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Parents ask state to warn Colorado teachers that nutrition lessons can be triggering to students prone to eating disorders

December 23, 2019
The Denver Post
Two fathers concerned that their daughters’ school nutrition lessons may have contributed to health crises have asked the Colorado State Board of Education to warn the state’s teachers to be more careful when talking about food.

By Meg Wingerter | The Denver Post
December 22, 2019 
 
Two fathers concerned that their daughters’ school nutrition lessons may have contributed to health crises have asked the Colorado State Board of Education to warn the state’s teachers to be more careful when talking about food.

Doug Salg, whose daughter attends Roaring Fork High School in Carbondale, said she already had concerns about body image, but they grew worse after the students in her health class were instructed to track their calorie intake for two weeks on a smartphone app.

The teen subsequently spent 10 weeks in the eating disorder unit at Children’s Hospital Colorado to reach a healthy weight and learn ways to cope with negative emotions surrounding food, he said.
“That kicked it into high gear,” Salg said of the calorie tracking.

Kelsy Been, spokeswoman for the Roaring Fork School District, said the tracking project was meant to help reinforce the Colorado standards on caloric balance. It included a reflection component, where students were asked to consider if they were eating too much or too little, and whether they were getting enough from all food groups, she said.

District officials are going to talk to mental health specialists and determine whether they should change how they teach caloric balance, Been said.

“We want to be more aware of what we can do, so our students are learning about nutrition but are not put at risk,” she said.

A parent with a student in the Boulder Valley School District, who also spoke to the state board, said his daughter’s struggles intensified after a teacher made an offhand remark about the fat in food becoming fat in the body.

Medically inaccurate information like that can be a “final straw” for students who are vulnerable, even though the teacher meant no harm, the parent, who asked not to be publicly identified to protect his daughter’s privacy. The body stores any calories beyond its needs as fat, and our bodies need some fat stores for insulation and to protect our organs.

Randy Barber, spokesman for Boulder Valley, said the district reviewed records from nutrition classes at the student’s school, and all students were taught that a certain amount of fat is important to a healthy diet, though too much saturated fat can be a problem.

Salg said he thinks teachers are acting out of good intentions, but they may not be getting enough training about how to teach nutrition without harming vulnerable students. He said he met other parents with children in treatment for eating disorders who also reported unhelpful experiences, like having students line up to measure their body fat percentage in front of their classmates. The treatment team advised opting his daughter out of nutrition lessons in the future to avoid potential triggers, he said.
Jeremy Meyer, spokesman for the Colorado Department of Education, said staff members are reaching out to Children’s Hospital Colorado for guidance about eating disorders. The board then will be able to decide if it wants to send a letter to teachers, or perhaps add something to the standards, he said.

Unhealthy relationships with food

Colorado’s health education standards state that information should be medically accurate and developmentally appropriate, and that students should learn skills to help them make healthy choices throughout their lives. They include that children should learn what constitutes “healthy food” as early as preschool, with more specific topics like how to read nutrition labels, calorie balance and the drawbacks of restrictive diets covered later.

Dr. Ovidio Bermudez, senior medical director of child and adolescent services at Eating Recovery Center in Denver, said it’s not uncommon for young people in treatment for eating disorders to remember a comment from an authority figure — whether a teacher, a doctor or a parent — as an important factor in their illness.

It’s difficult to determine how much of a role specific events played for a person who already was vulnerable to an unhealthy relationship with food, but adults need to be aware of the messages they send, he said.

While eating disorders typically are associated with teenage girls, boys and people of all ages can develop them. Risk factors include a history of dieting, being teased about weight and mental struggles like anxiety or perfectionism, according to the National Eating Disorders Association.

Contrary to popular belief, eating disorders aren’t always about looks, Bermudez said — sometimes people get locked into increasingly rigid diet and exercise regimes, thinking they’re improving their health but actually harming it.

“When the path to health becomes very narrow, where you have to chisel yourself into health, it almost always backfires,” he said.

Setting an example

Jeana Cost, executive director of Denver Health’s ACUTE Center for Eating Disorders, said it’s also not uncommon for patients in their program to report that something they heard at school added to their concerns about their bodies.

She said she opted her own children out of body mass index screening at school, because kids may compare their numbers and become fixated on weight. Body mass index is a comparison of weight to height, which is used as a rough measure of how much fat a person has, though very muscular people also may have a high BMI.

Cost and Bermudez agreed it’s not always possible to tell which kid will react strongly to messages about food, so it’s important that all children hear positive messages about how food can fuel your body, rather than learning certain foods or body types are unhealthy. Focusing on numbers, like a person’s weight or the number of calories in certain foods, is especially unhelpful, they said.
Stacey Snelling, director of the nutrition education program at American University, said teachers should reinforce the idea of listening to your body for cues about when to eat and when to stop eating. It’s OK to discuss that some foods are more nutritious than others, but the focus needs to be on moderation, because telling vulnerable people that they should never have a certain food gives that food too much power, she said.

“I think banning any food is a trigger,” Snelling said. “We need to talk about how food supports health and growth.”

Yet schools aren’t solely responsible for the messages kids absorb about food, Bermudez and Cost noted. They urged parents to pay attention to how their children talk about food and their bodies, and to keep the focus on what their bodies can do, rather than how they look.

“You can set an example by not talking about good and bad foods, not talking about dieting, not talking about your own body shape or weight,” Cost said.

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