| Harriet |
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| April 27, 2007 at 09:47 PM |
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Reply with quote | #1 |
I'm in the beginning stages of putting together a presentation/speech to give to middle and high schools on eating disorders from the parent's perspective and especially anorexia. My goal is to a) explain the severity of anorexia, b) talk about how schools can support families dealing with it, and c) what schools shouldn't do, both in general ("anti-obesity" curricula, public weigh-ins, etc) and in specific when dealing with a child in crisis.
So I put it to you, the experts: What would YOU want your child's school to know/do differently when it comes to anorexia and e.d.s?
I'm grateful for your thoughts and input, as always.
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| | | A |
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| April 28, 2007 at 12:45 AM |
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Reply with quote | #2 |
I wanted the school to see that my daughter actually had an ILLNESS, and was not a spoilt, attention seaking brat.
I would have liked the teachers to understand that it wasn't specifically about food also. Forcing her to eat was not going to solve anything.
I don't really know, i guess these are obvious. Just a little understand of the psychological implications of AN, and also how it effects her time at school.
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| | | Cheforexic |
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| April 28, 2007 at 09:32 AM |
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Reply with quote | #3 |
Harriet,
I like facts. Here are the ones I'd want my school to know:
1. Anorexia is the number one killer of girls between 16 and 24.
2. Anorexia/Bulimia are a physiological illness. Sufferers have a disease no different than leukemia, diabetes, cancer or the flu.
3. There are no "bad" foods. This is a value judgment, not a scientific one.
4. No peer reviewed multi-year/multi-decadal study shows any efficacy in dieting.
5. Any adolescent child who begins dieting is engaging in behavior that, statistically, is much more dangerous than smoking pot.
chef
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| | | Harriet | | | nora |
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| April 28, 2007 at 10:01 AM |
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Reply with quote | #5 |
When all my dtrs problems started one of the things she mentioned is that in school they had talked to them (during P.E.) about how bad fast food is for people, and they had seen the documentary Fast Food Nation (i believe its called) after that she started making changes, I think if the schools talk about how bad fast food and being overweight is, they should definetly talk about all the eating disorders. (just wondering is this something you are doing on your own, how did you get to do this? i would love my dtrs jr high and high school to share info with kids about this).
Things schools should change:
*No weighing kids during P.E.
*No talk about over eating and obesity not unless there is also talk about anorexia
*if schools are teaching them not to eat fast food....why are their cafeterias still serving pizza, hamburguers and tacos?
*And of course both students and staff should know the facts and dangers of this disease
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| | | anne |
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| April 28, 2007 at 12:45 PM |
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Reply with quote | #6 |
I would like schools to keep and eye out for and take seriously those "good little girls" (and boys) who seem anxious. Just random anxiety. Always wanting to please...their peers, their teachers,always willing to go the extra mile, who might, just might, slip into depression....
Anxiety and stress, I am convinced, were the underlying pins of my daughter's ED. But, because her grades were good, she wasn't acting out, she got her homework in on time, she wasn't high priority for intervention even when I said I had concerns. |
| | | ripley |
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| April 28, 2007 at 02:18 PM |
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Reply with quote | #7 |
- no "Supersize Me" as part of the curriculum
- coaches should be especially aware
- staff should be aware of effects on siblings in the school system
- parents, talk to counselors as soon as possible about interruptions to child's schedule, and link them to http://www.maudsleyparents.org
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| | | beyond words |
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| April 28, 2007 at 05:29 PM |
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Reply with quote | #8 |
Our clinic says that Oklahoma is actually planning to put BMIs on report cards as part of anti-obeisity awarness. Can't you just imagine what a fun tool that will be to compare who is thinest!?! |
| | | Harriet |
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| April 28, 2007 at 09:11 PM |
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Reply with quote | #9 |
Several states already do this--Massachusetts and Arkansas--with lots more planning to.
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| | | Jessica |
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| April 29, 2007 at 06:31 AM |
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Reply with quote | #10 |
EpidemicFrom Wikipedia, the free encyclopediaIn epidemiology, an epidemic (from Greek epi- upon + demos people) is a disease that appears as new cases in a given human population, during a given period, at a rate that substantially exceeds what is "expected", based on recent experience (the number of new cases in the population during a specified period of time is called the "incidence rate"). (An epizootic is the same thing but for an animal population.) Defining an epidemic can be subjective, depending in part on what is "expected". An epidemic may be restricted to one locale (an outbreak), more general (an "epidemic") or even global (pandemic). Because it is based on what is "expected" or thought normal, a few cases of a very rare disease like rabies may be classified as an "epidemic", while many cases of a common disease (like the common cold) would not. Common diseases that occur at a constant but relatively high rate in the population are said to be "endemic". An example of an endemic disease is malaria in some parts of Africa (for example, Liberia) in which a large portion of the population is expected to get malaria at some point in their lifetimes. Famous examples of epidemics include the bubonic plague epidemic of Medieval Europe known as the Black Death, and the Great Influenza Pandemic concurring with the end of World War I.
Non-biological usageThe term is often used in a non-biological sense to refer to widespread and growing societal problems, for example, in discussions of obesity, mental illness or drug addiction. My point is do we see the words AN or Bulimia? No, but in my child's school many parents have called me to ask me questions about this because it is an just that an epidemic in her school among a LARGE population of girls. Why they call me? Well my daughter was one of the first hospitalized, failed I must say, treated by a the school counselor, again failed, and given a psychologist, failed again until I took her 5'2" 70lb body dragged her out of school to re-feed using Maudsley and the parents, and professionals, and we all got her to 106. I put her back into school and in one week she dropped 3lbs. I wanted to see my daughter walk across the stage with the other students, I thought of me first, now I either share (again) with the school that Physical education is not " you won't run the mile so you will walk 1.25 miles, your BMI (you know the chart posted in the locker room) is too high, and you cant do 30 push ups in one minute, so our school can receive the Certificate of Presidential Physical Education, so you will receive a C or less," and turn into just that EDUCATION!!!!!! Does anybody mind if I share this Thread with her Dean? More than a dozen girls she knows are doing this, and cutting. I am NOT laying blame on the schools, I am saying their is alack of education about this. Am I wrong? If I offended anyone with the word epidemic I am sorry, I can't think of another word to use. |
| | | sondrad |
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| April 29, 2007 at 09:32 AM |
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Reply with quote | #11 |
Harriet,
I admire your determination to educate on the issue of eating disorder. I imagine your passion and feel I can imagine it well, as we all go through this nightmare landscape as a group.
I am not a big advocate of school based social/emotional programs. I don't believe schools should be in the business of monitoring my childrens weight nor of providing 'parental' type of counseling on how to make improvements in such. Both for obesity issues and/or eating disorder issues. Health classes are good, when they stick to the biological basics. The minute they stray into subjective areas (how much fat is too much in a diet, how much and what type of exercise is appropriate) then it comes into potential conflict with what our family unit embraces. But thats our families personal perspective on what we expect from our education system. And so I dont have much recommendations on what I would want the school to teach about eating disorders.
Having said that, I do want to share with you what my D's school did that I found helpful. And what they did that I found less helpful.
The vice principal and the dean of students in my D's school noticed her significant weight loss, about the time we were noticing the same. On a Friday they called her out of class and down to the headmistress' office. The girls counselor was there and they very gently and with great compassion told D how concerned they were for her, what they had noticed and how they wanted to be able to help her because of their love for her. My D beleived they were indeed doing it out of love and so was very touched but also hurt by this action. I apprecate their concern. I had only wished they had called us FIRST before doing this. We could have worked together as a team. So the first thing I would recommend is for the school to involve the parents in what they may see and devise an approach, if at all, together. Too often school teachers and administrators are afraid of parents and avoid calls at all costs. I would want them to be brave and reach out before addressing the child.
Secondly, her school was fully knowledgable in the seriousness of her diagnosis when we rounded back to them after D's checkup and consultation with her pediatrician. They helped us gather resources for counselors. They sat with us and helped us 'sort things out'. They even offered to setup a special lunch area for D in an effort to be accommodating. So the SECOND thing I would suggest to schools is to educate themselves on the disease and on the cutting edge theories, research, treatments available. I would NOT recommend they try to administer them themselves, but have a list of out sourcing resources for parents to use.
Finally, the school has been most accommodating with regard to her education. Although it has been bumpy in trying to get a tutor and get one paid for from our local taxes, the school has provided curriculum and has kept in touch regarding her recovery and is currently developing a plan of action on her integration back into school. They have in no way considered themselves to be the lead authority on what is "best" for our child. So I would say FINALLY the school administators should remain open and teachable on the subject of ED's and remain a constant and flexible partner in the recovery process for each child, taking direction from the therapists, parents and doctors along the way and lending their insight into how best to manage the education process during the illness.
Harriet, the school might receive information of this nature best from other administrators at schools that have dealt effectively and with good results with children with eating disorders. I'd be happy to share this info with my D's school and I am sure they would be happy to speak with other school personnel.
Good luck and keep forging ahead.
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| | | ripley |
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| April 29, 2007 at 07:39 PM |
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Reply with quote | #12 |
Quote: Originally Posted by sondrad
The vice principal and the dean of students in my D's school noticed her significant weight loss, about the time we were noticing the same. On a Friday they called her out of class and down to the headmistress' office. The girls counselor was there and they very gently and with great compassion told D how concerned they were for her, what they had noticed and how they wanted to be able to help her because of their love for her. My D beleived they were indeed doing it out of love and so was very touched but also hurt by this action. I apprecate their concern. I had only wished they had called us FIRST before doing this. We could have worked together as a team. So the first thing I would recommend is for the school to involve the parents in what they may see and devise an approach, if at all, together. Too often school teachers and administrators are afraid of parents and avoid calls at all costs. I would want them to be brave and reach out before addressing the child.
We had a similar situation - my daughter was called down to the counselor's office since a teacher was concerned, and it happened to be one day before the doctor's appointment I'd scheduled - of course my d denied and lied. Because I was afraid my d would dodge the appointment if she knew about it ahead of time, I hadn't told her about it. It really would've been better if her counselor had contacted me before, rather than after calling her down - I could have explained what was happening. Hadn't thought of that until I read your thoughtful post, Sondra.
Harriet, it's great that you're doing this, and if your presentation is something that could be used in other school systems, I'm sure ours would be open to it...they CAN be taught, and I'd be happy to pass the information on!
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| | | Mari |
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| April 30, 2007 at 07:53 AM |
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Reply with quote | #13 |
I would want them to know that this disease is NOT about control. Nothing bad happened to her to cause this. It's not her fault and it's not her parent's fault. She has a brain disorder with physiological and psychlogical symptoms. This is not a life-style choice--it's not a choice at all.
I think it is most important that schools understand that these kids are sick just like kids with cancer are sick.. They did not choose to be ill.
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| | | Susan S |
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| April 30, 2007 at 08:19 AM |
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Reply with quote | #14 |
Harriet:
I am so pleased you are doing this and hope it will have an impact. I am also astounded by some of the stories here and the way the schools tried to help.
My daughter was hospitalized for 2 months in the fall of the last year. She had just started a new school - she was in 6th grade, the first year of middle school. She didn't really know anyone in the school and she was very sick and withdrawn, etc. when the school year started. During her hospitalization I had to call and write repeatedly to get homework assignments and work to complete with the tutor in the hospital - and most times nothing came. When she went from in patient to outpatient, I asked for her to come back to school on a part time basis and was told by the idiot guidance counsleor that it was impossible to do that because it would be "illegal". I was also told that if she missed school she would be responsible for the homework for that day, etc. The principal even suggested that I consider a less challenging school. Nothing was offered in terms of help or compassion. On the contrary, they seemed to try to make it as difficult as possible. She managed to come back and do very well academically and is even better now but I will never forget the attitude when I first tried to bring her back. I guess this is the difference between a NYC public school and the rest of the world!
Anyway it would be wonderful if you could write something about the needs of kids when they return to school - flexibility and compassion chief among them. |
| | | Chocolate |
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| April 30, 2007 at 08:33 AM |
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Reply with quote | #15 |
Harriet,
Thank you for doing this.
I would like to add that school and for that matter counselors understand that our kids "CAN'T eat" and allow their parents or someone in school to eat with them. Our d. has been watched at school by teachers to report to me what she is eating (I would say what she ISN'T eating), like I don't know. School is almost over and I have been fighting this for the whole school year.
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| | | Jessica |
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| April 30, 2007 at 09:26 AM |
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Reply with quote | #16 |
One more thing I wanted to add, I have heard it many times, "Fat is the new 4 letter word", Perfect example on how this transcends to our children and other children. To jump start what my daughter thought was a quick fix to the comment , after a heated argument with a fellow student the girl said to my, at that time 90lb ,child, " Shut up you Fat b****," it was not the later of the words yet the fat word. Yes she had body image issues, as well as self-esteem issues, but this child intentionally used the word Fat to hurt a child. Though my child was thin, this began what she thought was an experiment to quickly change her outward appearance, and little did she know she was already suffering with AN. She was already beginning to portion control, but the words just set her into high octane mode. Schools must be aware that this word needs to be treated as a profanity. Might I say I pray this works in your school because it sure did nothing at mine. Even to the point that my son is African American and my husband and are both Caucasian, a child heard an awful statement , what this child thought was a joke and told the joke to my son, when I heard I called the school, no reaction. Then during a speech packet they asked my 9 year old son, " are you adopted?" I was furious the school system had failed me. He too came home in tears, asking am I adopted? After calling the school, they informed me of their once a year week called and I quote " Tolerance week," So our children must be tolerated? From the color of their skin to their religious beliefs. I am failing these children, I feel as though I am responsible for not educating the school, not them educating my daughters and son, oh I gotta go the today show is once again having a topic on Obesity, and that some of it is genetic, and can't be helped. Lord please I hope no child is watching this program. If you told me I was destine to be obese, I too would probably find a quick fix, only I am now educated on health. |
| | | Alice |
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| April 30, 2007 at 07:39 PM |
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Reply with quote | #17 |
No discussions on obesity OR anorexia!! After the unit on obesity, my daughter was so fearful of becoming overweight. Once the health class discussion switched to e.d.s, anorexia was the perfect "solution" to obesity in my daughter's eyes. |
| | | sue |
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| April 30, 2007 at 07:41 PM |
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Reply with quote | #18 |
Hi Harriett,
This sounds like a great idea and I am wholeheartedly behind you. I would love to see a copy of that speech when you're done (very much admire the way you can put words together). Given the issues we have had with d's school concerning what people understand of this illness I would love to get something similar happening here in Australia. I have had two children forced out of schools (one the sufferer, the other the sibling) because of the lack of understanding about the illness. Our experience was not so much the school not supporting, as it was the students. I think there needs to be wider education, in a more dramatic way, that helps people understand how life threatening their actions can be towards sufferers while they try to recover, and how difficult the life at home is for the siblings. No one would ever bully a child with leukaemia, nor tease their siblings, nor isolate their families, they would offer support and encouragement, and people are constantly in touch to see how they can help. Not so AN.
We need to change the way the illness is understood. The media can make it all about body image and models and celebrities, they're not helping us at all. There is a lot of publicity here in Australia at the moment because of the revelation that Olivia Newton-John's daughter, Chloe, is a sufferer. Every magazine you pick up has a story about it - and frankly, the information being reported is incorrect by today's research standards. It makes me want to scream, because when people read these stories and have them thrust in their faces on nightly news bulletins, they look at my d, and other sufferers, and assume they then know everything about the illness. We need people to understand at a more base level that it is an illness biological in nature, that it can be physically impossible for sufferers to eat due to changes in brain chemistry (not because they want to look like Nicole Richie - this enormous oversimplification of an intensely painful illness leaves me angry beyond speech) and that the road to recovery is strewn with gigantic obstacles, that families suffer intense and extraordinary pain and that it's not the result of dysfunctional families and bad parenting. The fact people still believe that rubbish is the reason so many of us face so much isolation and exclusion and it's the reason the illness is still so shrouded in shame.
We need schools to teach students (tomorrow's parents) that it's not about being pretty. It's dire, and monstrous, and deathly, and families need support and help and friendship. Our own generation is failing these kids. Our children's generation CAN step up, armed with the right knowledge and education, and might be able to battle this illness in future generations with more empathy for the 'victims' - and they ARE victims in every sense of the word. If we can get the kids to understand better, perhaps their parents will also.
Teachers need to be counselled on the ever-changing nature of the beast. That because they look well and seem like they're coping one day, doesn't mean they're facing the same child the next day. They need to know how little little things, like the way information is disseminated in health and PE topics, can cause a massive blowout in the reasoning capabilities of a person with, or entering the first phases of, an eating disorder. They must treat these kids with compassion and understanding, not frustration and expectation. Yes, it's tiresome, it's overwhelming, it's draining. Yes, they often have special needs, but teachers can help the child recover, or they can contribute to the problem.
If you can get them to understand, or at least consider that, you have done a wonderful thing Harriett. Please let us know how it develops.
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| | | Laura |
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Reply with quote | #19 |
Quote: Originally Posted by Mari
I would want them to know that this disease is NOT about control. Nothing bad happened to her to cause this. It's not her fault and it's not her parent's fault. She has a brain disorder with physiological and psychlogical symptoms. This is not a life-style choice--it's not a choice at all.
Harriet, you've stirred the passions of everyone here with your question. SO MUCH WORK TO DO.
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| | | Jessica |
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Reply with quote | #20 |
Yeah for this post. It made an impact, yes I ground my teeth when I heard the Dean who I contacted again say television this magazines that, but he heard US all of us, and he is in complete agreement something must be done, Had this never gone up I would never have had the courage to go at it a second time around with the school. Hey I know it is getting late in the year, but their is always next year, and the information we as parents provide (which we have learned) can be valuable to the school and other parents who ask the school what can we do to get started on something. So thank you all and Harriet, you truly sent a message to not only the schools but to us as parents to take action. Pat on your back , virtual of course, and hug, all virtual but heart felt. |
| | | Laura K |
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Reply with quote | #21 |
Our experience with the school and my d ed has been on several levels. Everyone from the school nurse to the administration, teachers and even lunch room monitors are so poorly informed on ed. The school nurse and I had a discussion after she tried to weigh my d for a sports physical for next falls sports.(we had no idea the physical was going to happen)Luckily my d stalled until there was no one else in the nurses office except her and the nurse. The nurse was aware that my d had an ed . She was told by my d and her Dad as he was taking her out of school everyday for lunch and my d would have to sign back in if she was late. Anyway, my d told her she didnt know her weight and is weighed backwards in a gown at the drs. office. So she weighed her that way and sent a form home to fill out related to medical problems/meds she may be taking as the nurse practioner would be doing the entire physical in a week. Needless to say I had a long telephone converstation with the school nurse that nite.
I myself am a nurse. As a part of my job I am regularly inserviced on medical conditions and important updates in the field. I also can go to conferences that my employer must pay for if they are germaine to my practice. So to my surprise I was stunned when the school nurse told me she really didnt know much about ed and could I give her some information. I told her I surely would and that there indeed were several girls in the school that not only my d has told me about that clearly have ed.
My suggestion is this: Mandated inservices and lectures about eating disorder causes, signs and symptoms, treatment, and how to best support sufferers and their families. Of course it goes without saying the information must be current and evidence based.
Who should attend: school nurses, school psychologist, guidance counselors, ,teachers, gym teachers, THE SCHOOL PHYSICAN, track coaches and other coaches, at least two school board members and, PTA members. Last but not least, school lunch room monitors. These folks see our kids for a large part of the day. I can't tell you how many stray comments, jokes about ed and kids NOT eating their lunch that go on in schools every day, day in and out.
They should also offer informational programs for the community much like they do already for things like autism, adhd, and other special needs populations. I have been to these, the CSE puts them out.
It is amazing to me how these adults, who work so closely with our kids all day long , know so little about such a widespread adolescent problem. There are several girls at my d school who eat no lunch and then leave at 3pm to go to a track meet that lasts until 730pm. They then go home and tell their parents they already ate dinner.
Yearly mandated inservices are the only way these folks would attend otherwise they would say they didnt have the time or this is not a problem in our school.
Laura K
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| | | Jessica |
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Reply with quote | #22 |
That is exactly what the Dean had told me In service days and even parents nights had been geared towards Sexual Misconduct ( a detention she got last week for PDA hugging a boy between classes) So next year he will hold parent night and an in-service day for just that. He was apologetic, on his turning a blind eye, he believes I takes a Village to raise a child, and was apologetic. Other in-service days were also done this year, and he wanted me to take the Maudsley book to him and he would go over it with his school nurse, not that they are going to be the parent but because of the information I gave him thanks to all of you. I will be giving him literature told on this site about ED's, he himself wants to learn. And wants his staff to understand it not just the PE teacher and counselors. When I think I have failed her I try to remind myself I am doing the best I can. Thanks to you all. I wish there was just in general packet the school district had to teach and to watch the warning signs, they are around our children during the day much more than we are. Again I have a new hope, although my child will not attend that school next year, others will. This is a true testament that Parents aren't always to blame, but Harriet, Lara, and the same to all of you, we will and can make a difference and change a child's life around or let them see that this disease is a killer of friends, family, and most importantly the child themselves. This will be my last comment. I am so happy with so far the out come of this board, and the outcome it has on my child's school. Thank you to all who informed a childs school. You are the best. Good-bye, and well wishes and prayers. \
The entire Hoggard Family
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| | | B |
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| July 30, 2007 at 12:08 PM |
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Reply with quote | #23 |
Quote: I'm in the beginning stages of putting together a presentation/speech to give to middle and high schools on eating disorders from the parent's perspective and especially anorexia. My goal is to a) explain the severity of anorexia, b) talk about how schools can support families dealing with it, and c) what schools shouldn't do, both in general ("anti-obesity" curricula, public weigh-ins, etc) and in specific when dealing with a child in crisis.
So I put it to you, the experts: What would YOU want your child's school to know/do differently when it comes to anorexia and e.d.s?
I'm grateful for your thoughts and input, as always.
Harriet,
Do you have a summary/presentation/paper of these comments? I would love to be able to give our school district "wellness committee" something before school starts this year. Also, what would you recommend at the elementary school level? Last year the "wellness committe" and school district put NONfat milk on the menu for elementary students - including kindergarteners! |
| | | mimi |
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| July 30, 2007 at 12:31 PM |
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Reply with quote | #24 |
Yes, please. We have a new principal this year and would love to pass on specific info. "Health Day" in the fall is one poorly orchestrated event.
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| | | Bridget |
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| July 30, 2007 at 06:45 PM |
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Reply with quote | #25 |
Hi Harriet - I support most of what has been said above but would also like an extra strong message to school sports coaches/dance instructors. While I in no way blame my daughter's running coach for her illness I do think that her efforts to improve her performance by eating 'more healthily' contributed significantly to her developing AN. I would like school coaches to understand
that child atheletes are not just little adult atheletes - their bodies are growing and changing and their requirements for food, rest and excersise are different than for adults that AN, while not a common illness, is over represented in atheletes, particularly runners, swimmers and dancers. that a much loved coach/teacher can have a great deal of influence over a teenager and that even a casual comment about weight gain or loss can have significant impact that loss of, or failure to start, menstruation is not just a natural consequence of heavy training. It can have very serious effects on future fertility and bone formation in young atheletes and can be an important health warning that should never be ignored that eating sufficient amounts to accommodate the extra energy demands of training is absolutely essential for health and long term performance. that low fat diets (often promoted for atheletes) can be dangerous for the health of young atheletes. Children need more fats and oils than adults. that significant growth and weight gain are the expected norm for adolescents. that long term health is so much more important than performance in any sport. that coaches should be aware of the signs of an eating disorder and should discuss even a suspicion with parents
theres probably more, but thats what springs to mind.
cheers
Bridget
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| | | Harriet |
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| July 30, 2007 at 06:50 PM |
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Reply with quote | #26 |
Thanks, Bridget.
I haven't put together this presentation yet; I'm working on one aimed at pediatricians and public health nurses first, as I'm scheduled to speak to two groups of medical professionals next month. I think everyone has made excellent points, and when I've pulled something together I'll post it for everyone to adapt as they see fit.
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| | | sue | | Janet
Registered: Aug 01, 2007
Posts: 2
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Reply with quote | #28 |
Thank goodness over in Britain we don't as yet have the extremes that seem to be prevalent in schools in the US. We don't have weigh ins or checking of BMI's. But were America leads, we generally follow. My concern is the school curriculum's obsession with healthy eating and governments involvement in the pushing of manufacturers to display 'nutritional facts', especially showing how many portions out of the five recommended of fruit and veg the food contains. I seem to be in a bit of a wildernesse in my criticism of this sort of information. Of course I am seeing it from the perspective of the mother of an anorexic and not an obese child, but to me they are both the same. Could all this information about what is healthy and what is not just messing up our relationship with food? On a recent visit to my son's new class (he is 7) there was a rather colourful display on healthy eating, but it concentrated mostly on fruit and veg. Having ploughed through the Maudsley's latest book, there was a rather interesting chapter on bingeing and overeating, which basically explained how our relationship with food is hardwired in the brain when we are young, that there are two mayor aspects of eating control in the brain, the Nutrostat, which is the physiological part, the chemical part which helps to adjust appetite according to the needs of the body, but probably more importantly for eating disordered people, the drive system which involves learning and memory. This relates to wanting to eat - the desire to eat and the pleasure that results from eating. The chapter goes on to state that the drive part of the brain can be disrupted if palatable foods have been banned eg chocolate or fatty foods, and also if access to these palatable foods has been associated with reward or punishment. Ideas about food being good or bad, or that we only have intermittent access to is hard wired. This can lead to obesity and other eating disorders. If schools (and government) knew this science would they push healthy eating so much? Or are we so influenced by food manufacturers and what they put in our food and their advertising, that we really have no hope? There is a well know hypnotist in Britain, called Paul McKenna who has now started offering advice on how to be slim. He doesn't hypnotise people any more, he just tells people to eat what they want, when they want, but to stop when they are full. And it seems to work! But isn't that how it used to be in the 'good old days'. There is no doubt that there has been an increase in obesity and anorexia since the diet industry has become so vast. Have we stopped listening to our bodies and stopped getting pleasure from food? Am I the only parent who still serves up cakes and chocolate at birthday parties? Sorry for the rant, but I am very fearful for the future in Britain, because I can see that obesity and other eating disorders are rising here and there doesn't seem to be anything anyone can do about it. |
| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #29 |
Quote: Originally Posted by Bridget
Hi Harriet - I would also like an extra strong message to school sports coaches/dance instructors. While I in no way blame my daughter's running coach for her illness I do think that her efforts to improve her performance by eating 'more healthily' contributed significantly to her developing AN. I would like school coaches to understand
I agree. This message needs to especially be distributed to coaches. My d is still in elementary school so there isn't the intense push that one finds in MS and HS. In our case, I enrolled the summer swimming coaches help. They would make announcements over the PA system at the club telling the swim team kids that it was noon and they had to go home, take a nap and go eat a big plate of spaghetti to carb up for the night. It became SO much easier to get my d's compliance to rest, particularly but also to eat a lot more. I would say "coach said so". She also talked a lot about eating enough during practice.
While on the topic of sports/coaches, we decided against year round swimming as I read that there is a higher prevalence of ANs and AN behavior with this sport and the caloric expenditure is extremely high. Instead d will do league soccer - if she continues increasing in weight and later mantains. Soccer players look different physically. They tend to be stockier than the lean swimmers. I hope this is more positive role modeling for her at this time.
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| | SusanS
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Registered: July 31, 2007
Posts: 155
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Reply with quote | #30 |
I wonder if it is the activity that matters or the mindset of the participant. My daughter was an avid soccer player for many years before she got sick. She heard the same advice about eating "healthy" foods, although she was told to make sure she ate enough.
During her recovery, she wanted to steer clear of anything that reminded her too much of the person she had been before. She discovered ballet, thought to be a terrible activity for an anorexic. For her, it made her feel her body was beautiful and it became her new passion.
So I guess maybe changing activities is a good idea for some but I don't think that one is necessarily less likely to cater to an eating disorder than another, or at least not in my daughter's case. |
| | LauraCollins
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Registered: July 31, 2007
Posts: 3,155
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Reply with quote | #31 |
Over the years I've changed my thinking on this topic.
Before joining ED world I thought youth sports were benign, just another passion that people explored.
For a while I saw organized athletics as a problem in itself as the coaches and environment seemed to encourage disordered eating and exercise.
But now I think what happens is that sports, especially the aesthetic ones, are not cause but EFFECT. The kids with ED brains are attracted to these sports and use them to purge and normalize their disordered thoughts.
So I guess my hope is that we train teachers and coaches and sports trainers to identify ED behaviors and see them as symptoms of illness. ED behaviors should be like a stress fracture: a sign that the person has exceeded their biological capacity at that sport.
Overtraining, undereating, weight loss, and odd rituals would not be seen as "determination" and "toughness" but an injury to the brain.
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| | MaryKay
Registered: July 31, 2007
Posts: 8
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Reply with quote | #32 |
I would like schools, including administrators, teachers, coaches, nurses, etc., and pediatricians, to stop assuming it is about a controlling parent and family dysfunction. You get so much of the patronizing attitude.
Also, let schools know how critical they are in supporting families undergoing a Maudsley refeeding and the specific ways in which they should be expected to provide support: supervised lunches and snacks, leniency in completing school work during the really tough initial weeks, extra TLC from teachers and other adults in school.
And stop with the bogus nutritional advice during "health" and home-ec classes -- my daughter's elementary school nurse initiated a wave of restricting when she talked about how bad eggs, avacados and nuts -- some of the most nutritious foods children can eat -- make you fat! No more "Supersize Me" and "Fast Food Nation." They need to be more sensitive to the fact that kids at risk of eating disorders can be kicked right into a crisis from these things.
And, please god, no weighing or calculatin BMI at school or -- horror -- BMI report cards. They think they are addressing childhood obesity by doing these things, but I think they are accomplishing very little in these areas and hurting the kids at risk of developing ed much more. |
| | Malia
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Registered: July 31, 2007
Posts: 853
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Reply with quote | #33 |
I would like to second, and third if possible, everything MaryKay just said. As for this:
Quote: Originally Posted by MaryKay
And, please god, no weighing or calculatin BMI at school or -- horror -- BMI report cards. They think they are addressing childhood obesity by doing these things, but I think they are accomplishing very little in these areas and hurting the kids at risk of developing ed much more.
Harriet, while you're addressing them, would you please throw this in, too? For another reason? While my AN-recovered daughter is willowy and always has been, my lovely 10-year-old is built as sturdy as a roller derby champ, and has been since birth. (Yes, that was exactly the image I intended to project.) There is plenty of historical precedent in our family to account for both ends of the body-type spectrum. And my littler one's height and weight curve has been rock steady, always. Plus, she's as healthy as a horse.
AND, she's still pretty, happy, intelligent, bright, funny (very funny), and not-as-of-yet especially self-conscious. But, as early as second grade (one year before our house had to deal with the horrors of AN) she was hearing that she was "fat" from some of the more "popular" girls at school.
We have been working to mitigate these messages at home without trying to make much of them. Sometimes these things aren't so easy to dismiss.
To be perfectly honest, I don't think my younger child has quite the same risk factors that my older daughter did or does, but I am adamant that she ought not be made to feel--BY HER EDUCATION INSTITUTION, OF ALL THINGS--as if there is something lesser about her, or wrong with her, just because her body type isn't what's currently considered "ideal."
Ok, this really pisses me off.
Sorry for the outburst. I feel better now.
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| | Maria
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Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #34 |
Would you all give me feedback on this letter? I met with my d's principal and came up with a plan for her. She was incredibly cooperative and basically told me to write her a letter so that she could share it with the team. I cut out all the greetins, fluff, etc. I welcome your comments. I plan to give it to her tomorrow. Thanks PS. My last paragraph is a little bit of a defense mechanism against being seen as a "helicopter Mom" who hovers over her child. Maybe not necessary? "D was diagnosed with an Eating Disorder (Anorexia Nervosa) in June 2006. She was 9 at the time. She has been in psychotherapy with an ED specialist since that time. We are following a family based therapy called the MaudsleyApproach whereby parents take full control of feeding the child by preparing, serving and supervising all meals and snacks. This is done until the child regains weight to a normal range (BMI 18.5 – 21.5) and is able to maintain it for at least a year without the presence of anorexic thoughts or behaviors. D doesn’t look ill and she is getting close to a normal range of weight. However, she still has ED and a single missed snack can cause her blood sugars to drop and/or trigger anorexic thoughts and behaviors. Last year, lunch time at the cafeteria was d’s worse time at school as it provoked waves of anxiety which precluded her from eating her lunch. To make matters worse, after eating very little she used her recess time to purge by frenetically playing soccer or running non stop around the playground. Since July, we have agressively implemented the Maudsley Approach at home following a very structured schedule of eating 3 meals and 3 snacks per day and now closely control her exercise activities. As a result, d has put on weight and we have seen big improvements in her anxiety level and and anorexic behaviors. As she starts school, we need to involve you, her teachers, as part of our treatment team which also includes her T and Ped. We have come up with the following plan:. · D will come home every day for lunch. I will pick her up and bring her back by the time she has to go back to class. · D is not allowed to run, jump rope or play sports during recess. Teachers on duty will have to supervise her. PE is OK as I will adjust her caloric intake on those days. · D MUST eat a snack mid morning (10:00 – 11:00 a.m.) under adult supervision. · She needs a special sitting assignment away from the AC vent because her body cannot regulate its temperature (hypothermia) and she is always unnaturally cold. · D must NEVER be weighed at school. If there are body measuring or weighing activities in class, she cannot participate. I will speak in more detail with nurse about this issue. · I am very concerned about the messages about food and eating that are part of the elementary curriculum. If there are going to be Health, PE or Science lessons about obesity, describing foods as “good or bad”, advice on cutting back on fats or sugar, not eating junk food, to exercise more, etc I would like for us to come up with a plan ahead of time so that Lauren is not adversely affected by these messages. D’s ED started with junk food restriction and she continues to be obsessed with restricting foods that are not healthy, in her mind. ED victims filter these messages very conveniently to serve their purpose and they become triggers for their disorder thus making their recovery more difficult. I will talk in more detail about this with the nurse, PE teacher and classroom teachers. · Please understand that Anorexia is a mental illness. It is the deadliest of all psychiatric disorders (20% mortality rate). The therapist supervised Maudsley Approach that we are doing, asks us parents to be like “helicopters” hovering around and above our eating disordered children until they are well physically and mentally. Surprisingly, d has responded extremely well to having all of her freedom around food and exercise taken away from her. She, as well as all eating disordered children, need their parents and caregivers to fight this horrific illness for them as they cannot do it themselves. I am asking you, her teachers, to join my husband and I in this fight for her life. I thank you in advance for the extra effort that you will put into looking after our daughter. " |
| | Malia
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Registered: July 31, 2007
Posts: 853
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Reply with quote | #35 |
I don't think the last paragraph sounds defensive.
I think it's a good letter!
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| | LauraCollins
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Registered: July 31, 2007
Posts: 3,155
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Reply with quote | #36 |
Maria,
I think this is an outstanding letter, and a terrific approach. And it will help all the other students with EDs in the school - it is like you are training the staff in the most up-to-date techniques.
Some parent down the line will encounter a teacher at your school and hear "You know, there is a successful technique for helping your child that we've helped out with here at the school. Let me get you some information on that."
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| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #37 |
Thank you Malia and Laura:
I didn't plan for this letter to be a teaching tool but you are right, it is! The only thing I added to it was that restoring our d to full health was our number one priority this year. When I spoke to the principal I told her that there might be days when d didn't want to finish her bkfast and in that case she would be late for school.
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| | Elisabeth
Registered: Aug 03, 2007
Posts: 17
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Reply with quote | #38 |
Dear Maria, I thought your letter was great and said so eloquently what I wanted to say to IEP team. I want to know if it is alright to use it as a template for a letter that I would like to bring to our first IEP meeting this week. I too have been bringing my daughter home from school each day for lunch last spring. We have had a set back and loss of weight this summer BUT unfortunately I cannot continue to supervise lunch at home since I need to work for financial reasons. Your paragraph about 'hovering" was so apt since the guidance counselor has already suggested I am perhaps to "enmeshed" in my 14 year old's life. (I should unenmesh and just let her starve to death?) I'm hoping with a IEP in place that the district can provide an aid during a study hall time to supervise eating. Here is my letter, if you would like me to change the wording more just let me know:
To IEP team
J was diagnosed with an Eating Disorder (Anorexia Nervosa) in January 2006. She was 12 ½ years old. She has been in therapy with an ED specialist since that time. We are following a family based therapy called the Maudsley Approach whereby parents take full control of feeding the child by preparing, serving and supervising all meals and snacks. This is done until the child regains weight to a normal range (BMI 19.5 – 21.5) and is able to maintain it for at least a year without the presence of anorexic thoughts or behaviors. J doesn’t look ill and she is getting closer to a normal range of weight. However, she still has an eating disorder and a single missed snack can cause her blood sugars to drop and/or trigger anorexic thoughts and behaviors. Her bone density, measured at Stanford in April 2006 was in the 1.8 percentile for girls her age, and at 14 years, puberty is delayed and expected growth has not happened.
February 2006 J was taken by ambulance to the Eating Disorder Unit at Lucile Packard Children’s Hospital at Stanford for medical stabilization because her heart had been compromised by inadequate nutrition. She was not able to return to her 7th grade classroom at the Waldorf School spring of 2006 because of health concerns. She did independent study through ______ school for the last quarter of 7th grade.
Fall 2006 she started 8th grade at WCS. Because of my work schedule lunchtime at the WCS School was usually unsupervised and she ate very little if at all. By December her health and weight were again so compromised Elisabeth quit her part time job so we could aggressively implement the Maudsley Approach during school hours as well. Elisabeth picked up J each day at lunch from January 2007 through the end of the school year so she could monitor J’s eating and prevent any purging behavior. As a result, J has put on weight and we have seen big improvements in her anxiety level and anorexic behaviors. Elisabeth is unable to continue bringing J home for lunch this year. As she starts high school, we need to involve you, her teachers, as part of our treatment team, which also includes her therapist ----------, our family physician Dr. ---------, and Dr.----------from the Stanford Eating Disorder Clinic.
The treatment team has come up with the following plan:
• J must be at a BMI of 18.5 in order for her to attend the first day of school. She must maintain a steady weight gain of ½ pound a week to stay in school. Once she reaches a safe weight, according to her doctors, she must maintain that weight to stay in school since her health is of utmost priority.
• J needs and adult to supervised lunch at school each day. Good and full nutrition is as important for Jessica as insulin is for a diabetic. If she does not eat an adequate amount she will not be allowed back to school the next day.
• J is not allowed to participate in PE until we get a medical okay from Dr. ------
• J must eat a mid-morning snack.
• If J has a hard time finishing her breakfast, as she did several times this last spring, she may be late for school. Her health is the number 1 priority.
• J must NEVER be weighed at school. If there are body measuring or weighing activities in class, she cannot participate.
• If there are going to be Health, PE or Science lessons about obesity, describing foods as “good or bad”, advice on cutting back on fats or sugar, not eating junk food, to exercise more, etc I would like for us to come up with a plan ahead of time so that J is not adversely affected by these messages. J’s eating disorder started with junk food restriction, ‘healthy eating’, vegetarianism and long walks. She continues to be obsessed with restricting certain foods. Eating disorder victims filter these messages very conveniently to serve their purpose and they become triggers for their disorder thus making their recovery more difficult.
• Please understand that Anorexia is a mental illness. It is the deadliest of all psychiatric disorders (20% mortality rate). The therapist supervised Maudsley Approach that we are doing, asks us parents to be like “helicopters” hovering around and above our eating disordered children until they are well physically and mentally. J has responded extremely well to having all of her freedom around food and exercise taken away from her. She, as well as all eating disordered children; need their parents and caregivers to fight this horrific illness for them, as they cannot do it themselves. I am asking you, her teachers and other school personnel to join my husband and I in this fight for her life. I thank you in advance for the extra effort that you will put into looking after our daughter.
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| | Mari
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Registered: July 31, 2007
Posts: 289
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Reply with quote | #39 |
Elisabeth,
You are very wise to be specific about what you don't want your child exposed to. I was assured that my daughter would be warned ahead of time when they had the 'ed movie' in health class. They did that, but then the very next week she had to sit through a class on body mass index and eating healthy foods and exercise, etc. It doesn't take a genius to figure out that they should have exluded her, but they were shocked when I confronted them about it. Even my daughter told them, in her own polite way, that they were truly clueless!
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| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #40 |
El · Elisabeth: Yes, you and anybody else is welcomed to use my letter if they want to. I thought your letter was great. Since you are presenting it as coming from your d's medical team, is the whole team signing it? I added this last line to my bullet points " Restoring our daughter to full health is our uncompromising priority and her most important job this year.". That kind of puts them on notice about where we stand on this issue. Is your d going to eat her snack on her own or will she have supervision? That part was not clear. Also, why does your d have an IEP? Does she have a Learning Disability? Where does the ED fit within the IEP? IEP's are legally binding documents so if everyone signs off on it, that is what will have to happen or you can literally sue them for non-compliance. However, I am trying to understand how ED fits into the IEP as opposed to a 504. A c |
| | Bridget
Moderator
Registered: July 31, 2007
Posts: 832
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Reply with quote | #41 |
Quote: Your paragraph about 'hovering" was so apt since the guidance counselor has already suggested I am perhaps to "enmeshed" in my 14 year old's life. (I should unenmesh and just let her starve to death?)
Hi Elizabeth - I wonder if it my be worth also lending the counsellors a copy the Locke and Le Grange book or a summary article by them (see the Maudsley Parents site) to help them understand the Maudsley approach more clearly.
take care
Bridget
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| | Elisabeth
Registered: Aug 03, 2007
Posts: 17
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Reply with quote | #42 |
My understanding of the law is that my daughter is entitled to an IEP because of her anorexia. She has no other learning disabilities that I know of. We will find out tomorrow when I have the initial meeting.
Under the Individuals with disabilities Act (“IDEA”) a child with anorexia could be entitled to the protections of an Individual Education Plan (“IEP”). An IEP is appropriate if the student requires specially designed instruction (“SDI”) in order to make meaningful educational progress. Anorexia can be considered to be a disability since the physical and/or mental impairments of the disease limits one or more of the child’s major activities. An example of a SDI could be a supervised lunch or snack period to ensure adequate nutrition and better mental functioning.
I got this info from the following site:
Stinson, Phil. “Another Look at Section 504.” Ed. Phil Stinson, Esq.
http://www.specialchild.com/archives/lf-008.html
I live in California but here is another site that would be great to share with educators everywhere. British Columbia rocks.
This site offers wonderful, humane coping strategies for educators who support students with eating disorders. For example, the site advises to make an “environmental scan” of the classroom to make sure that what is communicated is that the individuality of a person is more important that external appearance.
Government of British Columbia Ministry of Education: Special Education; “Teaching
Students with Eating Disorders”; 16 July, 2007 http://www.bced.gov.bc.ca/specialed/edi/12.htm
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| | Elisabeth
Registered: Aug 03, 2007
Posts: 17
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Reply with quote | #43 |
I forgot to add that the guidance counselor thought a 504 was the way to go too but the principal encouraged the more expansive coverage of an IEP. |
| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #44 |
Elisabeth:
These links were incredibly informative. You are very lucky that the principal is the one who suggested the IEP. In my experience as a former teacher, most schools would rather deal with these issues as 504's. I didn't even know that it was possible to have an IEP for ED's.
I printed the page from BC to give to my principal, psychologist, counselor and teachers at school.
Thanks for sharing and good luck to you.
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| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #45 |
What do you guys know about this national fitness test? I met the two new PE teachers today. My d met them too. There she was tanned, muscular, the picture of health and they were drooling all over her. They immediately found out that she plays club soccer. They told her "you are going to be leading our drills, and helping us get these kids running, etc.
When she left I told them that she has anorexia and that I need to talk to them about these issues. That even though she looks really healthy, she literally just hit a BMI of 18.5 on Monday and that she had gotten as low as 15.6 % last year. I told them that I was concerned about the healthy eating messages that they would be giving the kids. So, the female teacher tells me that when she does her National Fitness testing and does the BMI on the kids she will talk to my d separately. I said "NO! She can NEVER be weighed at school, she doesn't know her weight, nor BMI. You cannot measure her BMI ever." If they needed for their official, lawful records, I will bring them a copy of her weight, height and BMI signed and notarized by her pediatrician!
I realized that even though I wrote my fancy schamzy letter to the principal, I am going to have to train these teachers personally and walk them through this process by the hand. I am SO agravated about this! I have one week before school starts. Thankfully, both PE teachers are new this year and very young. I am a part time district employee and a former teacher in the district (43 with some gray hairs) and most importantly 1st VP of the PTA  ) So, I do have those advantages of been well liked, respected and VERY involved at my child's school.
I just feel for those of you having to deal with enormouse middle and HS! It is nearly impossible to get the word passed around to all the staff and then you can't really do anything about their peers!
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| | Maria
Moderator
Registered: July 31, 2007
Posts: 2,306
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Reply with quote | #46 |
I reread my post and realized that it sounds kind of arrogant though that was not my intention at all. I didn't mean that I am this big gun and poor you parents in Middle and HS are not. I myself will be in Middle school next year and dreading it too. I won't know anybody and will have no influence and will have to tread those treacherous waters just like the majority of you parents are doing. I was talking more about my influence at my kids' elementary school more as a venting mechanism since I had just gotten back after talking to the PE teachers and was frustrated about it. |
| | anne
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Registered: Aug 01, 2007
Posts: 240
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Reply with quote | #47 |
Harriet--Did your presentation ever get done and presented? If so, could you post it?
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| | Zeri
Mentor
Registered: Feb 19, 2008
Posts: 1,369
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Reply with quote | #48 |
I hadn't read this thread before, so I'm glad someone asked for an update.
I wish schools would stick to the 3 Rs and stop assuming that parents are too out of touch, controlling, abusive or otherwise inept to teach our own children basic life skills, good citizenship, and moral behavior.
My d was considering her 'electives' for next year, and I told my h that we should steer her away from home economics...I can't even imagine. Thankfully, she didn't even mention it as a possibility.
I'm with Sondrad...I don't like the subjectivity our kids are subjected to. And all of this measuring and recording of personal data is for the birds. It hasn't happened here, and if it does, I'll raise a ruckus.
Z
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| | IrishUp
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Registered: Sept 05, 2007
Posts: 256
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Reply with quote | #49 |
I was skimming, and it looks like everyone here did a great job, but I thought about one aspect that schools COULD and SHOULD do more about, that is contributory to lots of stress and social/academic problems - and in our case was the proximate trigger to the AN: BULLYING!
Our D had been the subject of some comments, which I bet even if a teacher or school employee didn't hear each time, they heard enough of, and nothing was done. Our D told us, but it would have been nice if a teacher had mentioned it at any of the parent/teacher's conferences. Or even better, intervened at that moment.
It's NOT OK to tease someone about how they look (what they wear, what they eat... whatever)!
It's NOT OK to be mean to the fat kid, the loner kid, the new kid, the stoner kid, the outsider and shy kid!
It's NOT OK to make fun of someone when they try but fail - or are too scared to try!
It's NOT OK to gang up on someone else!
We don't allow these things in our home, because home should be safe, and these behaviors make the victim feel unsafe. School should be safe, too.
Teachers & school personnel should consider replacing misguided Food/BMI/Health curricula with good ol' civics. How to be nice to each other. How to stop and think about if one's behavior is helpful or hurtful. Make it safe for kids to tell a teacher if they hear or see bullying - or if they're the victim of it. Kids who bully are usually in need of intervention themselves, this would help them too.
While schools may not be an appropriate place for many things, they absolutely have a duty to provide appropriate behavior standards, enforce them, and communicate with parents and students when there appear to be problems.
OK, that's my rant. Great project Harriet, I can't wait to see it!
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| | jacques
Registered: Jan 11, 2008
Posts: 20
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Reply with quote | #50 |
IrishUp's suggestion is very pertinent. How many of our kids' low self-esteem began or was reinforced by a schoolmate's teasing about their appearance? For our d, real injury was registered on her psyche several years before AN onset when a boy (coincidently named Ed!) thought it was cute to tease her in the schoolyard with the simple words "big butt." If he had been educated as to the possible lethal harm one could inflict with such words, might he have held his tongue? So maybe the saying should be revised: "sticks and stones may break my bones, but names can kill me."
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