As the government attacks "fashion and the tyranny of thinness" for undermining the confidence of girls, experts are seeing younger and younger children with eating disorders. But blaming stick-thin models might be too simplistic.
Rhodes Farm is a clinic dealing with children suffering from anorexia nervosa. Opened 16 years ago, it has seen the average age of clients drop and children as young as eight are now being treated.
Culture Secretary Tessa Jowell has pledged to tackle "the cult of size zero" by establishing a task force with fashion leaders, but for many girls at the clinic the issue is more about control.
Twelve-year-old Natasha was admitted to Rhodes Farm after her weight fell to less than four-and-a-half stone. She says the furore over "size zero" models and celebrities has nothing to do with why she stopped eating.
"[The media's] story is people get anorexia because they want to be thin and they see other people in magazines and on the catwalk and they think 'I want to be like that'," she says.
"That's a really good story and why would they change it - it's a perfect story. But it's not the truth. Maybe for some people it is, but I know that for me it's not. I haven't got anorexia because I've been inspired to look like other people. It's the image in my head. There's no one that's my idol.
"People at school were saying that I was already skinny - but I didn't think so. I wanted to see it for myself and I wanted to be able to look in the mirror and think I am, maybe. That's when you stop eating and you still don't see it. You know others say you're freakishly skeletal but you don't see it at all."
Like many children who are admitted to Rhodes Farm, in London, Natasha had spent nearly two months on a paediatric ward trying to gain weight.
"In hospital they were telling me that I would die, I was thinking 'well you said that to me a week ago and I'm not dead now, am I, and I've lost more weight'. You know you push it to the limit really."
Yet left untreated, one in five anorexics will die of the starvation caused by the illness.
Once at Rhodes Farm, Natasha has to gain two and a half stone and reach her target weight of seven stone before she'll be discharged. She has to eat a daily diet of about 2,500 calories consisting of all the food she hates most - chocolate, chips, cream and cheese. It's a prospect she dreads.
"When you step on the scales and see that you've gained weight, you just sort of think you're a failure, you're huge. When I get to my target weight I know that I'm going to feel absolutely disgusting and I'll want to lose more weight."
Her dad Laurence is allowed to visit her once a week. "Natasha had always been a very happy go lucky sort of kid," he says.
This Brazilian model died weighing just 88 pounds
"It came as a massive shock when they said she had anorexia, most of the people who know her said she was the last child they would expect to suffer from this.
"But it's such a devious disease, it carries with it so much underhand behaviour it was only when I found out that she was skipping school lunches that I really knew."
Natasha's fear of gaining weight is not unusual, says Dr Dee Dawson, the medical director of the clinic in north London.
"We know that almost all people who are starving become depressed, so not surprisingly almost all the children who come here have some degree of depression."
She also notices another worrying trend among the children she sees.
"Since I opened Rhodes Farm 16 years ago I've seen the average age of the children drop without a doubt. We're seeing younger and younger children than we used to see. It's not unusual for us to have eight, nine and 10-year-olds in here."
Anorexia is a complex illness and is not caused by a single factor. Dr Dawson has "no doubt" people are born with a genetic predisposition to develop it.
"They are children who are perfectionistic, high achieving but often lack self-confidence and have low self-esteem despite the fact they are very gifted and talented people."
Opened in 1991, the first residential unit to treat children with eating disorders
Today it's the largest of its kind, with 32 places
Boys make up 5-10% of admissions, with at least one at the clinic at a time
School sessions included in daily routine
Those who might vomit after meals, or exercise endlessly, are supervised
But she's is also careful to explain that those characteristics alone do not mean a child will become anorexic.
"If a child like that develops lots of problems, has lots of problems in and around puberty, then they might decide dieting is a way of taking some control and when they set themselves a task they do it to the best of their ability."
Naomi, 13, was admitted to the clinic in May, but despite gaining the weight she needs, she is still plagued by anorexic thoughts. Measuring 5ft 4ins tall, she still desperately wants to be four stone.
"I know that when I get to four stone I'd want to be less than that, but that is what I want to reach at the moment. I think I'd be a lot happier and more confident in myself if I was four stone, but deep down I know that I'd also want to get lower."
She should have been discharged in August but the clinic wouldn't allow her home until she can eat on her own and maintain her weight. However, Naomi, is under-going a procedure known as tubing - a last resort if the patients refuse to eat.
"They got a tube and it goes from your nose to your stomach - they feed you full-fat cream, chocolate spread and peanut butter and all horrible things like that - and then they liquidise it like in a blender."
Left alone, she constantly tries to burn off the food she's had to eat.
"I exercise any where and anytime I can. I just continuously walk back and forth or I run up and down the stairs for no reason, I stand up and exercise until I go to bed really. I don't go to sleep until 11pm and then wake up at 4 O'clock in the morning and do the same thing."
The treatment at Rhodes Farm works better on some than others and two months after she was admitted, Natasha reached her target weight and was discharged. Naomi, however, was struggling more than ever - refusing to drink even water.
"I feel like when you're dehydrated you can feel the pain, you feel that you've done something worthwhile" she says. "If I can exercise even though I'm not drinking it just feels like an achievement."
I'm a Child Anorexic is broadcast in the UK on BBC Three, Monday 29 January at 2100 GMT.
Add your comments on this story, using the form below.
Hmmm - I've had anorexia. In hindsight - and it takes many years before that hindsight is accurate - fashion is a factor, but it's one of several. Fashion and the body, given our culture, is where perfectionists, particularly women, tend to locate their battle for control. Fashionable images of extremely thin women are a form of representational violence against all people. I think these images should be subjected to controls, as is pornography.
I became anorexic when I was 17. It had nothing to do with media images of skinny models and everything to do with trying to regain control of at leats one aspect of my life. I was in my final year at school and the pressure put on me to do well in exams and go to a 'good' university took their toll. Coupled with the death of a close relative it felt like things around me were just happening and I couldn't do anything about them. Controlling what I ate felt like the only thing I could decide for myself. Whilst size 0 models are not the ideal image to be promoting people have to be careful that they do not take a too simplistic approach to what is a very complex issue.
Elizabeth, London, UK
The facts are that societies that do not worship thinness as a physical ideal, do not have any occurences of eating disorders. There is also no physical reason whatsoever why more girls should be susceptible to eating disorders than boys. As the above stats tell us - boys only make up around 5-10% of patients at Rhodes Farm. Prob about the same percentage of ads that feature male models as opposed to female models. I feel so so sad to read these girls stories and I can see their views as to why they think they developed the illness - yet I don't think it's as simple as aspiring to a specific 'idol' such as Victoria Beckham. We are bombarded with images of extreme thinness, presented to us as the only acceptable form of female beauty, on a daily basis. How can we expect this to have no effect on young girls?
Jackie Ladbroke, London
I agree that it's too easy to blame stick-thin celebrities and models. Anorexia is a mental illness. It's not just about weight and self-image. Although the media do very little to tell us otherwise.
With a planet full of children desparately trying to survive against starvation and disease why are we wasting resources on people deliberately doing it to themselves.
Mark Bell, Guildford
It is very sad to see young girls like Naomi with anorexia. But I do belive that the stick thin models in magazines are not helping these youngsters of today. I have watched my weight for years but have managed to do it through exercise and eating sensibly. I think you can acieve your perfect weight but by being disciplined and not wanting to be too thin like the models of today. I think that youngsters are under a lot of pressure today in school and in there everyday activities, and it can only take a sentence that someone might say that you are fat and it can do so much damage to these individuals.
Linda Masters, Port Talbot
I blame fashion - not the stick thin models but the clothes. The fashion for low slung trousers, and high cropped tops exposes the midriff - and even skinny girls (let alone slim ones) look like they've got bulges in the wrong places when trousers are tighter than they should be just to hold them up.
Christine Bowles, Milton Keynes
I feel some anorexic girls may be trying to be in control over their parents by being awkward and refusing food like a rebellion.
liz buckley, Leeds
I think the medical establishment attributes far too much significance to 'genetic predisposition' when it comes to mental disorders like anorexia. I fully accept that each person will have a bias of some kind, but after reading Oliver James' 'They F*** You Up' I'm inclined to agree with him and attribute more than is currently, to learnt behaviour. Isn't it more probable that the parents we instinctively 'idolise' influence our behaviour, rather than it being a genetic 'fluke'? If it truly is just a fluke, why are the number of cases per 100 or 1000 constantly growing? We need to take a long, hard look at the power the opinion of the medical establishment has and then start entertaining other possibilities more seriously. If we wait for someone to 'prove' that genetics play a minor part at most, it will already be too late for many people. Anorexia has the highest mortality rate of any pscyhiatric disorder and more needs to be done to address its existence than simply addressing the issue of low weight in its patients. The weight problem is only on the surface, so addressing it whilst the emotional problems continue to run riot will only keep the illness at bay for a short time.
Jonathan Hobdell, Southampton, UK
This is a horrible illness and i support all familys that have to go through this ordeal.
It's so easy to become anorexic and the publicity is much-too-available to young people. However on saying that, when I was 'anorexic' I didn't know what 'anorexia' was and how you got it.
I developed anorexia in my early 20s and it was never about actually being 'thin' or losing weight for me. Amongst other problems at the time, the relationship I was in was in difficulty and what I ate became the only thing in my life I could control. I look at myself in the mirror and think I look horrible but in the sense that I look too thin and look ill. However, just because I think this, and desperately want to get better, doesn't mean I can. I've never had the help I've requested to get better, perhaps made worse by the fact I wasn't as 'expected'. People need to wake up and realise that anorexia is not a 'one box fits all' disease.
Not that simple, Scotland
Good article, about time someone in the media said it. Blaming only fashion models and clothes sizes is so simplistic, and the public gets the wrong idea about people who suffer it. Anorexia is not about being fashionable, is about control and self-esteem.
Raquel , London
Force feeding junk food seems a strange way to deal with an eating disorder. Surely they should be forcing the patients to eat healthy high-calorie foods, rather than crisps, chocolate and other foods full of trans fat and cholesterol. Another consideration is the high rate of cross over from anorexia to bulimia and vice versa. Feeding these young girls junk food seems a little dangerous in that respect too, since bulimic binges tend to consist of huge amounts of junk food being consumed in a short time and then purged. It is an obsession with food, and types of food. Encouraging a diet of high calorie healthy food seems to me (and I have had an eating disorder) a much better idea than encouraging patients to eat chocolate and crisps.
I am 29 years old, have been overweight most of my teenage and adult life and now been told I am suffering with Bullimia, this is not because I aspire to be like a model although there is s huge pressure on women to be thin, but because I have been under an enormous amount of pressure over the last year and food felt like a control mechanism for me. Politicians and the media need to understand that there are two different issues here, one is eating disorders, the other is the long time tradition of thin models which is being hyped by the media into a size 0 debate, which lets face it, if they didn't print the articles, we wouldn't be worried about, surely the quickest way to stop this debate is to stop printing this rubbish and focus on helping those who really need it.
Helen, Hampshire Uk
It doesnt make any sense to force feed them cream, chocolate and cheese, surely these kids can put on weight with a sensible diet of meat, vegetables and starch foods...
deborah allen, worcester
There is a much deeper psychological problem with individuals who suffer from anorexia that goes beyond just looking up to models. Whether it be attention seeking, overall lack of confidence or other reasons, for children it is difficult to help them through mental block but I feel it is worse for adults. Todays government are concentrating solely on teenagers with eating disorders yet forgetting about adults, who as they are not under the care of their parents anymore, can not as easily be admitted to a mental institution were the sucess rate is very high. If admitted by their own doctor they can easily sign themselves out and then all confidence is lost with their doctor, dropping the number of individuals they feel they can confide in. This to me is a failure in our Health system and doctors have admitted this but nothing is being done or mentioned.
I was shocked reading this article. Especially the last quote "I feel like when you're dehydrated you can feel the pain, you feel that you've done something worthwhile". How dreadfully sad for a child to have said that.
How truly sad
I don't understand why underweight people get this special treatment and special hospitals and sympathy from everyone, but overweight people just get told to get over it and stop being greedy, and even worse get humiliated on TV. Would they ever make a programme similar to 'You Are What You Eat' for people trying to gain weight rather than lose it, with Gillian McKeith showing a table of food they should have eaten in a week and making them unhappy? I don't think so. All people with weight issues should get the support they need.
I was anorexic when I was in my early 20s, and went down to 5 stone (I'm 5'3''). Luckily, I narrowly escaped having to go to hospital. It was certainly a control issue with me, and I was incredibly lucky that I managed to recognise it and decide to tackle it for myself before I became unable to. I realised that I was actually not in control at all; the illness was controlling me. If I had had to go into an institution and be 'made' to eat certain things - especially really fatty things - I'm absolutely sure I wouldn't be here now. I would only have wanted to fight against it. In the end you can only really recover if you change your own mindset. (Although of course I can understand well that people who are in danger of dying need to be treated urgently.) It's exacerbated by the fact that starvation affects your brain chemistry, making you incapable of 'thinking clearly' and sending you spiralling downwards.
Kitty, Leicester, UK
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