Questionnaire Helps Identify Eating Disorders In Pregnant Patients

The screening tool will give clinicians a fast, accurate way to determine if pregnant patients need care from an eating disorder specialist.

Some estimates indicate that approximately five percent of pregnant women suffer from eating disorders (ED). Now, a team of researchers with the WVU School of Public Health and School of Medicine have developed a 12-question screener to help identify those patients.

The screening tool will give clinicians a fast, accurate way to determine if pregnant patients need care from an eating disorder specialist.

According to the National Eating Disorders Association, an eating disorder during pregnancy increases the risk of complications for both the pregnant patient and their child, including preterm birth and low birthweight. Risks for the pregnant person include

West Virginia already has one of the highest preterm-birth rates in the nation, and a low-birthweight rate that exceeds the national average.

Estimates suggest that at least five percent of women experience some type of eating disorder during pregnancy. When the researchers published their findings in the “Archives of Women’s Mental Health”, they pointed out that other estimates are much broader from 0.6 to 27.8 percent, “indicating the challenges in identifying an ED in this population.”

Meghan’s Law Requires W.Va.School Education In Self-Harm And Eating Disorders

Beginning with the 2022-2023 school year, a new West Virginia school program requires teachers and school staff to receive training and education in self-harm behaviors and eating disorders.

Beginning with the 2022-2023 school year, a new West Virginia school program requires teachers and school staff to receive training and education in self-harm behaviors and eating disorders.

Meghan’s Law, as it’s known, stems from a near-death health episode with Jefferson County Del. Wayne Clark’s teenage daughter, Meghan, after she was told she was too fat for a school cheer team. Randy Yohe spoke with Clark about implementation of the program, and how his family is doing.

Note: This interview has been lightly edited for clarity. 

Yohe: Training for state school personnel and education for middle and high school students on self harm behavior and eating disorders begins this September first. Where do things stand on putting plans into action?

Clark: These trainings will occur during the teacher’s early school development program, before the kids come in, and they’ll have their first training in place. So that they can kind of learn some of the triggers on what to look for that kind of stuff, along with the service personnel and anyone else that comes in contact with the kids.

Yohe: You mentioned coaches, as well, was anything different or specific in that regard?

Clark: Well, the hard part with the coaches is changing their culture of how and how they speak to kids in regards to making comments, like “you’re too fat,” or “you need to lose weight” that can’t lead to some sort of misunderstanding by the kid. So, we want to make sure that the coaches are using correct wording as an example. If you have an offensive lineman on a football team, and that lineman is 280 pounds, but hasn’t spent the day in the gym, maybe the coach instead of saying, “you’re just a fatty,” the coach should say “hey, let’s work on you cleaning up your frame by getting you in the gym, getting you to lifting weights,” that kind of stuff.

Yohe: Another important element is faculty and staff awareness of a problem in class or anywhere in school, if there’s a situation that needs immediate attention, right?

Clark: Correct. So if a teacher sees a kid one of the one of the triggers is, self harm. So what the kid might do in the evening before is they might cut themselves. That’s an immediate pain relief, that helps them address the stress or anxiety situation that they’re dealing with. And then, during school, obviously, they can’t cut themselves, but what they’ll do is they’ll take a rubber band, and they’ll put a rubber band over top of the cut. So a teacher might see a kid popping the rubber band on their wrist, or wherever the cut is, like the teacher might see the kid using the back of the eraser, and erasing on their hand or their arm, giving that burning sensation. So identifying that, and then how to handle that, how to not necessarily scold the kid, but walk up to the kid and politely ask them what kind of situations are they going through? What anxiety are they feeling? Or, are they nervous about the assignment, what can the teacher do to help to alleviate this anxiety? Or, did something happen in the hallway? So, rather than yell at the kid, identify, that this kid here is doing some sort of self harm, because of some sort of a situation. Now, how do I address that?

You have teachers that are doing cafeteria duty, and cafeteria aides as they’re walking around, and they’re watching kids just sit there and not eat on purpose. Or maybe they’re eating and then spitting it out in napkins, and they have trays full of napkins, that’s full of food. They’re trying to hide it that way. So we want to make sure that the kids are identified at an early stage so that they don’t get too far gone.

Yohe: We know self-harm behaviors and eating disorders affect thousands state wide, millions nationwide. You explained to me that this is not an instant fix by any means, and it can be a durational, even lifelong challenge for any family.  How is your family and Meghan doing?

Clark: So we’re handling things. Well we have situations here and there. Obviously, we have another huge stress situation going on in the household with my wife and her multiple sclerosis diagnosis that was recent, in January. So it’s very important that we’re paying attention to the little things to make sure that we don’t have a trigger on Meghan or even her twin sister, because it’s not uncommon for it to make its way through the household. So, at this point, we’re doing okay, but it’s an everyday, I don’t want to say struggle, but it’s in our minds every single day, because we never know when something could come up.

W.Va. Bill: Schools Must Train On Eating Disorders, Self-Harm

Legislation crafted after the horrific experience of a lawmaker’s daughter would require West Virginia public schools to provide training to students and teachers about eating disorders and self-harm.

Dubbed Meghan’s Law, the bill cleared its final legislative hurdle Thursday upon passage in the state Senate. It had unanimously passed the House of Delegates.

The lead sponsor, Jefferson County Republican Del. Wayne Clark, said in prepared remarks during House deliberations two weeks ago that one of his twin teenage daughters had an eating disorder triggered by a cheerleading coach who said she was “too fat to be a flyer.”

A flyer is a cheerleader who performs from the top of a formation and gets tossed by others during stunts.

According to Clark, his daughter was “not fat in the least.”

The girl exercised. But when the weight didn’t come off, she sought help from the internet and social media sites.

She lost more than 30 pounds (13.6 kilograms) and her organs were shutting down because she hid food in napkins, vomited after eating, restricting her food intake while her exercising went into overdrive, according to Clark. Last September she was taken to an eating disorder treatment facility, where her resting heart rate was just 20 beats per minute.

The disorder “took control of our family and our lives. Our daughter was determined to kill herself all over the belief of the image that she looked better emaciated,” according to Clark’s speech, which was read by another delegate because he was too emotional to deliver it.

Clark said the situation could have been dealt with sooner had coaches, teachers and counselors been better trained.

Under the bill, middle and high school students would undergo training every year on the warning signs, prevention and treatment of self-harm and eating disorders. Educators would be trained every three years.

The state Board of Education would be required to establish training guidelines in consultation with the Bureau for Behavioral Health and Health Facilities.

“What we did not know then was this was going to be the best thing as parents that we had ever done,” Clark said.

In addition to his daughter, Clark is dealing with his wife’s recent multiple sclerosis diagnosis and currently is on leave from the Legislature. He posted the Senate’s 33-1 roll call on his Facebook page shortly after its passage.

Rural Areas Bring Unique Challenges For Those With Eating Disorders During Pandemic

Alicia Lewis has struggled with a binge eating disorder for most her life. It involves eating large amounts of food in a short period of time.

Like others who suffer with the issue, Lewis, who lives in Huntington, often feels a loss of control and guilt.

But overeating is how she copes with her depression.

When the pandemic hit and she was furloughed from work, she found she was more depressed. So, she turned to food.

“I gained about 30 pounds — I want to say in probably three or four months just from depression eating,” Lewis said. “I was so unsure of what the future was holding, and I was anxious about my husband going to work and bringing COVID home to me or going out and catching COVID, and I was worried about my mother and my family.”

Lewis is not alone. Mental health across the nation has taken a toll since the pandemic began — and this includes eating disorders.

According to the National Eating Disorders Association, hotline calls are up nearly 80 percent in the past year.

Nationally, more than a third of the country’s population dealing with binge eating disorders reported an increase in episodes after the pandemic kicked off. For those diagnosed with anorexia, more than 60 percent reported an episode, according to a study last year by the International Journal of Eating Disorders.

This trend seems to exist in West Virginia, as well. Jess Luzier, Charleston Disordered Eating Center clinical director, said she saw dozens more people requiring services when the pandemic first hit.

“People who were in early or even sustained remission from eating disorder behaviors, many of them struggled with relapse when the COVID-19 pandemic hit us,” Luzier said.

Eating disorders are complex psychiatric illnesses — no one chooses to have one, said Luzier. Their severity can depend on a variety of factors.

“Dieting history, perfectionism or impulsivity, self-esteem, body esteem, even things like participation in sports that emphasize weight can affect the development of eating disorders,” Luzier said.

For many, these factors have only gotten worse as more people are practicing social distancing and spending time by themselves at home.

But there is something else that can make eating disorders even worse, and Luzier said it is especially true to West Virginians — limited access to affordable food.

“I don’t know where my next meal is going to come from, or I’m not sure that I can pay for groceries this week, most commonly is going to be loss of control eating episodes, or binge-eating episodes,” she said.

Food insecurity has gotten even harder for people living in rural food deserts in the middle of a pandemic, Luzier said. Food pantries were literally running out of food this time last year.

“And that was really scary for a lot of people,” Luzier said. “It led to this hyperfixation on food, and, ‘Will I have food?’ Because none of us knew what was going to happen.”

As more West Virginians have access to the COVID-19 vaccine, and the world begins to return to a sense of normalcy, Luzier said eating disorders and poor food access will still be here. This makes treatment crucial.

She recommended researching on NEDA’s website and visiting a primary physician first.

As for Lewis, she is hopeful and in “recovery” from her eating disorder.

In the last year, Lewis received a gastric bypass surgery to limit her appetite. She lost the 30 pounds she gained at the start of the pandemic, re-entered trauma therapy and is learning again how to care for herself.

Lewis said she takes comfort from this mantra: “We are human, you are human. And we’re in a pandemic, these are unprecedented times,” Lewis said. “‘You are human’ was what I needed to hear after struggling all year with my weight and my eating and my depression because there were so many days where I felt less than human.”

If you or someone you know needs help with an eating disorder, call the national helpline at 1-800-931-2237.

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