Unmasking eating disorders in the schools.

Body Wise Handbook: Eating Disorders Information for Middle School Personnel (2nd ed.) by U.S. Department of Health and Human Services; Washington DC: U.S. Government Printing Office; 2000, July.

Due to the fact that school counselors often have daily contact with a large number of students, they can play an important role in the prevention and early detection of students who display the signs and symptoms of disordered eating. Educating school counselors and providing them with materials to combat disordered eating and eating disorders may help decrease a growing trend amongst adolescents. The Body Wise Handbook, which is a publication of the Office of Women's Health (OWH) of the U.S. Department of Health and Human Services (HHS), is such a resource developed to assist middle grades educators with issues regarding disordered eating. This material is provided free of charge and can be retrieved through one of two Federal websites: www.4women.org/BodyImage and www.health.org/gpower.

While the mission of OWH includes the improvement of women's health across the life span, and eating disorders still target a predominantly female population, this handbook was developed to prevent eating disorders among school-aged youth. This is an effort to dispel myths that eating disorders occur only among middle and upper class, white females. Therefore, resource sheets which address eating disorders in male and ethnically diverse populations also are included.

The handbook's introduction explains that this publication is part of the Girl Power! Campaign also conducted by HHS. Seeking to reinforce and sustain positive values and behaviors in students of grades five through seven, the HHS office on Women's Health implemented the BodyWise initiative to address a critical health problem that affects adolescent females. This publication is directed to school counselors and other school personnel in order to disseminate relevant information through guidance programs, school curriculum, and other school programs.

The actual handbook contains four distinct sections. The sections are titled: Understanding Disordered Eating and Eating Disorders, Key Information for School Personnel, Using the Body Wise information Packet, and Definitions to include diagnostic criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The first section explains the difference among normal eating, disordered eating, and eating disorders. Additionally, in the second section, the handbook explains how students' academic achievement often suffers due to the effects of problematic eating behaviors. The remainder of the second section outlines mental and physical health issues, the importance of early detection in successful treatment and recovery, the vulnerability of students from all ethnic and cultural groups, and the significance of the school community in fostering an environment which encourages healthy eating habits.

In section three, Key Information for School Personnel, the handbook describes how to use the information and resource sheets. Since advance permission to reproduce the document is granted by HHS, school counselors are encouraged to reproduce and distribute handbook materials to appropriate stakeholders including students, parents and caregivers, and school personnel. Resource sheets provide practical information about both disordered eating and eating disorders. These useful resource sheets are directed toward school principals and administrators, classroom teachers, and food service and nutrition personnel. School personnel are provided with suggestions on how to effectively recognize and respond to warning signs and symptoms of problematic eating. Because prevention of disordered caring is also vital, ideas are presented on how school personnel can develop a positive school climate regarding eating. Reading lists citing relevant information about girls' health issues are provided for counselors who desire more in-depth information. Further reference materials list videos and educational organizations that could also provide more information about pre-adolescent health issues and the media's role in influencing students. Fiction and non-fiction reading lists give suggestions on books counselors and teachers may recommend for student reading.

In summary, this information packet is especially helpful for middle school counselors, but also could be adapted for other age groups and be used by teachers, coaches, school nurses, and other school personnel. The handbook provides information regarding eating disorders' symptoms and pathology, how counselors can approach students believed to have an eating disorder, and real life examples of individuals dealing with an eating disorder. It also contains information on how students can help their peers when they see possible signs of disordered eating. Because the wealth of information contained in the handbook addresses a very real and current trend in adolescent populations, school counselors will find this resource invaluable in their comprehensive guidance program.

Reviewed by Susan R. Boes, PhD, NCC, LPC, associate professor, State University of West Georgia, Carrollton, e-mail: [e-mail]; Vicky Ng, Vocational Rehabilitation Counselor, Georgia Department of Labor, Carrollton; Tracy Daviston, Lead Counselor, Taylorsville Elementary School, GA