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Supporting Children with Medical
and Mental Health Needs at School


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The most common eating disorders are anorexia nervosa and bulimia nervosa. Eating disorders affect more women than men. However, the condition is less understood in men and boys. 

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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. 

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.

Supporting students with eating disorder

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  • 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.

More information

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HOPE (Hospital Organisation of Pedagogues in Europe)