Anorexia in High School Students
Schools, especially high school, are important developmental places for all individuals. Schools are largely responsible for molding an individual into what they become in their later lives. Arguably, one of the most important responsibilities of schools is cultivating a positive self-image for an individual and guiding them from poor company. Of concern for high school is the development of poor self-image and resulting disorders. Among the most common disorders affecting high school-going children are eating disorders, principally Anorexia Nervosa. Statistics on the prevalence and effects of eating disorders, particularly Anorexia Nervosa, on high school students and the rest of the population paint a grim picture. The Eating Disorder Coalition informs that at least one person dies every hour from an eating disorder (Crow & Swanson, 2014). Aside from death, Anorexia Nervosa and other eating disorders have debilitating effects on mental and physical health and academic performance of the students.
Anorexia Nervosa is an eating disorder characterized by an individual’s obsession to maintain minimum body weight (Bennett et al., 2004; Livingston & Summons, 2006). As a psychiatric disorder, individuals with the disorder have an obsession to maintain certain body weight, often leading to starvation. Bennett et al. (2004) posit that Anorexia Nervosa qualifies under both DSM-IV and ICD-10 mental disorder classifications systems, with its core feature being an intense fear of gaining weight. Vilela et al. (2014) inform that the disorder got its first description in 1667 due to the great physical and psychological distress.
As a culturally-bound disorder rare or absent save for Western cultures, Anorexia results from poor body image (Vilela et al., 2014). Individuals suffering from the disorder, therefore, do not see themselves as thin, thus continually restrict diet in a systematic manner. Anorexia Nervosa’s almost exclusive occurrence in Western cultures is an attribution to the existence of pervasive pressure to diet to attain a socially desirable weight and shape (Bennett et al., 2004). Moreover, the fact that Western culture largely venerates women with slim bodies points to its almost exclusive manifestation in Western cultures, although thanks to globalization and media, it is fast becoming a staple in other cultures as well (Vilela et al., 2014). While the obsession with thinness and the cultural factor are important driving factors for the disorder, it is important to realize that the first description of the disorder came at a time when the stereotype of female beauty was a far cry from the current slim standards.
That said, Anorexia Nervosa is more prevalent among high school girls than boys. Austin et al. (2008) from a longitudinal eating disorder study inform that in America, almost 15% and 4% of girls and boys respectively scored above the threshold of 20 on the Eating Attitudes Test (EAT-26). Additionally, the study indicated that Caucasian females were more likely to develop eating disorders, even as 25% and 11% of girls and boys respectively showed disordered eating and weight control signs, which required clinical evaluation. In a study of high school students in Brazil, Vilela et al. (2014) discovered that eating disorders peaked in the 11-16 age group, consistent with other studies into eating disorders. The disorder, however, is not exclusive to high school-going children as Crow and Swanson (2014) inform that 0.9% of American women suffer from the disorder in their lifetime, while 2.8% of American adults suffer from an eating disorder in their lifetime, Anorexia Nervosa being one of them. According to Austin et al. (2008), men make up a paltry 10-25% of the population with Anorexia Nervosa, even as the median onset age of the disorder stands at 18-21 years.
While the high prevalence rate of Anorexia Nervosa among high school students and the general population is a cause for worry, even more causes for worry are the potential effects of the disorder. Crow and Swanson (2014) provide grave statistics on deaths related to anorexia, stating that each hour, a person dies from an eating disorder complication. Moreover, Anorexia has the highest mortality rate of all mental disorders, standing at 5% per decade (Crow & Swanson, 2014). The disorder additionally put the young people suffering from it at risk of death. Fichter and Quadlieg (2016) further intimate that young people with the disorder aged between 15 and 24 years are 10 times more likely to die in comparison with their peer without the disorder.
Creating further concern is not the comorbid nature of Anorexia and its potential to cause death but its potential to trigger suicide and self-harm. According to Koutek, Kocourkova, and Dudova (2016), suicide is among the leading causes of death among Anorexia patients. The authors indicate that studies into Anorexia show a higher prevalence of suicide and suicide attempts among girls with the disorder. Specifically, suicide attempts among Anorexia patients stood at between 3% and 20% (Koutek, Kocourkova, & Dudova, 2016). The fact that Anorexia affects not only young people but cuts across the entire population makes it even more of a concern. Koutek, Kocourkova, and Dudova (2016) in their study found that approximately 16.9% of people with Anorexia attempted suicide in their lifetime. This fact puts perspective on Anorexia as a disorder transcending adolescence into adulthood with the potential of causing attempted suicide, self-harm and at worse cause death.
Additional concern as an effect of Anorexia is its potential to cause patients to inflict self-harm. According to Koutek, Kocourkova, and Dudova (2016), 30%-40% of adolescents with Anorexia inflict self-harm on themselves. Associated with conscious and intentional, often repeated activities with potential of causing injury, self-harm usually has no suicidal underpinnings, but usually, have sever lethal impact. Self-harm among Anorexia patients includes activities such as cutting with a razor blade, scraping with a sharp object, and burning with cigarettes, in addition to subtle forms such as cold showers, extreme physical activity, tightening waistbands, drawing blood, and swallowing objects (Koutek, Kocourkova, & Dudova, 2016). While medication overdose may signal attempted suicide, it is a form of self-harm, where the adolescent’s intention is not to die, but rather convert the psychological distress at the core of the disorder to somatic pain.
While not all anorexics will gravitate towards self-harm and suicide, the disorder’s impact on an individual’s self-image and social relations is quite significant. Social withdrawal, obsessive compulsion, and depressive behaviors are among the red flags of the disorder (Livingston & Summons, 2006). Substance abuse, sexual promiscuity, and depressive behaviors, while largely affecting bulimics, also easily affect anorexics.
Perhaps the greatest warning and effect of Anorexia is decreased academic performance. Livingston and Summons (2006) inform that anorexic students spend 90-100 percent of waking time on food, weight, and hunger. Moreover, hunger and food constantly disturb the anorexics’ sleep. The result of the inconsistent sleep and constant though on food is an inability to concentrate, lack of energy, irritability, and nausea. The disturbing experiences greatly reduce motivation and cause absenteeism, consequently degenerating to poor academic performance (Livingston & Summons, 2006). The lack of proper feeding additionally causes deficiencies in nutrients such as iron, which affect the student’s memory and ability to concentrate, essentially dipping the students’ performance in tests and school work.
Livingston and Summons (2006) suggest that treating the disorder at its onset has a positive prognosis for adolescents. It is for this reason that they suggest that school counselors should be on the lookout for any warning signs portending the onset or presence of the disorder. Moreover, schools’ administrators must ensure proper counseling is available in the schools, as well as diversity, especially in the body types. Bould et al. (2016) suggest that exposure to a wide variety of female body types in the school and real life greatly altered body dissatisfaction.
Although anorexia’s prevalence cuts across the whole population, both males and females, female high school students have the largest share of the disorder’s prevalence. Poor self-image, the media, and the socialized expectation of the ideal western woman are to blame for the occurrence of the phenomenon among female high school students. Given that high school marks an important part of any individual’s formative years, societal expectations and trends in the media easily affect the young girls’ self-image. The effects that come with the development of the disorders are fatal, particularly the potential for suicide and self-harm. Moreover, poor academic performance, self-image, and depressive behavior do not create any confidence for the future of anorexics. Early identification and treatment can go a long way in correcting the devastating effects of Anorexia among high school students.
Austin, S., B. et al. (2008). Screening high school students for eating disorders: Results of a national initiative. Preventing Chronic Disease, 5(4), A114. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2578782/.
Bennett, D. et al. (2004). Anorexia nervosa among female secondary school students in Ghana. British Journal of Psychiatry, 185, 312-317.
Bould, H. et al. (2016). The influence of school on whether girls develop eating disorders. International Journal of Epidemiology, 45(2), 480-488. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864880/.
Crow, S., J. & Swanson, S. (2014). Facts about Eating Disorders: What the Research Shows. Eating Disorder Coalition
Fichter, M., M., & Quadflieg, N. (2016). Mortality in eating disorders – Results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, 49(4), 391-401.
Koutek, J., Kocourkova, J., & Dudova, I. (2016). Suicidal behavior and self-harm in girls with eating disorders. Neuropsychiatric Disease and Treatment, 12, 787-793. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833374/.
Livingston, D., & Sammons, L. (2006). The effects of eating disorders on student academic achievement and the school counselor’s role. Perspectives in Learning, 7 (1), 35-37.
Vilela, J., E. et al. (2014). Eating disorders in school children. Jornal de Pediatria, 80(1). Retrieved from http://www.scielo.br/scielo.php?pid=S0021-75572004000100010&script=sci_arttext&tlng=en.