New programme aims to increase eating disorder awareness in teens

Inside Out, a new programme for secondary schools, educates teens about the links between dieting, body image, and self-esteem

Conor Nolan: "I wanted to get my health back, my life back. The penny dropped: The power was in my hands. If I could get the weight back on, I’d get my life back. It was a great turning point." Picture: Lorraine Teevan.

Conor Nolan is 26, with a background in software engineering, but the Cavan man doesn’t know why, at the age of 12, his love of football and running took a sinister turn.

“I was big in to football and running. And then I started exercising more and eating less. I kind of knew something wasn’t right: The exercise and training had gone from fun to something I felt I had to do. I had this fear of gaining weight. It was no longer enjoyable.

“I’d been a slim child, to begin with, and then I lost a lot of weight. So I had no energy; my mood was on the floor. I couldn’t take part in PE at school, in football — all the enjoyment had gone out of life. My family stepped in: They said, ‘This has to stop.’ ”

Diagnosed with anorexia nervosa at 13, Nolan says being “put in to” counselling was the turning point. “It was 100% life-changing. I was very lucky. Within a couple of months, things changed. I wanted to get my health back, my life back. The penny dropped: The power was in my hands. If I could get the weight back on, I’d get my life back. It was a great turning point.”

Conor doesn’t know why he became anorexic, but he suspects it may have been triggered by transitioning from primary to secondary school. “I’ve noticed that at periods of change in my life, like finishing school or college, that my mental health can go down. I can get anxious. Counselling has helped with that.”

Conor Nolan who has lived experience of an eating disorder and features in the new Bodywhys school wellbeing programme pictured at Lough MacNean near his home in Blacklion, Co. Cavan. Picture: Lorraine Teevan

Nolan’s experience of an eating disorder features in Inside Out, a new evidence-based programme for secondary schools developed by Bodywhys to improve body image and wellbeing. 

The programme has documentary video content directed by Alan Bradley that tells the stories of young people across Ireland who have eating disorders.

The aim is to promote positive mental health, improve body image, and increase awareness of eating disorders and the supports available.

Bodywhys: The Eating Disorders Association of Ireland developed the programme in collaboration with teachers, mental-health professionals, and young people from SpunOut, Belong To, Webwise, and Comhairle na nÓg. They did so on foot of rising concerns about body image and eating disorders in secondary schools. 

Of 231 educators surveyed by Bodywhys, 74% said they have observed students struggling with body image. And 45% are aware of students in their classes who have an eating disorder.

The findings echo Ombudsman for Children research that 65% of young people in Ireland identify body image as a key factor affecting their mental health, as well as Health Research Board data showing a 43% increase in hospitalisations for eating disorders in under-18s from 2019 to 2023.

When to seek help

Bodywhys youth development manager Fiona Flynn says negative body image is one of the main risk factors for the development of an eating disorder.

“Restrictive dieting and excessive exercising are very common behaviours among young people,” Flynn says.

“We want to highlight that these can be risk factors for the development of eating disorders and help them recognise when these behaviours have gone too far. And we want to empower young people on how and when to seek help.”

Inside Out focuses on four people who have overcome eating disorders, Flynn says the engaging documentary-style video format is more effective than listing signs and symptoms. “It enables young people to see how the eating disorder really took over and to see and recognise these behaviours in themselves. And it carries a very positive message of hope and recovery.”

Bodywhys CEO Harriet Parsons says it is not always possible to know who will develop an eating disorder, because internal and external factors are at play. “Internal include a tendency to be anxious or perfectionist, to have black-and-white thinking, as well as factors such as low self-esteem.

“External factors [related to] the world the person lives in, for example, social-media messages around body image, eating, and exercise. Trauma, something difficult happening, or periods of transition, such as moving from primary to secondary school, can also be involved.”

Bodywhys CEO Harriet Parsons.

More detailed analysis of the educators’ responses to the Bodywhys survey found that 76% of the worrying behaviours related to students in the junior cycle and that the most commonly affected group was second year. The survey invited teachers to give specific examples of what they had observed. One noted that the summer after first year is high-pressured: “Teens often want to return ‘improved’ for second year, physically thinner, or more buff.”

Another said that first and second year are difficult for teens: “They already know what society expects from them. They believe they don’t ‘fit in’. Often, teens [don’t find] their tribe until third or fourth year. Confidence is low and they’re more easily led into self-loathing behaviours by comparing oneself to another.”

Parsons says the move from Junior Cert to transition year can also be a crunch point.

“In Junior Cert, there’s this clear end goal they can measure themselves against. They can work for Christmas and mock exams and get a real sense of achievement. Whereas, TY is all about self-exploration, figuring out who they are, what they like, what they enjoy.

“For some, this ambiguous space proves difficult. They’re not measuring themselves against anything; it’s all about themselves. Suddenly, they don’t know who they are, whether they’re good enough. An eating disorder can be something that ‘helps’ them feel better by giving them rules to follow, helping them feel in control.”

Parsons advises parents to trust their gut around red-flag behaviours:

• Changes to eating patterns: Reluctance to eat certain foods, refusing previously enjoyed foods, being uncomfortable at mealtimes, deciding to be vegan or vegetarian to have more control over what they eat, skipping meals, and saying they’ve eaten elsewhere but not eating at home.
• Changes to how they are exercising: Over-exercising or exercising in unusual ways, for example, in the late evening.
• Showing a lot of anxiety or guilt around food, weight, and exercise. These issues are playing a lot on their mind. The young person doesn’t seem to be themselves or in good form.
• Physical changes, such as being tired, lethargic, or cold.
• Personality changes — there’s a marked difference. For example, isolating from friends or not engaging with their normal social life, being very quiet and non-communicative, being anxious and upset, or hyper-focusing on schoolwork.

The turning point

Kildare-based mother-of-two Julie Lee is a psychotherapist who started binge-eating when she was six or seven and who by the time she was 12 had bulimia. “It completely took over, restricting and controlling food, exercising. I was trying to look a certain way. The way I looked became my complete focus, the only thing that mattered.

“I believed that for me to be accepted, loved, and popular, I had to look good, be a certain size. My self-worth was entirely tied to my looks. That stayed with me right through to my 20s.”

Julie Lee at home in Ballyroe, Co Kildare. Picture: Alf Harvey.

The turning point came at 25, when she hit “rock bottom”, felt completely tormented and alone, and deeply disliked herself.

“I realised I needed help. I went into a treatment centre, which was really only the beginning. It took years of therapy. It was a holistic healing journey. I needed to look at trauma I’d suffered, at the emotional and mental side as well as the physical.”

Today, she loves her body. “I have this beautiful acceptance of who I am as a person and of my body.”

Lee’s lived experience is included in Inside Out.

To young people, she says: “You are absolutely good enough as you are in this moment, as difficult as that might be to feel, that is the truth. The way you look does not define who you are — it is only a small part of who you are.”

She urges parents faced with a child’s disordered eating to keep hope alive for themselves, and for their child.

“Apart from taking them to the doctor, psychologically they just need to be really seen and heard in their own experience.

“Be there emotionally to acknowledge their pain, rather than giving advice.

“They already feel a lot of shame and advice without acknowledging their feelings can magnify feelings of shame.”

Visit bodywhysbodyimage.ie/resources-and-support and bodywhysbodyimage.ie. for more information.