The stereotype tells us that eating disorders sufferers are A* students, perfectionists and generally succeed at all they do. Superficially, this often appears to be true - so their academic work may be the least of your concerns. But this is a mistake. It’s really important for us to revise our expectations of pupils with eating disorders because encouraging a constant strive for perfection can be damaging, especially if their illness makes them unable to succeed like they’re used to.
Aiming for perfection
Whilst it’s not a universal truth, many eating disorders sufferers are high achievers. One of the key risk factors for developing an eating disorder is a perfectionist personality. As such these young people are the type who will be expecting to achieve very highly across the board and would probably consider anything less than perfection failure. This point of view is likely to become more and more extreme as the illness takes grip and their thinking becomes more and more black and white.
Complex cognition is difficult
But the brain is a hungry organ and by starving it, through anorexia, or giving it only sporadic bursts of energy through bulimia, it becomes a lot more difficult for sufferers to process their academic work at the levels they may previously have been able to. This can often mean that at a time when a sufferer is more perfectionist than ever about their work, they may be far less able to achieve those coveted A* grades. It’s very common for these types of pupils to spend many many hours slaving away over their work, barely sleeping, in an attempt to live up to everyone’s academic expectations of them.
A dangerous cycle
Many people think that to focus on a pupils’ ability to achieve above average grades, at a time when there are a lot of negatives in their lives, is a good thing as it brings the focus back to what is going well. I disagree though as I think that either the pupil ends up obsessing over their work in just as unhealthy a way as they obsess over food in order to live up to expectations; or they try and fail – and this failure will be taken very hard and often fuel the eating disorder, which in turn will make them likely to fail further academically.
Some things are simply more important than exam results
Ultimately it’s more important that this young person gets their life back on track and beats their potentially fatal eating disorder. Walking out with a string of top grade exams to their name isn’t actually the most important thing right now. There is absolutely nothing to stop them sitting their exams at a later point, but if they defer their recovery they might not get another stab at it.
You might need to push the issue
Even if the school staff and parents agree that it makes sense to take the pressure off academically, the young person in question may not agree. Eating disorders sufferers are notoriously tough on themselves and they are likely to strive to succeed regardless of what your suggestions are as to what they should be aiming to achieve academically. It’s important to remember here that you need to take control. They’re being driven by their eating disorder which will kill them given half a chance. You may need to really push the issue and withdraw them from external exams etc as necessary to get the point across. This doesn’t mean to say they should withdraw from their studies entirely but they need to be given the time and space to focus on their recovery and just do an appropriate amount of studying to ensure they don’t fall too far behind and are able to pick up where they left off once they are coping with their eating more successfully.
Think carefully about how you respond to success and failure
This is a really important and often overlooked point. Eating disorders sufferers will often define themselves more keenly in terms of success and failures than most people do. That means that you have to think very carefully about how you respond to failure – and remember that devastating failure for an eating disorder sufferer might be something as trivial as achieving a B grade. Look for the positives and try to find the success in failure. Learning to manage failure is a really important lesson for those trying to recover from eating disorders as sadly this is a path fraught with failure – both imagined (they will feel they’ve failed when they eat a healthy meal, although everyone else might see it as a huge success) and real (relapse is very common, recovery can be very two steps forward, one step back).
You should also respond carefully to academic success. By emphasising academic achievements, you are inadvertently putting pressure on the young person to succeed. Something that may be increasingly difficult for them as their eating disorder takes grip.
Don’t work in isolation
The academic expectations of a young person with or recovering from an eating disorder need to be agreed with them, their parents, other school staff and if appropriate any external agencies they may be working with. This is especially applicable if they are receiving inpatient care and the school is providing work.
When negotiating expectations with a young person, look outside the box. You may have to be firm in insisting they will not be sitting their maths GCSE a year early after all, but instead have them aim for an important recovery goal – this might be as simple as spending more time with friends.
