Anorexia nervosa and bulimia nervosa  

• Someone with anorexia nervosa worries all the time about being fat (even if they are very thin) and eats very little. In girls, periods become irregular or stop.
• Someone with bulimia nervosa also worries a lot about their weight. They alternate between eating very little, and then having binges when they gorge themselves.
• Bulimia sufferers vomit or take laxatives to control their weight. 
  

Avoidant/restrictive food intake disorder (ARFID)

• A clinically recognized eating disorder characterized by a persistent avoidance or restriction of food intake, leading to significant nutritional, physical, and/or psychosocial challenges.
• People with autism spectrum conditions are much more likely to develop ARFID, as are those with ADHD
  

  Causes of eating disorders  

• Worry or stress may lead to comfort eating.
• Low self esteem.
• Puberty, anorexia can reverse or halt the physical changes linked to puberty. 
• Control- losing weight can elicit feelings of being in control.
  
• Anorexia or bulimia can develop as a complication of more extreme dieting, perhaps triggered by an upsetting event, such as family break-down, death or separation in the family, bullying at school or abuse.
  
• More ordinary events, such as the loss of a friend, a teasing remark or school exams, may also be the trigger in a vulnerable person.
• The condition is less understood in men and boys, who may not get the support then need due to steriotyping. 

Symptoms of eating disorders  

• Significant weight loss or gain.
• Continuous dieting even when underweight.
• Fear of weight gain.
• Persistent preoccupation with food/eating/weight.
• Eating while alone or in secret.
• Hidden food or laxatives/diuretics.
• Vomiting – or regularly retiring to the toilet – after meals.
• Frequently running the taps while in the toilet (to cover evidence of vomiting).
  
• Swollen cheeks and/or bad breath (from vomiting).
• Excessive exercising to burn calories.
• Poor concentration and knowledge retention.
  
• Reduction in cognitive functioning, for example, abstract thinking, 

Treatments for eating disorders  

• Most eating disorder cases will be treated on an outpatient basis.
• However, in very severe cases an admission to hospital or specialist inpatient centre may be required.

Anorexia nervosa 

• Treatment includes refeeding and psycho-social interventions.
• Psychotherapy or counselling.
  
• Family intervention that directly address the eating disorder should normally be offered as part of the treatment plan.
• Medication may be offered where other symptoms are present, for example, depression or OCD. 

Bulimia nervosa

• A course of specially designed cognitive behaviour therapy may be offered.

• Addressing whole school issues of bullying, perfectionism and social isolation can help reduce some of the underlying triggers that may lead to Eating Disorders in some young people.  
• Transition from primary to secondary school and from school to university are high risk times for sufferers of Eating Disorders. Be proactive in discussing available support. 
• Review PSHE or personal development programmes so that issues related to body image, social media, and peer pressure are explored.

Medical treatment plans

• Liaise with parents/ carers/medical professionals regarding the young person’s treatment plan. Support at mealtimes may be requested. The medical team may provide guidance on PE and physical activity. 
• If treatment requires home rest or a hospital admission liaise promptly with parents/carers and the hospital school/tuition staff.
  

Support for learning

• The ability to focus and concentrate may be impaired. Provide shorter tasks and check for understanding before moving on. 
• Students may feel overwhelmed if they are unable to work as effectively as when they were well. Offer reassurance that their cognitive abilities will improve as they work towards recovery. 
• Discuss a reduction in subjects for a period so that they can focus on doing well in some subjects. This may reduce anxiety for some students.