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Anorexia, bulimia and high-achieving students

The Times 22-02-2014
The SubScribe review of the papers yesterday commended the Times splash about the prevalence of anorexia among girls in independent schools. 
From observations of her daughter's cohort at one of England's top-performing grammars, Gameoldgirl had suspected that this was also the case at high-achieving state schools. A friend who had taught at such a school for several years held the same view, saying that anorexia, bulimia and self-harming were common among pupils in years 8 and 9.
Last night SubScribe received an email from an elite university student who said that while the Times's story was welcome, it had fallen into some common linguistic pitfalls. Invited to write on the subject, she submitted the piece below. 

Schools, society, stress: can we stop 
the rise in mental health cases?

student against wall
Sunday 23 February, 2014
A weekend sat at my desk with a mountain of work that will be followed by a week bound to a tight schedule of lectures, private study, tests and multiple hospital and medical appointments. Something so natural, something that has become normality over the past seven years - first at a grammar school and then university, both ranked in the top ten in the UK.

I began to develop an eating disorder at the age of 12 and started to self harm a few months later. This was followed by a diagnosis of depression and a series of other conditions, including social anxiety disorder. The correlation between my mental health and starting at a high-achieving school seemed too unlikely to be a coincidence, it appeared to be a causational relationship. While it is not certain to be the sole cause it most definitely contributed.

There is undoubtedly an increase in the number of cases of mental health illnesses in high-achieving schools, not only independent schools but also grammar schools – schools that can appear to care more about their results than their students' welfare. The rise of anorexia, bulimia and other eating disorders is a particular concern in girls' schools, but boys are also affected.


The desire to be ‘perfect’ as a result of the school’s need for students to obtain top grades can lead students into self-harming, either as a coping mechanism or as a way of punishing themselves for not achieving highly enough. 


Eating disorders are slightly different and can provide a form of control and not just a way of coping. Furthermore, eating disorders do not just concern food. Purging and over-exercising are another two in a variety of methods of maintaining a ‘perfect’ body image and overall appearance.

I found that it was not only the school's attitude, but also
competition among the students that led to my low self-confidence. When I eventually confronted this issue with a CBT therapist, I described 'perfect' as 'pretty, intelligent and thin'. I later admitted that I found these people irritating, lacking in natural energy and passion; that all that was behind them was cardboard. I realised that it wasn’t all about being perfect, but escaping from the cycle was difficult – the thoughts remained.  

It isn’t only schools that are falling short; universities can also fail to offer the support their students need.  When I was in my first year at university I continued to  suffer with mental health issues. I referred myself to the counsellor, who said I was too ill for him to deal with. Instead I was taken to hospital and later referred to the crisis team. I was then told that I needed to sort myself out and that I should take a year out because my illness was affecting the other students. It was clear that the staff did not know how to address a mental health patient.

All mental illnesses can be fatal if not treated correctly. Anorexia is the most visible and deadly of all: you are more likely to recover from cancer than from anorexia; more people die from the causes of eating disorders than breast cancer. 

Girls and women aged between 15 and 24 are twelve times more likely to die of an eating disorder than from anything else.  Society needs to learn help those with mental health illnesses and understand what can cause them, so that contributing factors can be properly addressed.

Sometimes all that is needed is love, compassion and a form of understanding. It is not necessarily special training that is required for staff in schools but knowing the language to use when talking to someone with these kinds of illness. A person should no more be described as 'anorexic' than they would be 'canceric', rather they are suffering from anorexia. Even words said with the best intentions can be interpreted in a negative way - for example “You look well” is heard as “You look fat”.

Schools should have policies in place relating to mental health and pupils should have access to a school nurse or counsellor. 


The best way to deal with the high prevalence of these disorders is to address the points that are causing them. Maybe society should consider how everyday pressure and stress is being cultivated among normal people.

We need to focus on doing our best and not being the best.
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