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Description
Abstract: This investigation assessed health teachers' perceptions and teaching practices regarding disordered eating behaviors. Surveys (n=600) were mailed to a random sample of high school health teachers. The 32-item survey utilized several theoretical constructs. Most respondents (88%) agreed that health teachers should provide disordered eating behavior education, yet 25% currently do not. The majority of respondents (84%) could confidently refer students to receive help for disordered eating but only 36% indicated they had a cooperative referral plan. Findings delineate the perceived importance of disordered eating as a health problem in high schools and the role health teachers can play in prevention.
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Obesity and overweight among youth has gained significant attention due the increase in the number of young people who are classified in these categories. While most of the focus has been placed on lack of physical activity or consumption of high fat or high sugar foods, less emphasis has been placed on issues of disordered eating in the form of self starvation, binge eating and purging, or various other forms of unhealthy eating behaviors. Some of these behaviors may be the result of weight concerns or other underlying social or mental health issues. The National Eating Disorders Association (NEDA) estimates 10 million girls and women, and one million boys and men struggle with some type of eating disorder (NEDA, 2004). Homeier (2004) estimated that 1% of teens in the United States have an eating disorder. Although most professionals agree that school health educators should provide instruction in eating disorder prevention, there is some discrepancy about appropriate content and the most effective instructional methodologies.
Some researchers (Carter, Stewart, Dunn, & Fairburn, 1997) have argued that simply providing information about eating disorders has the potential to do more harm than good. Muir, Wertheim and Paxton (1999) found that instruction on "appropriate" Body Mass Index (BMI) sometimes contributed to negative affect concerning body image and resulted in adolescent girls being more prone to potentially unhealthy dietary behaviors. Other researchers have reported significant reductions in factors that contribute to the development of eating disorders using an intervention focused on improving self-esteem (O'dea & Abraham, 2000). There is also some concern about the tenuous relationship between increased levels of knowledge and positive modifications in health behavior. Increases in knowledge often translate into changes in behavior as a delayed effect, meaning changes might be observed well after the intervention (Grave, De Luca, & Campello, 2001).
Eating disorders are a multifaceted problem stemming from physical and psychological stress, cultural expectations, family interaction, fear of weight gains that normally accompany puberty, and a myriad of other contributing factors (LoBuono, 2001; Manley, Rickson, & Standeven, 2000). This health problem crosses all gender, cultural, age and socioeconomic strata. While adolescence is believed to be a critical time in the development of disordered eating behaviors, children as young as first grade report the desire to be thinner (Collins, 1991).
The age of students should be considered when teaching eating disorder prevention. Studies designed to determine the cause of young girls' concerns about weight found that the importance peers place on weight and eating was strongly related to the development of excessive weight concerns in both elementary and middle school students (Taylor et al., 1998; Muir, Wertheim & Paxton, 1999). Taylor et al. (1998) suggested that prevention programs should include both boys and girls because the pressure from peers was perceived to come from both sexes. These results suggest that effective school based eating disorder prevention programs should be implemented as early as the elementary grades and should include both males and females.
Teaching strategies and mode of delivery may also affect the success of an intervention program. Several reports have supported the idea that a didactic (information only) approach is not as effective as experiential learning (Grave, 2003; Kater, Rohwer, & Levine, 2000). Hands-on, experiential learning strategies at the upper elementary grades have been successful at improving knowledge, positive attitudes, healthy intentions related to body image and weight, and recognition of the hazards of weight loss strategies in upper elementary grade students (Kater, Rohwer, & Levine, 2000). Peer support group interventions using a life skills approach have also shown success in improving weight and appearance esteem, as well as eating attitudes and behaviors (McVey et. al, 2003). O'dea and Abraham (2000) chose to implement a program that used cooperative and interactive learning with a student-centered approach focused on developing self-esteem, not simply giving information on the dangers of eating disorders. This intervention program improved students body satisfaction, body image, attitudes toward eating and students overall self-perceptions with no negative side effects. Improvements in body image and eating attitudes were still present at the 12-month follow up.
Several researchers provide guidelines and suggestions for school personnel who are in a position to teach curriculum including eating... |
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