Information Unlimited: ALL THE FACTS YOU NEED TO AVOID HEARTACHE: No.13 EATING DISORDERS

Who is at risk?

About 60,000 people - 90 per cent of them women - are recognised as suffering from eating disorders in the UK, but that figure may be far higher.

5,000 children are currently being treated for disorders.

50 per cent of women are on a diet right now.

There are 5,000 Weight Watchers' clubs in the UK and 560 Slimming magazine clubs.

A range of disordered behaviour in which food and body size are used to control underlying emotional conflict. The causes are thought to be partly genetic and partly environmental, but common triggers are trauma in childhood, pressure to achieve, repressed anger, a fear of growing up and low self-esteem. Depression is both a symptom and a cause of eating disorders. As most people with eating disorders are usually secretive, parents and partners may be unaware of the problem until some sort of crisis occurs.

1 in 150 teenage girls is affected by anorexia; 6 per cent of them die. Girls between the ages of 10 and 19 are at most risk, although the age at which it starts is steadily decreasing.

Women starve themselves and see themselves as fat, even though they may be very thin.

In many cases, the condition is initiated with normal dieting which spirals out of control as dieting becomes a means of coping with stress, unhappiness and social pressures.

It may also be an attempt to delay "growing up" as anorexic girls lose, or don't fully develop, signs of maturity such as pubic hair, breasts and periods.

Some children and teenagers find that saying no to food is the only way they can express their feelings.

Anorexics use a variety of methods to lose weight, including fasting, slimming pills, excuses for food avoidance such as "food combining" or "food intolerance", a diet of very low-calorie foods such as salad and fruit, excessive exercise, self-induced vomiting, use of laxatives, and drugs such as ecstasy and cocaine.

Three in every 100 women are affected by bulimia at some point in their lives. It usually affects women between the ages of 20 and 40.

Bulimia nervosa applies to people who binge on large amounts of food and then make themselves vomit.

Bulimics may maintain a stable weight in the long term, but weight can fluctuate by as much as 10lb in 48 hours.

Bulimics, like anorexics, may use other methods of controlling weight: fasting, pills, avoidance tactics, laxatives, diuretics, drugs and alcohol.

If you live with someone you suspect is bulimic look out for:

- Lengthy and frequent visits to the toilet shortly after eating.

- Excessive fluid intake with food (makes vomiting easier).

- Stomach cramps and constipation (from using laxatives).

- Complaints about the cold.

- A chaotic and obsessive approach to food.

Involves overeating well past the point of satisfying hunger, often in secret.

Compulsive eaters use food compulsively as a means to control their emotional feelings.

Although overeaters may have extreme fluctuations in weight, they may not necessarily be overweight, because they may have bouts of food bingeing followed by a period of time where they rigidly control their eating.

Starvation - extreme weight loss, malnutrition, absence of periods, muscle-wasting, hair loss, abdominal bloating, constipation, osteoporosis, loss of sleep, poor circulation, coldness, dry skin, development of fine, downy hair all over the body, possible death.

Vomiting - dental problems (stomach acid dissolves tooth enamel), puffy face (swollen salivary glands), irregular heartbeats, exhaustion and muscle weakness, kidney damage, epileptic fits, vitamin and mineral deficiencies.

Overeating - poor circulation, shortness of breath, poor complexion, back pain, wind, body odour, bad breath, sluggishness.

Laxative abuse - persistent stomach cramp, swollen fingers, bowel muscle damage, constipation, potassium, magnesium, zinc and vitamin B deficiencies.

Depression, tiredness, lack of concentration, lethargy, mood swings, guilt, obsessive and disturbed behaviour, social withdrawal, tendency to other addictions.

For any treatment to be effective, the underlying causes need to be tackled.

Admit that you have a problem and confide in someone.

You may well find that your friends or family have already noticed that you have a problem with food.

See your doctor, who may refer you to a psychiatrist or psychologist. You will usually be treated as an outpatient, unless your case is very severe.

Contact the Eating Disorders Association for information, help and support. Helpline - 01603 621414. Youthline - 01603 765050 or visit their website on http://www. gurney.org.uk/eda. There is also a recorded message on 0906 861 5466 (calls cost 50p per minute).

The Women's Therapy Centre has leaflets and group workshops - 0171 263 6200

The Royal College of Psychiatrists - "Changing Minds" Leaflets - on eating disorders 0171 235 2351

There are many private treatment centres where you can get concentrated help, such as Farm Place - private treatment centre for eating disorders - 01306 627742

Contact Overeaters Anonymous - for information on help locally through groups of people who suffer from the same problem - 01426 984674.

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