The PE department need to be involved in the recovery of any young person with an eating disorder whether they are overweight, underweight or within an acceptable weight range. Here we focus on working with young people who are recovering from anorexia as this is an area that school staff often feel unsure about.
Over-exercise and anorexia nervosa
If left unmonitored young people suffering from anorexia nervosa will often choose to exercise hard for many hours a day in order to burn calories. This level of activity is clearly unacceptable during recovery, but removing the ability to exercise or participate in sport at all can be detrimental to their long-term recovery. It is important that pupils who habitually over-exercise learn to form a more healthy relationship with exercise in the same way that they must improve their relationship with food.
The social aspect of school sport
There is a certain extent to which it is important to try and include a pupil recovering from an eating disorder in as many normal school activities as possible – and sport / PE is no exception. Exempting a pupil from PE quickly marks them as different which can feel stressful for them and lead to questioning and sometimes teasing from their peers.
Seek guidance from health providers
If the pupil is in some form of treatment, it is a good idea to approach their health providers to discuss what would be an appropriate level of sporting activity for them to be participating in. At its most extreme, anorexia can result in patients being prescribed complete bed rest whilst their bodies are re-nourished. However, if a pupil is considered well enough to attend school, then it is likely that their health practitioner will condone some level of exercise.
Work with the pupil to agree a healthy exercise plan
As ever, it is important to ensure that the pupil is allowed to feel some sense of control over their own life. Rather than being told exactly how much exercise they can do, and when, this should form the basis of a discussion between the pupil, the school, their health practitioners and their parents. If the pupil desperately wants to be involved in a sporting activity at a level or intensity that is considered inappropriate by their health provider then instead of telling the pupil ‘no’ work together to decide what other recovery targets must be met before they are able to participate. And think of ways to work towards these targets and to gradually increase their participation in their chosen sport.
Work with parents
Where possible, parents should be involved throughout the conversation, but if this is not the case you should inform parents about the exercise plan agreed for their child. It’s important that they are aware of how much and what types of exercise it is appropriate for their child to be taking as they will be responsible for monitoring the pupil’s exercise habits outside of school hours. Make sure that the lines of communication are open or you may find a situation where the pupil plays the school off against their parents allowing each to believe they are doing no exercise in the other setting.
In more extreme cases, and particularly where a pupil is learning to overcome a compulsion to over-exercise, an exercise diary can be a helpful tool. Where, relevant, this is something that can be used to form the basis for discussion during treatment sessions so the pupil could choose to record thoughts and feelings in addition to stats about the amount and type of exercise undertaken.
Determine which types of activities are most acceptable
As well as the amount of exercise to be taken, there should be some discussion around the type of exercise that is appropriate. If, for example, a pupil has been obsessively using gym equipment or cross country running in a quest to lose weight, this form of exercise may have extremely unhealthy associations for them and they may struggle to exercise in a measured way. It can often make sense to avoid ‘trigger sports’ during the early days of recovery. Equally, it may be inappropriate to allow a pupil to participate in a sport to competition level as their perfectionism and drive to succeed can make it difficult for them to avoid over-exercising and they may not be psychologically ready to be put into a highly competitive situation. Additionally, sports which have weight category requirements are likely to be inappropriate until the pupil is at an advanced stage of recovery. Again, their health care practitioner will be able to offer sound guidance on these points.
Ensure weight / physique is not a focal point for coaches
Any sports coach or PE teacher working with the pupil, either within school hours or extra-curricularly should be made aware of their eating disorder (with the pupil’s permission) so that they can help the pupil to exercise in a healthy way. It is paramount that they do not make comments about the pupil’s physical appearance or weight, even if they perceive their comments to be positive.
Exercise and sport as a means of relieving stress
If an appropriate balance is found, sport and exercise can be a very positive outlet for a pupil’s stress during the difficult process of recovery. Some slightly alternative options like yoga or pilates are well worth considering.
If you would like further support, Pooky can deliver an eating disorder training session at your school or college.
You may also be interested in other free eating disorder resources I have uploaded: [gallery_bank type=”individual” format=”masonry” title=”true” desc=”false” responsive=”true” animation_effect=”fadeIn” album_title=”true” album_id=”3″] [gallery_bank type=”individual” format=”masonry” title=”true” desc=”false” responsive=”true” animation_effect=”fadeIn” album_title=”true” album_id=”4″]