'I ate a carrier bag full of chocolate'

In the first of a series of articles on women and body image, Women's Editor Christen Pears reports on the illness that affects more than 160,000 people.

CATHERINE Temple hands me a cup of tea and sits down. On the table in front of us is plate of biscuits. She munches one; I have two. "There was a time when I could have eaten a whole packet - and loads of other stuff - and then I'd go into the loo and make myself throw up," she says, smiling wryly.

Catherine suffered from bulimia for five years. Now 27, she has her eating disorder under control, but during her university years she was at the mercy of an illness that made her binge and vomit in secret.

"I had never really had a huge problem with my weight. I had tried a few diets but nothing serious, but that changed when I went to university. There was quite a lot of competition to be skinny.

"I wasn't doing very well. I was finding the course quite hard and I felt really bad about myself. Everything seemed to be going wrong. I think the bulimia was a way of me taking control of things."

There were days, she says, when she ate healthily, but others when she ate to bursting point - bars of chocolate, packets of crisps, entire loaves of bread. She then felt so guilty, she would sneak off to the bathroom and make herself sick by sticking her fingers down her throat.

"It was a kind of relief. It felt like I was controlling my body and that made me feel better about everything else."

As well as making herself vomit, she regularly took laxatives and appetite suppressants. After a while, the cycle of bingeing and vomiting began to take its toll on her health.

"I didn't realise at the time what sort of damage I was doing to my body. At one point my periods stopped because I had lost so much weight. I used to get a lot of mouth ulcers and bad breath but I never went to the doctors about them because I was afraid they would find out.

'I think I knew I was bulimic but I was in denial about it for a long time and I wanted to deal with it myself. It carried on for a couple of years after I left university but then I did start to get really ill and had a lot of problems with my stomach. It was actually my brother who made me get help and I started going for counselling."

The Eating Disorders Association estimates that about 165,000 people in the UK have an eating disorder, and ten per cent of them die as a result. Most sufferers are women but one in ten are now men. The most common disorders are anorexia and bulimia, and the number of cases is steadily increasing.

Julie Seed, senior lecturer in psychology at Northumbria University, has published research showing that eating disorders are spreading to African women. The study, carried out among 80 female students, half from South Africa and half from Newcastle, found that more than 50 per cent of the Zulu students had disordered attitudes towards eating. This has been linked to the introduction of Western waif-like ideals to a country where fat is traditionally regarded as desirable.

She says: "The explanation that most people have for eating disorders is thin models and celebrities and, although there is something in that, it's a lot more complicated.

"In our culture, we are all exposed to the same media images but only a relatively small number of women develop eating disorders. Media images have a role to play but they combine with other factors."

There can be a genetic predisposition - eating disorders run in the family. Certain personality types are prone to eating disorders, people who are obsessional, methodical and ritualistic. Other factors are depression, anxiety and low self-esteem.

"The biggest single risk factor," says Miss Seed, "is being female."

Princess Diana famously admitted to being bulimic during the darkest periods of her marriage. Former Spice Girl Geri Halliwell has spoken publicly about her battle with bulimia. Last month, TV presenter Gail Porter revealed she must take medication for the rest of her life because her anorexia has left her with a permanent thyroid problem.

Although eating disorders are commonly perceived as a problem affecting young people, older women also suffer. Fifty six-year-old Margaret Walton from Newcastle has battled uncontrollable eating since she was 17.

"It's a compulsion. It started when I was still living with my parents and I remember one incident when I went to a shop and bought a carrier bag full of sweets and chocolates and ice creams. I got home and just binged. It has been like that on and off since," she says.

Her problem became worse in 1989 after she gave up smoking and she usually binges three to four times a week. Her weight fluctuates between eight-and-a-half and 11 stones. Ironically, she's a fitness enthusiast, very keen on long-distance walking, and when she's not bingeing, she eats very healthily.

She says the binges are triggered by a number of factors: boredom, stress at work or being alone.

"I feel very relaxed afterwards and all the sharp edges have gone, but then I start to feel angry with myself and I promise I'll start again the next day with a clean slate. Sometimes I can conquer it and sometimes I can't. It's always there."

Margaret has received help from NIWE Eating Distress Service, a charity which was set up in 1988 under the name the Northern Initiative on Women and Eating. It has its origins in the West End of Newcastle, where a number of health days were held to explore the issues that concerned women.

"A lot of the women attending those days said they were struggling with their eating and there wasn't any help in the area," says Barbara Duggan, project administrator.

Therapeutic groups were set up, as well as a telephone helpline, and there are now sessions in Newcastle, Durham and South Shields, with further groups planned for Stanley and Ashington.

"A lot of women don't know where to come for help but the therapeutic groups offer a safe space where they can talk about how their eating behaviour is affecting their lives and the underlying emotional issues around that."

There are always two facilitators present at each session - experienced counsellors who can guide the women through the issues. The service is provided free of charge and varies according to what each group wants. Durham is currently running art therapy sessions.

There is a maximum of ten in each group and there is always a waiting list. The women come from across the social spectrum. Some are in their teens, others as old as 70.

Barbara says: "We have new people contacting us each week but I don't know whether the numbers are increasing. I think it has become more acceptable to come out about having an eating disorder and that may be a factor."

She adds: "The causes of eating disorders are as varied as the women we see. It might be something as simple as a chance remark made to an adolescent about someone's size or it could be a way women have of coping with other things that are happening in their lives. That may be stress or abuse or a traumatic event such as bereavement. There are many, many reasons why women use food to cope. That may be denying themselves food or eating and then getting rid of the food."

The NIWE Eating Distress Service helpline can be contacted on 0191-261 7010.

* The Eating Disorders Association adult helpline is 0845 634 1414. The youth helpline for under 18s is (01845) 634 7659.