I. Summary:
Eating disorders affect many young people. Anorexia, bulimia and binge eating are all disorders that are symptomatic of other issues. The media often delivers the message that being beautiful and thin is the solution to all problems. Many of today’s teens are influenced by this and attempt to emulate what they see. Today, 1 out of every 100 teenagers will suffer from an eating disorder. The onset of most eating disorders occurs before the age of 20. Eating disorders left untreated can be life threatening.

II. Objectives:

• Students will be able to evaluate the signs and symptoms of eating disorders.
• Students will be able to explain why it is important to speak with a trusted adult about themselves or someone they may be concerned has an eating disorder.
• Students will be able to evaluate the short-term and long-term effects of eating disorders on the body and emotions.
• Students will describe anorexia, bulimia and binge eating.
• Students will be able to identify the signs and symptoms of an eating disorder.
• Students will be able to explain the statement: “What’s inside is more important than what is outside”.
• Students will explain why teens choose to use food as vehicle to control things they feel they cannot control themselves.

III. Materials Needed:

• Computer with Internet access
• WANTED Poster Worksheet
• Gone On Too Long Worksheet

IV. Procedure:

1. Read to the class the first half of the story titled “Jessica’s Anorexia,” from the PBS Kids Website It’s My Life. Hold a class discussion about why they think Jessica has started starving herself. Lead the class to the conclusion that eating disorders are often not about food, but about deeper issues. Have students generate a definition for eating disorders.
   URL: /pbskids2008/itsmylife/body/eatingdisorders/article3

   After generating a definition, read the rest of Jessica’s story to the class. Discuss what the real issues are for Jessica and that refusing to eat food is symptomatic of other problems and issues. Propose the following questions for discussion:

   • What are some of the signs that Jessica has an eating disorder?
   • What do you think is happening to Jessica’s body physically?
   • Jessica is struggling with some emotional issues. What do you think they are?
   • What would be a healthy way for Jessica to deal with her feelings?
   • Who could step in to help Jessica?
   • What influences has the media had on Jessica’s decision not to eat?
   • How does Jessica handle criticism?
   • What do you think would happen to Jessica if she never got help for her eating disorder?
   • How long do you think Jessica will have to deal with having an eating disorder?
   • After receiving treatment, what do you think Jessica has to do every time she eats, watches television, goes to the movies, reads magazines, buys clothes or goes out with friends?

2. Pair students in partners and tell them they are going to take a partner quiz and share their answers with the class. Print out the 10 scenario questions from the It's My Life quiz titled “What’s the Deal?” Do not print out the answers. Hang ten large pieces of paper around the room with each question number at the top and the multiple choice answers at the bottom. After reading each question, each set of partners puts a mark on each sheet of paper indicating what they think the answer should be.
   URL: /pbskids2008/itsmylife/quiz/eatingdisorders.html

   Hold a class discussion by reviewing each question and the consensus of what the class majority felt the answer to be. After reviewing each question, read to the class the correct answer and the given explanation. This activity should move the class towards a better understanding of the different types of eating disorders and that eating disorders are symptomatic of deeper issues.

3. Review “Jessica’s Anorexia” with the class briefly, and prompt them to come up with Jessica’s type of eating disorder: anorexia nervosa. Then read to the class or have the students read two more stories from the It's My Life Web site:

   ”Stephen’s Problem”
   URL: /pbskids2008/itsmylife/body/eatingdisorders/article4.html

   ”A Model’s Bulimia”
   URL: /pbskids2008/itsmylife/body/eatingdisorders/article2.html.

   These stories cover two other types of eating disorders: bulimia and binge eating.

4. Put students in small groups or in partners to complete the WANTED Poster worksheet. Students will create a “WANTED” poster that focuses on counteracting the cultural fixation on being thin, and on looking past the physical appearance of others. Posters will also list ways eating disorders can be prevented, who to go to for help in the event you or someone you know may have an eating disorder, and ways to balance eating, exercise and self acceptance. Hang the posters in the classroom.

5. Distribute to students the list of symptoms related to eating disorders found on the It's My Life Web site.
   URL: /pbskids2008/itsmylife/body/eatingdisorders/print_symptoms.html

   After reviewing the list, discuss who they should speak with in the event they feel they themselves or others may have an eating disorder.

6. What happens if an eating disorder goes untreated? 86% of eating disorders begin before age 20. It can be a silent disorder, often going unnoticed and not reported for a long time. What are the physical and emotional effects as the disorder progresses? Students can complete the matching worksheet titled Gone On Too Long. Discuss the answers and review why it’s important to seek help and let trusted adults know about possible eating disorder symptoms.

7. Culminate the unit by having students write and reflect on the statement “It’s what is on the inside that counts,” or choose from any of the following:
   • Read to the class one of the non-fiction stories that can be found on the It's My Life Web site, and evaluate the portrayed physical, mental, and emotional struggles.
     URL: /pbskids2008/itsmylife/body/eatingdisorders/print_books.html
   • Have students research how eating disorders affect boys and girls differently.
   • Have students research sports where eating disorders may become a potential problem.
   • Have students write a short informational narrative on why a thin, trim body is not the solution to all of their problems.
   • Evaluate media advertisements and what messages they portray. Then write or provide a speech on how teens can discern what is “picture perfect” from what is real.
   • Show the PBS documentary “Perfect Illusions: Eating Disorders and the Family.”
     URL: http://www.kcts.org/productions/perfect/index.asp

V. Classroom Assessment

The “Wanted” and “Gone On Too Long” worksheets can be graded and assessed. A culminating project can also be used to assess student knowledge.

VI. Extensions and Adaptations

1. Invite a local doctor to visit the class and discuss the types eating disorders, as well as their long-term and short-term effects.

2. Invite a guidance counselor to class to discuss eating disorders and getting the proper help.

3. Invite a person in recovery from an eating disorder to come and talk with the class.

4. Research ways that advertisers promote slender and thin body types and how they play on our emotions.

5. Distribute copies of the It’s My Life “Discussion questions for kids to bring up with adults” on this topic. Have students use the questions to hold a conversation with an adult or parent on the topic of eating disorders.
   URL: /pbskids2008/itsmylife/body/eatingdisorders/print_discussion_qs.html

VII. Relevant National Standards

Standard 1: Students will comprehend concepts related to health promotion and disease prevention.

• Students will recognize health problems caused by eating disorders.
• Students can describe appropriate healthy ways to deal with problems.

Standard 2: Students will demonstrate the ability to access valid health information and health-promoting products and services.

• Students can describe valid health information related to eating disorders.
• Students can explain how to combat the lore of the media advertising in being unrealistically thin.

Standard 3: Students will demonstrate the ability to practice health-enhancing behaviors and reduce health risks.

• Students can identify responsible and harmful behaviors, develop health-enhancing strategies, and manage stress.

Standard 4: Students will analyze the influence of culture, media, technology, and other factors on health.

• Students can describe the pressure that the media portrays to solve solutions through physical appearance.

Standard 5: Students will demonstrate the ability to use interpersonal communication skills to enhance health.

• Students can describe ways to deal with problems and issues.

Standard 6: Students will demonstrate the ability to use goal-setting and decision-making skills to enhance health.

• Students can set goals related to good health habits.

Standard 7: Students will demonstrate the ability to advocate for personal, family, and community health.

• Students can identify community resources related to eating disorders.

About the Author:
Donna DeTommaso-Kleinert is an elementary physical education teacher in the North Penn School District in Lansdale, Pennsylvania. She has been a learning coordinator and an elementary and middle school health and physical education teacher, and is presently completing graduate work in Kinesiology in the areas of curriculum and instruction at Temple University.