Abstract
Background: Eating disorders are severe and debilitating conditions, with a typical age of onset in adolescence, and carrying significant morbidity and mortality. To assess quality of school counselors' knowledge of and attitudes to eating disorders and discern extent to which knowledge gaps and stigma act as a barrier to service provision.
Methods: Respondents were randomly allocated to one of five clinical vignettes, each depicting a young person with anorexia nervosa, bulimia nervosa, binge-eating disorder, depression, or type-1 Diabetes. A study-specific questionnaire examined school counselors' eating disorders attitudes, and knowledge.
Results: Forty-nine counselors participated. School counselors correctly identified target case in over half of cases with anorexia nervosa being the most frequently correctly identified (75%) compared to depression or Diabetes. Diagnostic knowledge of anorexia nervosa was lower compared to other eating disorders, although not significant. The seminal role of the family in anorexia nervosa was also under-recognized. School counselors viewed eating disorders most often presenting in female youth, of long duration, and responsive to treatment.
Conclusion: School counselors play a crucial role in the recognition and management of school-aged youth mental health difficulties, and eating disorders in particular, given the high rate among youth. This study is encouraging as it highlights reasonable knowledge levels and few stigmatizing attitudes.

Key words: School counseling, Stigma, Treatment, Eating Disorders, STED-SCIT.