Browsing the news stand, the headline in The Times caught my eye: “The silent epidemic hitting top girls’ schools.” I bought the paper and settled down in my favorite Sunday café to read more. The report claimed that eating disorders are sweeping through the UK’s elite educational establishments, affecting thousands of the brightest students. According to leading psychologists, girls from aspirational, middle-class families are the ‘fastest-growing’ group using mental health services as they struggle to cope with the pressure to achieve top grades. The Eating Disorder charity B-EAT claims that many private schools are in denial about the scale of the problem because they do not want to damage their reputation. These centres of academic excellence, it appears, are also breeding grounds for eating disorders.
This wasn’t news to me. From the ages of 11-18, I attended London’s top private girls’ school, along with both my sisters. Although I didn’t develop anorexia until the year after I left, I’m conscious that I conform to the anorexic stereotype: perfectionist, insecure, driven. The latest media reports outline precisely those same characteristics: academic and highly competitive. Individuals develop eating disorders for a range of complex reasons, of course—but of the hundreds of woman and men I have met with anorexia, every one conforms to this profile.
Why should the compulsion to excel—which propels these privileged students to Oxford. Cambridge, Harvard and Yale, among other top universities—also make them acutely vulnerable to eating disorders? To me it makes perfect, dangerous sense that intelligent, driven girls are prone to anorexia. They excel not just at English and Math, Drama and Science and Music, but also at exercise and weight-loss. They strive to be beautiful, popular, self-disciplined, and yes, thin.
In the past year alone there has been an eight percent rise in the number of UK hospital admissions for eating disorders, most shockingly among the under -15s, some patients as young as five. Despite these escalating numbers, many of the top independent schools seem unable or unwilling to face the problems in their midst. Their discomfort with this so-called ‘silent epidemic’ is understandable: anorexia is notoriously resistant to treatment. Twenty percent of anorexics will eventually die, the highest mortality rate of any mental illness: there is no fail-safe, effective cure. But what is undeniable is that the longer it lasts, the harder it is to recover. Intervening swiftly can save years of misery and chronic ill health.
As part of Eating Disorders Awareness Week, I’ve been travelling the UK giving talks at universities. From ‘Mind Your Head’ Society in Exeter, to York St. John’s ‘Healthy Body Image’ campaign, our universities are full of groups speaking out about mental illness. Why is it ok to talk about these issues at universities, but not at schools, where many of the problems begin? Whatever our top academic schools preach about valuing pupils for what they do rather than for how they look, they also harbour an atmosphere of intense anxiety and secrecy.
There are, of course, forward-thinking exceptions. Last week I spoke to around 200 pupils, parents and teachers at an all-girls day school in south west London, full of academic high-achievers from affluent families.
I told the audience about my own battle with anorexia, which began when I was 19. My eating disorder took hold as I struggled to come to terms with the end of my first serious relationship. I blamed myself for the fact that my boyfriend had ended things; for the first time in my life I stopped eating. First I cut out all fats, then all carbs, then practically all solid food. The less I ate, the harder I pushed myself, academically and physically. Not eating seemed a logical form of punishment—it hurt and very quickly it worked. My weight plummeted to around five stone (70 pounds).
It took most of my twenties to sort things out, and I didn’t return to my current, healthy weight until my early thirties. Those years in the grip of anorexia were truly the loneliest and unhappiest of my life, so when I talk to teenage girls I strive to be honest. My message is, if you’re skipping meals, if you’re pretending you’re not hungry when you are, or weighing yourself every day, then you need to seek help. Don’t bury the problem because it will only escalate.
In the Q&A which followed my talk, I was deluged with questions from worried girls (‘I feel fat, what should I do?’) and terrified parents, asking how to spot the warning signs in their children, and what to do about them.
In the days following that talk I received emails from others in the audience who hadn’t felt able to speak publicly. “I came to the talk you did last night… I’m 14 and I was diagnosed with an eating disorder 3 years ago. I read your book An Apple a Day when I was in hospital. It made me feel less scared and alone, and gave me the motivation to gain weight. Your talk has actually led to discussion around school about positive body image… Today I feel more determined to recover! Thank you for speaking openly about anorexia. Among my friends, we all worry about our weight and the way we look. We all feel so bad when we eat.”
It wasn’t only students—a teacher emailed to say that she was finding it hard to teach positive body image to her pupils when she was battling her own eating disorder. A mother in her forties wrote that she had long-standing problems which she was desperate not to transmit to her daughter.
None of these experiences is abnormal. As women, society judges us on our body shape and weight—female attractiveness is social and sexual currency. From earliest childhood, from Cinderella to Sleeping Beauty to Barbie, little girls absorb the message that fat is bad and thin is good. A dainty appetite is ladylike: being greedy is not. Everywhere we look, happiness and success seem to belong to the slim. No surprise then that the highest-achieving young women are falling prey to the most perfectionist, and deadly, mental illness of all.
One day I hope to have a child of my own. I always assumed that if I had a little girl, I’d want the same academic privileges for her that I had, attending one of the UK’s best schools. But would I want her to grow up with the level of pressure and perfectionism that make so many young women vulnerable to developing anorexia, the condition which nearly killed me? These days, I’m not sure I could take that risk.