When Kids Can’t Concentrate: How Eating Disorders Impact Our
Children’s Education
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Myths and Facts about Eating
Disorders: What we know from Research and Treatment
Anita Sinicrope Maier, MSW,
Executive Director of the Pennsylvania Educational Network for Eating
Disorders
Good
afternoon. My mission today is to notify you that our most precious
natural resource is in danger. No, I am not talking about water or
oil, trees or coal, or any of our other natural resources that get so much
press, attention and concern in order to preserve. I am talking about the
resource that cannot be substituted by any other substance, the resource
that if it is not “saved” will result in a dim future for America. I am
talking about our best and brightest young girls and boys, women and
men—in other words—the cream of the crop—who are vulnerable because of
biological, psychological, cultural and genetic predispositions and
influences to develop eating disorders. These vulnerable youth may
experience emotional pain that is so severe that it seems impossible to
face and express. Their eating disorder serves as a maladaptive coping
mechanism as it anesthetizes and distracts from the real problems they are
experiencing. Moreover, it appears to be, at first, the avenue to a better
self-esteem.
But, eating disorders are cunning. They are
seductive. They are a total paradox—because just as that young person
believes that this “magic formula” is the path to gaining control in their
lives, to becoming more beautiful or handsome, to being better accepted by
their peers and loved ones, and to actually feel better about
themselves—they soon discover that the exact opposite prevails. As the
behaviors progress from dieting to extreme restricting or sporadic
bingeing and purging to protracted rituals and daily obsessions, there
seems to be no turning back. Their social acceptance becomes meaningless
as they withdraw further and further into isolation and alienation and the
self-hatred and loathing that they feel increases rather than decreases.
The illness invades their every hour—both day and night. Control is now in
the hands of the illness and life is often perceived as not worth living.
Eating disorders are not a fad, passing fancy,
dieting gone wild or an illness someone will outgrow. Nor are they
really about food and body image. They are multi-faceted, potentially
life threatening illnesses with biological, psychological, genetic and
sociological components. Most, but not all, begin with dieting---even
though the person may not really need to lose weight.
In anorexia, eating becomes more and more
restrictive and weight loss is 15% or more of normal body weight. Even
when emaciated, the person with anorexia may continue to see herself as
overweight. When dieting and/or restricting leads to feelings of extreme
hunger and deprivation, someone with bulimia may begin a cycle of
secretive bingeing followed by purging through self-induced vomiting, the
use of laxatives, diuretics, diet pills or excessive exercise. The
majority of people suffering with bulimia are of normal body size. Binge
eating disorder is characterized by eating large quantities of food that
may be interspersed with periods of dieting, fasting and restrictive
eating. People with BED are represented by all types of body sizes from
normal to obese. It is not terribly unusual for someone to move from one
behavior to another in the progression of the illness.
Treatment is long—between 5-7 years--and the
outcome depends on the quality and quantity of specialized treatment, the
social support received and the sufferer’s belief that they can recover.
Early and aggressive intervention provides the best prognosis for
recovery.
If you will refer to the fact sheet that we have
provided, you will see that the lifetime prevalence rate is: 7 million
women and 1 million men suffer from eating disorders.
v
0.5-3.7% of girls and women suffer from anorexia nervosa
v
1.1-4.2% of girls and women suffer with bulimia nervosa
v
2-5% of the population suffers from binge eating disorder
v
4.5% young women and 0.4% young men report bulimia in the
first year of college.
The prevalence among adolescents is: 0.5% suffer with anorexia and
2-3% with bulimia. If, however, we recognize dieting as the strongest
predictor and entrée into an eating disorder, we can see what the future
may hold in the following data.
v
40-60% of high school girls diet
v
13% of high school girls purge
v
40% of 9-year-old girls have dieted
v
5 year old girls are concerned about their weight
Anorexia
nervosa has the highest death rate of any mental illness—upwards to 20%
over time. The true numbers may be illusive because of the secretiveness
and shame of the illness and because death is often attributed to suicide,
heart or kidney failure instead. The precursors of dehydration,
electrolyte imbalances, gastrointestinal disturbances, heart arrhythmias,
amenorrhea, osteopenia and osteoporosis—just to mention a few—may have
gone completely undetected as the suffer ignored or dissociated from the
symptoms. Depression, anxiety and other emotional disturbances are
exacerbated by the behaviors and friends and family may begin to view the
sufferer as a stranger.
School functioning is profoundly affected
although it may at first go unrecognized. Let’s face it. These are often
our brightest, highest achieving students who even under stressful and
disturbing circumstances can study a little harder to maintain their
grades. But as time progresses, concentration becomes impaired, memory
disturbed and judgment and decision-making seem like impossible tasks. The
simplest decisions such as choosing clothes or a movie may cause
tremendous distress. Sleep disturbances—either not being able to sleep at
all, frequent awakening or sleeping too much—make it so difficult to get
up in the morning and actually get to school that absenteeism becomes a
problem. Some may have trouble sitting in their chairs because their
tailbone now sticks out and the lack of “padding” from too low body fat
and muscle atrophy causes pain. This also causes them to feel cold all the
time and the simple act of climbing stairs may cause exhaustion.
Perhaps the most heartbreaking thing to witness
in anorexia is that when weight loss and emaciation becomes so severe,
fellow students shun and avoid the sufferer. They become as one of my
clients describes a “freak” in the eyes of their peers. Sadly, many must
also endure teasing and name-calling. Not only are their bodies suffering
the effects of starvation but their brains as well. Under these
circumstances, it is not rational that we expect them to be able to go to
school.
Schools must become more educated on the
complexity, causes and treatment of eating disorders and more involved in
the process of how to adjust the educational process so these very bright
students do not fall to the wayside educationally. Traditional schooling
may not be possible in the most acute stages and re-entry to the system
must be done with compassion and understanding of the extreme emotional
and physical conditions the child has experienced. This can best be done
with a team of people including guidance counselors, teachers, school
nurses, administration, parents and the child’s therapist. In my own
professional experience, this approach has been most effective in helping
the child to return to normalcy in the school setting.
I have watched this process first hand for over
20 years now. First as a parent with my own child, then as a professional
with my clients and those who attend the support groups that I facilitate.
I have not, however, become desensitized over the years to the
fear, sadness and profound disruption of life that occurs not only in the
eating disordered individual but in their family and friends as well.
Watching your child or loved one literally deteriorate before your very
eyes as you feel impotent to stop the process is a hell one can’t truly
comprehend unless you have experienced it.
But we can have empathy. We can
develop an understanding and we can do something to try and
intervene in a timely and more aggressive manner. Families often cannot
get help because they do not have enough mental health insurance coverage
to get the treatment that these illnesses require. Treatment, especially
in the past 15 years, has been progressively and severely compromised
because of the lack of reimbursement even though we can potentially
provide better treatment now due to the continued research of the efficacy
of treatment modalities. We also need more education to provide awareness
for earlier and appropriate intervention and prevention and more
research dollars in order to discover better ways to conquer these
devastating illnesses. Comprehensive and aggressive treatment is the only
thing that makes sense. The rewards will not only be better health for our
precious children but, in the long run, less cost for the treatment of
related and chronic illness. We need mental health parity now.
I want to end this talk on a positive note to
give hope and inspiration to those who are still suffering. Today I am
blessed to have a healthy daughter who is a family practice physician and
three beautiful granddaughters who light up my life. When my daughter
recovered from her very complex illness at age 15, she said she wanted to
become a doctor unlike the ones that she had seen. We need to let her and
others like her dedicated to saving our children do their jobs now.
The briefing was held
Wednesday, February 26. We thank Representative Judy Biggert (R-IL) and
Representative Ted Strickland (D-OH) for hosting this briefing.
