In New York, there are attempts to implement eating disorder awareness and prevention programs within the Department of Health. The idea behind the implementation of this bill is to help identify children with eating disorders earlier.
This new bill will require that public schools include an assessment of students for an eating disorder as part of the required health certificate to attend public schools. Additional items included in the bill are developing a media campaign to promote health and raise awareness about eating disorders, establishing school-based eating disorder awareness and prevention programs as part of health education classes, sponsoring conferences, and making training programs available to health professionals.
A similar bill also attempting to increase awareness of eating disorders and aid in earlier detection just passed the General Assembly this year in Virginia. This bill requires that teachers who suspect a student of having an eating disorder report it to the child’s parents, and it requires that the school board give parents of children in grades 5-12 information about eating disorders. This bill currently awaits confirmation or veto from the governor.
While these states should be commended for their efforts, it is unclear how these bills will influence the detection and prevention of eating disorders. For example, the New York bill does not provide details about the media campaign or prevention programs they will develop. Similar campaigns have been developed in the past (remember DARE?) and have not achieved the anticipated success. As an eating disorder professional, I wonder how the New York bill will integrate eating disorder awareness and prevention into their health education classes. Most health education teachers are not experts in eating disorders. Will they be provided appropriate education and training first?
Additionally, neither the New York bill nor the Virginia bill discusses how an eating disorder, or suspected eating disorder, would be defined. This is particularly important in Virginia as teachers may be in the complicated position of being mandated to report suspected cases. How will teachers be trained? What “signs” will they be told to look for? What behaviors will reach the level of reporting concerns to parents? How will they be coached to approach parents with this delicate information?
Looking at the New York bill, students would be required to have an eating disorder assessment as part of their health certificate to attend school. Several critical questions arise. Who will complete this assessment? If this is done as part of a yearly physical, many family physicians may also not know what to look for when assessing for an eating disorder. Are assessments of other problems also being required such as depression, anxiety, substance abuse? Who will pay for these assessments? How will privacy and confidentiality be protected? As we all may remember, middle and high school are rife with gossip and rumors. Although mandated reporting could improve detection and referral, if improperly implemented, it could also easily lead to further stigmatization.
Although these governmental attempts to increase detection and prevention of eating disorders may be well-intentioned, the lack of detail and potential unintentional adverse consequences require careful consideration and monitoring.
By: Jessica H. Baker, Ph.D.