Birmingham expert Pam Virdi tells Jo Ind about an initiative in schools to help prevent young people from developing eating disorders.
Six out of ten teenage girls think they would be happier if they were thinner. That statistic is sad enough on its own, but it is a cause for real concern given the evidence that people who are dissatisfied with their bodies are vulnerable to illnesses like anorexia, bulimia and compulsive eating.
At Birmingham's Eating Disorder Unit, based at the Queen Elizabeth Psychiatric Hospital in Edgbaston, the team is setting about preventing eating disorders before they start.
This week is Eating Disorders Awareness Week and they have marked the occasion by announcing an initiative to develop a programme in schools.
"We know that body dissatisfaction is a risk factor for people developing eating disorders," says Pam Virdi who is a lecturer and therapist at the unit.
"We need to help people feel better about their bodies and more accepting of them before they develop a full-blown clinical eating disorder which is a form of illness that is very disabling."
The team at the Eating Disorder Unit is now ready to deliver a programme for secondary schools. All it needs is for schools to volunteer to take part.
The programme is likely to consist of eight sessions. The first four would be learning to develop a critical awareness of the media, which is a powerful element of young people's body dissatisfaction.
The body fat of models and actresses portrayed in the media is at least 50 per cent less than that of healthy women.
Less than five per cent of women are naturally as thin as is required to be a model, but still this is the ideal to which teenage girls strive.
In the first four sessions, the young people would critically assess media images, learning to think about how they have been created and for what purposes.
The key to the success of these sessions is that the youngsters speak in groups and do the thinking for themselves.
"If the young people are holding contradictory ideas about something - like wanting to be ultra-thin but not wanting the cost of being ultra-thin, like starving themselves, being body obsessed and vomiting - if they can put words to that contradiction and actually say it themselves to their peers, then they can no longer hold that contradictory position and that has an impact on their behaviour," say Pam.
Studies have shown that sessions are most successful when boys and girls are taking part in the programme together.
Boys need to develop a capacity to critique the media, partly to resist pressure they feel to change their own bodies and partly to support the girls.
"It's very helpful when boys can say: 'Don't go on a diet. I'd rather you ate'," says Pam.
The next four sessions of the programme involve learning about the body and the effects of fad dieting.
For example, the standard way of assessing if someone is overweight is through using the body mass index, which gives a band within which a person's weight should fall based on height. This is the index used by most GPs and the Government to measure obesity.
But there is a growing criticism of this measure which takes no account of gender, genes, or the fact that muscles weighs more than fat so an athlete could be classed as overweight in body mass index terms.
The programme devised in schools by the Eating Disorder Unit would include education about set points.
Set point theory is derived from the observation that the body regulates its weight much as it regulates its own heat.
Experiments involving the starvation and feeding of rats have shown there is a biological resistance to permanent weight change. The body will compensate for being starved to retain its natural weight.
That explains why dieting can make people fatter as it interferes with the metabolic rate. It also explains why dieters tend to put back on weight they have lost. It is to do with the physiology of the body rather than lack of will power.
A person's set point is the weight he or she is on eating three meals a day, having three snacks a day and exercising moderately.
At the Eating Disorder Unit, set point is considered to be a better indicator of a healthy weight than body mass index. The focus is on being the weight you naturally are rather than trying to pick a body weight you would like to be and striving to attain it whatever the consequences.
"Some people don't like set point theory because it means accepting being heavier than they want to be," says Pam.
The Unit recognises that educating young people on eating disorders can sometimes inadvertently exacerbate them.
For example, telling them about people who make themselves sick after eating can give youngsters the idea of doing just that.
Best practice has been developed to minimise this effect through means like avoiding using celebrities as examples and thereby glamorising the illness.
The Unit is also keen to work with teachers on their own issues around dieting and body dissatisfaction so that they do not inadvertently communicate negatively to young people.
"Body dissatisfaction is very prevalent in our society. You are swimming against the tide if you don't feel unhappiness about your appearance," says Pam. "Learning body acceptance is an important thing for everybody, including myself.
"Our aim is to help not just individuals but to affect the whole culture that works against us being happy with ourselves and who we are."
* Schools interested in taking part in the programme should contact Pam Virdi or another member of the team at the Reed Eating Disorder Unit, Birmingham and Solihull Mental Health Trust on 07985-882549 or 0121-678-2169 or firstname.lastname@example.org.
* Pam Virdi teaches a one year modular course on eating disorders at Birmingham City University which is open to people from any discipline. Contact her on the numbers above for details.
* Anyone wanting advice, information or support on eating disorders can contact the Reed Eating Disorder Unit on 0121-678-2169 or 0121-678-2167.