Identify eating disorders early

While recent figures suggest that less young people are hospitalised due to eating disorders, many are still battling with these complex conditions and young men are more likely to remain under-diagnosed.
A picture of a school dinner of pasta and sweetcorn on a plastic red tray.
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While recent figures suggest that less young people are hospitalised due to eating disorders, many are still battling with these complex conditions and young men are more likely to remain under-diagnosed.

Having recently delivered training with my colleague, Kirsty Uytendhal – from the Therapeutic Intervention team – Louis Theroux’s insightful documentary Talking to Anorexia really emphasised the importance of early identification and support for young people who may be vulnerable to an eating disorder.


According to the NHS, eating disorders are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour. A person with an eating disorder may focus excessively on their weight and shape, leading them to make unhealthy choices about food with damaging results to their health.

There are a range of conditions that can affect someone physically, psychologically and socially. They include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Othorexia and over eating (BEAT, 2017).

It is important to note here that all eating disorders are serious and can cause harm and even fatality. Shockingly, anorexia is linked with the highest mortality rate in comparison to any other mental health condition.


The signs and symptoms of eating disorders are variable and dependent upon the type of eating disorder. However, BEAT identify the following signs that may be particularly apparent in schools:

  • Social isolation
  • Avoiding eating around others
  • Difficulty concentrating
  • Tiredness
  • Irritability
  • Low confidence and self-esteem
  • Anxiety
  • Obsessive and/or rigid behaviour
  • Perfectionism and setting unreasonably high personal standards
  • Self-harm
  • Changes to weight – either gaining or losing weight, or experiencing fluctuating weight


Contrary to common perception, eating disorders it can affect anyone from any walk of life, from any gender, ethnicity or cultural background and in fact is increasingly affecting the male population, with more than a quarter of sufferers being male.

There are so many different reasons as to why and how a person develops an eating disorders, such as family stresses, loss, a significant event, alongside personality traits. Social media can be a negative contributor to a person’s sense of self and well-being but is not the cause of an eating disorder.

The Care Quality Commission has recently published its Review of children and young people’s mental health services which stresses early intervention is key to recovery. The report also highlights that young people and their families are having to wait to endure long waiting lists before getting the help that they need, in turn leading to the eating disorder becoming deeply entrenched.

So what we can in schools do to support these young people? Firstly, staff need to have an understanding of the complexities around eating disorders, what they are and what they are not.

Comments that the person should “just eating something” or “take control of their over- eating” demonstrate a common misunderstanding of the complex nature of people’s relationships with food and body and how this relationship can quickly turn into a damaging one combined with the need for control in what can feel like an out of control world.

An understanding and genuine empathy to the complexity of an eating disorder is crucial alongside a shift from seeing behaviours as “attention needing” as opposed to “attention seeking”.


Factors that contribute to the development of an eating disorders and the nature of them can mean that a young person or adult can quickly become embroiled in its grips and that it can become a coping strategy and cycle entrenched in intense feelings of fear, guilt and control.

With this in mind, schools play a crucial role in promoting general positive wellbeing as part of a whole school ethos, the development of healthy coping skills and support for young people to build resilience during times of difficulty. Putting a school policy in place around eating disorders is also a starting place in ensuring a clear pathway for support.


There is a wealth of information around building resilience in schools and One Education can offer excellent training on this topic. The first step in schools may be to really consider their impact on mental health and well-being as a whole school ethos.

In order to create change young people need to recognise feelings as feelings and to be able to see these feelings as passing thoughts rather than becoming entrenched in them.

This “noticing” of body and mind is a key to mindfulness practice Mindfulness can play a key role in young people recognising and dealing with difficult emotions in a healthy way before getting to the stage of developing unhealthy coping strategies.


Rathika Marsh is an Educational Psychologist is a Specialist Practitioner in therapeutic interventions and supervision.

For more information on the above contact the team of educational psychologists on 0844 967 1111. If you are interested in further training on eating disorders please do not hesitate to contact us.

Tips on how to talk to someone who may have an eating disorder can be found in the Eating Disorders Help Guide.

ABOUT THE AUTHOR RATHIKA MARSH Dr Rathika Marsh, Educational Psychologist, previously worked as a primary school teacher and as a pupil development assistant supporting children and young people with multiple and profound difficulties before completing her doctorate training at the University of Bristol.

Please get in touch or visit our educational psychology page for more information.

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