September 13, 2004
Eating disorders have nearly tripled nationally among teenagers in the last decade — and have recently been spotted in children as young as 6 in Arizona.
That leaves schools walking a fine line when teaching children about nutrition and self esteem, as they try to balance the needs of obese children with other children who are taking weight loss too far.
"Children are just avoiding whole groups of food," said Edward Cumella, a psychologist and medical doctor for Remuda Ranch, a nationally known eating disorder center with sites in Chandler and Wickenberg. "They won’t eat carbs, fats. Only eat salad, because they’re worried about being fat."
Remuda recently admitted its youngest patient — a 6-year-old.
"We’re seeing this in 7-, 8-and 9-year-olds," Cumella said. "Eighty percent of fourth graders are dieting."
East Valley school districts and local organizations are trying to target a growing lack of nutritional comprehension among children as the media continues to market "skinny."
But the message is difficult to package, as teaching about eating disorders can plant the idea in the child’s mind — rather than preventing the behavior. The key, Cumella said, is that no child — even an obese child — should unreasonably cut his or her food intake because children are still growing.
A healthy weight should be achieved and maintained through exercise and eating balanced meals that include all food groups, he said.
TEACHING GOOD HABITS
Schools fit nutrition into curriculum as part of physical education and science courses. And many districts invite the dietician who creates the districtwide lunch menu to visit classrooms and teach how to eat well.
Amy Shore, a physical education teacher at Scottsdale’s Kiva Elementary School, teaches students about the food pyramid, nutritional snacks and exercises to do at home to stay fit and improve their self-esteem. A reduction in physical education has had a negative effect on the health of children, she said.
"If there’s a kid that’s really skinny, we try to talk to them to see if they’re eating today," Shore said, adding she doesn’t teach specifically about eating disorders for fear kids will try one of them.
Cathy Rosick, a psychologist with Scottsdale Prevention Institute, said school nurses and teachers keep their eyes open for a student skipping lunches or disappearing to the bathroom after meals. Parents need to be observant of this, as well as whether their children have been eating less while exercising more, growing too thin, making negative statements about their appearance or suggesting they feel they’re "too fat."
"Studies have shown that if you go into an audience of kids and they know nothing about eating disorders — and you teach them about eating disorders — it almost has a negative effect," said Wes Dubridge, food and nutrition specialist for the Chandler Unified School District. "It instills in their mind that this exists."
He visits schools on request to explain how to eat right. Parents often call Dubridge if they’re concerned about their child’s eating habits, and want restrictions or requirements placed on the accounts used to purchase lunches.
Cumella worries whether the counterattack is as strong as advertising that has traditionally focused on tall, thin models with physical proportions unattainable by those with other body types.
The National Eating Disorders Association reports that while eating disorders occur in children as young as the elementary school level, few schools are prepared to identify victims of the disorder.
"A lot of school guidance counselors are not fully aware of this problem and how to intervene," Cumella said.
A TABOO SUBJECT
About 90 percent of all eating disorders are suffered by girls, Cumella said. One reason: To avoid growing up.
Many teenagers don’t want to talk about it. Several students walking to lunch recently outside Chandler High School wanted to avoid the topic .
Those who would discuss it were vague and only hinted at knowing whether friends had or are suffering from the illness.
"You wouldn’t know who has it," said Manny Garcia, 16, a junior. "They won’t go as far as skin and bones, but probably have it."
Junior Diane Perez, 16, said she’s known girls with eating disorders, and has even considered it herself before watching others become sick.
"They know they’re hurting themselves . . . but they don’t really see it that way," she said.
Young children with eating disorders can become seriously ill within a month, making themselves infertile and even causing themselves to suffer from osteoporosis by the age of 18, Cumella said.
While Cumella said schools and families need to keep an eye on the phenomenon of younger children having eating disorders, teenagers are suffering from them as much as three times the rate of five years ago.
"The statistics say between 5 and 10 percent of all teens have a serious eating problem or disorder," he said. "Something is really breaking down in America in relationship with our food and our bodies."