Love me slender

While for most of us Christmas is a time of celebration and excess, it is also, for a minority of women, the most anxious time of the year.

Take Catherine. She begins the Christmas preparations months early. Every tempting recipe in a magazine is clipped and filed. Days are spent hunting for the perfect sourdough loaf to use in the stuffing.

The cooking itself is a two-day affair with no help allowed and children and relatives are banished from the kitchen. Like the super-conscientious Bree in Desperate Housewives, she painstakingly produces mountains of mince pies, calorific trifles and pure butter macaroons by hand.

When the family finally sits down together for what is a truly amazing feast, Catherine, who at 5'6" weighs barely eight stone, helps herself to two slices of turkey breast without gravy and half a dozen Brussels sprouts.

“I’m not hungry,” she declares . Then she goes about making sure that everyone else’s plate is full to the brim. Her family knows better than to comment.

Comparisons between Catherine and the uptight Bree, played by Marsha Cross, go beyond the kitchen prowess the two mothers demonstrate.

Catherine is one of a growing number of women succumbing to what has been termed ‘Desperate Housewives Syndrome’- adult women with eating disorders which experts say may be triggered by an attempt to achieve the alarming thinness of actresses such as Cross and Teri Hatcher, star of the US drama series.

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Dr Chris Freeman, consultant psychiatrist at the Royal Edinburgh Hospital, said recently: “Desperate Housewives is a popular programme showing older women who are attractive and have rampant love lives. I believe it is influencing women to have eating disorders.” Some clinics have reported a fourfold rise in the number of women aged 30 to 50 seeking treatment for anorexia.

Dr Alex Yellowlees, an eating disorder specialist and medical director of the Priory Hospital in Glasgow says it was virtually unheard of for an “older” woman to be suffering from anorexia five years ago. Now, around a fifth of his patients are women approaching middle-age. He speaks of an “intense obsession with thinness” among adult women.

“More older groups of celebrities are expressing concern about their bodies,” he says. “They think that to stay young, they have to be thin….We have gone kind of mad and women have taken it to the extreme.”

Unfortunately, we have become almost “used” to eating disorders among teenagers, but the rocketing rates of anorexia and bulimia in women approaching middle age is something new and worrying. Moreover, eating disorders in adult women touch an uncomfortable truth (who doesn’t wish they were thinner?) and provokes hostility rather than pity.

While many adult women with eating disorders may have struggled with them since puberty, society expects them to have “got over it” by the time they are wives and mothers, with careers and responsibilities.

Many women regard eating disorders in older women as narcissistic and self-obsessed. Whereas being insecure and obsessively body-conscious is socially acceptable at 17, at 37 it’s time to be contemplating more important things.

We react with outrage (when will she grow up and accept that she has responsibilities?) while secretly we envy the super-slim woman who can wear those spray-on jeans at her age. “Women regard each other’s weight as a competitive benchmark,” says Alison, a statuesque 35-year-old museum curator who has wrestled with her eating disorder for twenty years.

She believes it is now untrue that anorexia and bulimia are less prevelant once women get past their teens. “Weight issues are hugely competitive at all ages. It’s all my friends talk about.” Alison can spot an eating disorder across a room. “I can recognise all the mannerisms and the food avoidance, the obsessing about food and encouraging everyone else to eat while not eating oneself,” she says.

Alison also dreads the Christmas period because it is inherently chaotic, something anyone with an eating disorder dreads. “ I get stressed going into supermarkets, I panic in restaurants. Parties worry me. Anyone who has a problem with food dreads this time of year because of the fear of losing control.”

Alison goes through periods of total starvation followed by bingeing, and has abused laxatives and diuretics. She has been in and out of addiction clinics for years and has a deep understanding of the disease, yet still she lives with the constant fear of the next relapse.

However, this does not mean that there aren’t fully functioning, successful anorexics and bulimics leading very active lives (many actresses and models fit this bill). Far from it - it is, after all, a smart woman’s illness.

They can hold down high-pressure high-flying jobs, have children (research shows that some women can control their eating disorders during pregnancy) even though they are seriously underweight and are rarely seen allowing a morsel of food to pass their lips.

“I know a brilliant paediatrician,” says Leslie, a 45 year old barrister from London. “She can nurse a canapé for a half an hour. She always accepts the food gladly, but you notice that she never actually eats it. The only thing I have ever seen her actually swallow is poached sea bass. She weighs about seven stone but still travels the world lecturing.”

Leslie’s former best friend Kate is also both anorexic and bulimic. They no longer speak. “The point is she thinks she looks beautiful. She has a closet full of designer clothes. But she weighs five-and-a-half stone and has lost all of her teeth.” Holidays and any group situation are always an issue for her. “It always ends up in a big falling-out with someone - either friends or family, probably because she - and everyone else - finds the situation so stressful.

In the middle of dinner, she will go upstairs and vomit not caring that everyone in the room is aware of it. They all feel very upset but incapable of helping.”

Many of my own friends privately admit to having eating disorders. Liz (not her real name) is a blonde television producer , in her thirties with model good looks. She appears to eat perfectly normally though she tells me it’s all a façade. “I definitely have a disorder,” she says. “I can’t bear anyone watching me eat.

Normal people will grab a sandwich, but I have to stir fry something from the Atkins diet book.” When she hears someone had a stomach bug and lost five pounds she thinks “lucky her”. The terror of the binge is always around the corner. “I could easily put away 12 fishfingers in one session,” she says. She too dreads Christmas , which for all intents and purposes is one big socially-endorsed binge.

Of course, there probably isn’t a single fashion-conscious woman in her twenties, thirties and forties who doesn’t worry about her weight at least a little, but this is a far cry from having an eating disorder.

Modern eating patterns also offer a smokescreen to women obsessed with counting the calories. Being on a “special diet” (no gluten, no wheat, no dairy, low-GI, vegan, macrobiotic) is more socially acceptable than refusing food or running to the loo three times during dinner.

What all sufferers, whatever the severity of their disorder, have in common is low self-esteem, and the need for control.

Recognising the condition is part of the battle, though without therapy it is almost impossible to treat. Alison for one is fully aware of her own illness, describing it as a life sentence. “It’s a private, painful debilitating disease, a form of self-punishment that occupies my mind every minute of every day.”

To casually accept a mince pie and worry about it tomorrow is her life’s ambition.

For help and advice

The Eating Disorders Association provides free advice and support for anyone with an eating disorder including anorexia and bulimia nervosa.

Call the Eating Disorders Association helpline on 0845 634 1414 (Mondays to Fridays 8.30am-8.30pm, Saturdays 1pm-4.30pm) or visit the website at www.edauk.com.

Careline provides confidential telephone counselling for children, young people and adults with any problems, including eating disorders, as well as depression, loneliness, anxieties and phobias.

Tel: 0208 514 1177 (Monday to Fridays 10am-4pm and 7-10pm)

The National Centre for Eating Disorders

(www.eating-disorders.org.uk) offers information about eating disorders such as compulsive or binge eating, anorexia, and bulimia.