Today is the start of International Eating Disorders Week, but how much do we know about such conditions as anorexia and bulimia? In an exclusive interview, young journalists from the news service Children's Express reveal the nightmare world of one sufferer, and ask how much the media influence body image among the young.
"When I was three I laid on the kitchen table and all my ribs stuck out and my hip-bones and I thought 'Gosh, this is really nice. I wish I was like this all the time.' When I was a little bit older my sister started to eat solid food and I watched what she ate like a hawk and I'd never eat more than her and I drank a lot less than her as well."
Poppy Bowler (not her real name) is 23 years old. She has 10 GCSEs, four A-levels and a degree, and is now studying for a masters degree at Sheffield University. She is intelligent, self-aware and seems a model of success. But through her teenage years and into adulthood she has wrestled with what some experts call a "secret illness."
For a decade, anorexia and bulimia have threatened her health and education, her friendships and family relationships. Revision timetables have been disrupted by eating binges, vomiting and anxiety. She failed her A-levels at the first attempt and her health nearly collapsed when university finals approached. Hours have been devoted to the shame-ridden, private world of food diaries, clinics, therapy and support groups. The two conditions have sapped her energy for years.
"You wouldn't ask for eczema and that's horrible and irritating and that's what an eating disorder's like," she insists. "They're so all-consuming. You lose your life, you haven't got time for your friends, you don't want to see them because you don't look right."
There are tens of thousands of young women like Poppy across the UK: between 60,000 and 90,000 people are receiving treatment for disorders ranging from anorexia to bulimia and binge-eating. The Eating Disorders Association estimates that 1.15 million Brits have a "significant problem" with food. Most don't speak out because they won't admit they have a problem, feel too ashamed to talk about it or just don't know where to turn.
Despite the publicity given to eating disorders in recent years, the conditions are claiming more victims at an increasing rate. Maggie Young, an occupational therapist treating eating disorders among the 16-56 age group, says she is getting 4-5 new referrals a week at Community Health Sheffield, an NHS Trust. The majority are young women whose problems began at puberty, when natural weight gain causes conflict with the thin ideal of our image-obsessed society. Young describes this as girls 'fighting their own biology.'
"[At puberty] girls have got this weight to put on, but because of the cultural ideal they're sort of fighting against it," she explains. "Instead of thinking 'This is absolutely normal, this is natural,' girls are thinking 'Oh no, I'm not allowed this flapjack because if I have it I won't look like Cindy Crawford.' "
The physical and psychological damage can be immense. Sufferers of eating disorders risk inhibited growth, infertility and interrupted brain development. Anorexia claims more lives than any other psychiatric illness - mainly through suicide. Bulimia, associated with severe depression, is not far behind. Anorexics and bulimics become obsessively secretive about their eating habits and can suffer in silence for years.
"Sometimes the parents don't even know. I had a young person that was coming here who was 17 and she felt quite deeply ashamed of having an eating disorder and hadn't dared tell her mum about it."
But even if parents do know, lack of proper information may leave them bewildered about what to do. Poppy recalls her own parents turning a blind eye to her struggle with anorexia because they feared the condition.
She recalls: "We were on holiday in France and there was this family next door, whose daughter was really, really thin. Her mother told my parents 'I'm really worried about her, she's anorexic. I've taken her to the doctor." My parents were saying 'They'll just make it worse, She's not anorexic, but they'll turn her anorexic by saying she' s anorexic.' "
When Poppy finally told her parents she was anorexic, they were relieved and supportive. But their earlier response to the condition was typical of a society that almost refuses to admit eating disorders really exist.
"If you have three people on a medical ward," Poppy says, "one has got lung cancer, another has had a heart attack and one of them has got an eating disorder, the way the person with the eating disorder is treated is completely different to how the other two are treated. It's seen as 'You silly little girl. Get on with it. What are you playing at?'"
The ignorance runs deep. When the Labour health minister Tessa Jowell tried last year to launch a campaign to regulate images of young women in the media, she was ridiculed by Conservative politicians and the press.
Poppy's anger is clear: "My mum wrote to William Hague and the letter she got back said 'We are sure that you would prefer your money to be spent on worthwhile things like education and the health service.'" She says: "Eating disorders need treating because not doing so is economically foolish. People with eating disorders tend to be intelligent young women who are high achievers and it takes them out of society. If they're not treated they're not paying taxes"
Former sufferers are often too ashamed to talk openly about their experiences of anorexia. For her, though, the issue is "too important." Ignorance of eating disorders can drive sufferers deeper into their painful cycles of denial, shame and guilt. Without intervention from parents and friends, Poppy, like many sufferers, pushed herself compulsively towards her anorexia.
"My greatest desire in life was to be anorexic: I wasn't impressed with myself. I wasn't good enough. I always had to be perfect. I'm a real perfectionist." She continues: "Your achievements aren't enough. You can be brainy or whatever, you've got to be thin and pretty, and if you're not pretty you damn-well best be thin.
"It wasn't real even when I was really, really bad. It was something I was making up for attention, even though I didn't tell anyone." Even after beginning treatment for severe bulimia at university, Poppy felt there was something unreal about her condition. Though she saw a specialist for 18 months, she eventually quit because "I felt like I was taking up her valuable time."
But things are perhaps improving for sufferers of eating disorders. There are now more than 20 eating disorders clinics around the UK and standard treatments are being developed. In Sheffield, the Eating Disorders Association and the health authority are setting-up a peer mentoring programme that will take ex-anorexics into the classroom. Poppy's own involvement with the Sheffield EDA has, she says, helped her feel positive about her chances of overcoming her condition.
"It's just nice to actually talk to them and actually have people go 'God, I've felt like that,' " she says, adding: "It makes you think a bit more and slow down a bit." But schools could do more to educate young people about anorexia. "They need to make people aware of it and people need to know how horrible it is, how truly horrible it is. You don't get thin and that's it, you just lose everything. It's awful. It's the most disgusting, all-consuming thing there is and you don't want to openly invite it into your life."
About this team
This article was produced by editors David Burnham and Mark Lewis, 15, and reporters Rachel Walmsley, and Kimberley Bennett, 13. It was published in the Sheffield Star.
