Schools over-emphasising the risks of being overweight could unwittingly be encouraging eating disorders, a leading child psychiatrist has warned.
Dr Janet Walsh said a significant proportion of young people had identified lessons focusing on weight and healthy eating as one of the triggers to their eating disorders.
Recent Government figures revealed that one in five primary school-age girls said they had been on a diet while soaring numbers of children and young people are being taken to hospital because of eating disorders, NHS figures show.
Dr Walsh, who heads a specialist child and adolescent eating disorders unit at Priory Hospital in Altrincham, Cheshire, said: “Young people in particular can feel under enormous pressure to be very popular, look thin, and excel in exams.
"Many sufferers from eating disorders are highly competitive in everything they do – and sadly, this can include their attitude to losing weight.
"When other parts of their life seem to be in chaos, limiting eating can make a young person feel more in control.
"Rather than food being labelled as 'good' or 'bad', it is important to focus on eating a balanced diet, eating three meals a day and participating in regular exercise."
Eating disorders charity B-EAT also expressed concern that public campaigns to tackle childhood obesity were sending conflicting and pressurised messages to young people. Its chief operating officer, Lorna Garner, said: “Low self-esteem and self-worth can be an influencing factor in the development of an eating disorder.
"Eating disorders are complex and multi-causal, and the onslaught of information about diets, calorie intake and ‘good’ or ‘bad’ foods, along with exercise, can add to the insecurities a child might have about their weight and body shape.
"Healthy attitudes towards food and lifestyle should be positive, not solely negative messages. This includes healthy attitudes to variety in shape and size of bodies, particularly at a time when young people’s bodies are developing and changing rapidly.
"It is concerning if schools focus on the words ‘diet’ and ‘exercise’ alone in relation to obesity. Care must be taken to ensure the messages we convey to young people are consistent and responsible."
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One 16-year-old girl being treated at Priory Altrincham, who had developed anorexia, said: "Schools are all 'don’t eat too much carbs, don’t eat too much fat' and in biology it is the same. No-one ever teaches you that it is fine to have a chocolate bar every now and again, no one ever teaches you 'go and eat that meal' – it is almost the opposite."
Another female patient, aged 15, said: "My school did not appear very helpful to me – focusing on who was larger and who wasn't, instead of just promoting healthiness."
Dr Walsh said: "It is important not to stigmatise, and moralise, about size. The debate is not about being fat or thin and certainly not about encouraging girls to be thin.
"In some cases there may also be missed opportunities at school for identifying eating disordered behaviours earlier."
But she said she was seeing evidence that schools were getting better at spotting the signs of eating disorders, and communicating their concerns to parents.
"It is quite often a concerned phone call from school to a parent that has triggered the young person and their parents to seek professional help," she said.
The number of young girls admitted to hospital with an eating disorder has doubled in the last three years, according to figures from the Health and Social Care Information Centre.
The Priory - the UK’s largest independent provider of treatment for eating disorders - has seen its own increase.
Since 2010 there has been a rise of 85% in eating disorder patients aged 12 to 17. Its experts say that exam stress, social media, bullying and the pressure to look slim are all combining to make children's lives unmanageable.
"I would advise parents to look out for signs of their children under-eating and act swiftly if they notice their child consistently going without food, making repeated claims they have already eaten, constantly checking the calories in food, or becoming highly selective in the foods that they will eat," Dr Walsh added.
"Don't be afraid to be open with your son or daughter about your concerns, and even if, initially, they deny that there is anything wrong, keep a close watch on the situation and talk again if you still feel that things aren't right.
"Reassure your child that you will support them to eat a normal healthy diet and maintain a healthy weight, but explain the dangers of being underweight. Early intervention is vital and can stop a habit developing into an eating disorder. If things don’t improve, speak to your child’s GP and request help."
Useful websites and helplines:
Beat, call 0845 634 7650 or email fyp@b-eat.co.uk
Samaritans, open 24 hours a day, on 08457 90 90 90
Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
