/studies being done to help in the understanding
taken into account. This included the physical, psychological, social,
family aspects of treatment (Watkins, 2002).
I hope that
you now have a better understanding of this chronic illness.
recognizing the severity of this illness is the key to helping those