Last month, the American Academy of Pediatrics released its first comprehensive guide in 15 years to address childhood obesity. It's so concerning in the U.S., that for the first time the organization recommended weight-loss drugs and bariatric surgery, along with dietary and lifestyle interventions for children ages 12 and older. For this reason, Effective Schools Solutions — a New Jersey-based organization focused on student mental health — shared some tips for teachers and other workers in public and private schools to adequately address the issue of childhood obesity.

During the recent National Awareness Week on Eating Disorders (NEDA, held the last week of February), special emphasis was placed on the need to urgently address childhood obesity, taking into account that eating disorders have the highest mortality rate of all mental health disorders. Increasing data suggests that overweight children are at significant risk of developing a variety of chronic and life-threatening conditions.

“Body image concerns often begin at a young age and endure throughout life. By age six, girls especially start to express concerns about their own weight or shape, and 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat. Furthermore, over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives,” highlighted organizers of NEDA.

Support at school

National Eating Disorders Awareness Week was an ideal time for school districts to educate staff, students, and parents on how to offer help to students with eating disorders and encourage them to cultivate healthier relationships with food. It also became a space to examine and challenge social stereotypes of the 'perfect body' and encourage acceptance of different body shapes and sizes.

During the annual public awareness campaign, eating disorder professionals and advocates conduct educational outreach programs aimed at both preventing eating disorders and helping those already suffering the physical and emotional consequences eating disorders.

Based on data from diagnostic interviews collected between 2001 and 2004, the National Institutes of Mental Health (NIMH) reported that the lifetime prevalence of eating disorders among U.S. adolescents ages 13-18 is 2.7%.

Other data suggests that children are likely under-diagnosed, as many incorrectly assume that the group does not have eating disorders and do not succumb to body image concerns.

How can educators help?

“Educators spend a lot of time with young people and often are the first ones to detect that something is wrong. Early intervention is critical, so school professionals should consider involving school-based mental health or medical staff,” stressed Effective School Solutions.

The organization also invites parents to notify the following warning signs:

• Child is showing significant weight gain or loss.
• He/She always wears clothes that hide the shape of the body.
• He/She never brings lunch to school, throws away most of his lunch, refuses to eat in front of others, or shows extreme pickiness with food (although the latter can also be a sign of neurodiversity, for example, autism or other mental health problems).
• He/She constantly spends a lot of time in the bathroom, especially after lunch.
• He/She is increasingly tired and distracted, perhaps a sign of a malnourished brain.
• Frequently expresses dissatisfaction with his/her body or his/her appearance.
• Shows persistent and extreme perfectionism.
• Frequently expresses feelings of being out of control.

“Apart from guiding individual students and their families toward assessment and eating disorders treatment, the biggest contribution that school professionals can make is in the area of prevention. This involves actively pushing against the many forces that can affect the development of body image disturbances and unhealthy relationships with food,” added the Effective School Solutions.

Eating Disorders Awareness Week 2023: raising awareness, spreading hope, and offering support to those affected by eating disorders. #EDAW #EDAW2023 #EatingDisordersAwareness @NEDAstaff pic.twitter.com/MbAlDd0Dlw

— Effective School Solutions (@EffSchSol) February 27, 2023

Actionable steps

Districts may consider various educational and school culture interventions to address these sensitive issues, such as:

• With all students, regardless of whether an eating disorder is known or suspected, it is advisable to avoid talking about eating habits, weight, or physical appearance. Exceptions to this, of course, would be health, science, and physical education classes that teach nutritional concepts and an appreciation for the miracle that is the human body. In nutrition classes avoid labeling foods as "good" or bad."
• In anti-bullying discussions and interventions specifically label body-shaming comments and behavior that contributes to weight stigma as unacceptable. 
• Engage students and families in conversations about the hazards of buying into "diet culture" and our society's relentless messages about striving to achieve the "perfect" body size and shape. Help students identify and actively resist cultural messages that promote weight stigma and the idealization of thinness.
• Help students and families reduce negative risk factors that contribute to disordered eating (e.g., body dissatisfaction, depression, self-esteem based on appearance) by advocating and referring for mental health services.
• Help students and families increase protective factors, e.g., by fostering non-appearance-based ways of defining oneself. Encourage students to recognize and value characteristics such as hard work, honesty, kindness, creativity, etc. in themselves and others.
• Use SEL and other classes to teach and practice various self-regulation and self-soothing strategies as many emotional factors (e.g., anxiety, anger, frustration, boredom) can trigger eating in the absence of actual physical hunger.
• Re-evaluate food offerings in the school cafeteria and vending machines.
• Develop a list of community resources that offer healthy food for families struggling economically and/or who live in "food deserts" where affordable fruits, vegetables, and other healthy foods are largely unavailable.
• Find ways to creatively introduce movement into the school day.
• Keep in mind that certain groups of students might be particularly vulnerable to eating disorders, such as student athletes in weight focused sports (e.g., wrestling and gymnastics) and those engaged in the performing arts (e.g., ballet and theater). Coaches and other extracurricular instructors should de-emphasize weight, body shape, and appearance goals and strive for inclusion in both athletic and other enrichment activities.

For help with eating disorders, contact the NEDA Helpline at Eating Disorders Helpline | Chat, call or text | NEDA (nationaleatingdisorders.org) or call 1-800-931-2237. NEDA also offers an Educator's Toolkit that contains a variety of suggestions for school professionals to consider.