Eating disorders have escalated since Susie Orbach started working with compulsive eaters 23 years ago. She welcomes the greater awareness of the problem, but says: 'I think compulsive eating has suffered terribly from the glitziness of bulimia and anorexia, which have been made into these almost exotic problems. It's taken a lot of attention away from the regular distress of women who look perfectly OK but are obsessed with food all day long, who are living with the daily anguish of feeling nervous around food and not understanding why they feel they have to diet.'
When Susie Orbach started, there was no vocabulary to distinguish bulimia from compulsive eating. And there are, she says, links between the three disorders, as well as discreet differences: 'Compulsive eating is a kind of background, low-level (though not to the person involved) distress symptom. And it has features in common - the bingeing that's associated with bulimia, and the attempt to stop eating that anorexia has. But anorexia and bulimia are much more dramatic symptoms; they represent a different level of control over food.' She believes that 80 per cent of women have some kind of difficulty about food, even if they don't acknowledge the problem. Many of them, like Christine Haig, started dieting as teenagers and continued throughout their adult lives. Christine's tale of phenomenal weight loss reads like an advert for Weight Watchers, but it's got nothing to do with dieting. It was only when Christine gave up diets for good that she lost 5 1/2 stone.
More and more women are discovering, as Christine did, that the most efficient and lasting way to lose weight is to forget diets and accept themselves as they are. Instead of diets, women are attempting to discover why they overeat. The new message, which has been proclaimed across the United States in recent years, is that overeating is a sign that something is wrong. Put that right and the weight falls off. These days, increasingly, diets are seen as the problem rather than the solution.
At the same time, attempts to challenge accepted notions of perfect body size are gaining ground. In May, MPs signed an Early Day Motion in support of National No Diet Day, the focus for the campaign against the diet industry in nine countries. In the US, support for the National Association for Fat Acceptance continues to grow. And on both sides of the Atlantic, groups which help individuals to give up dieting are on the increase.
It was Weigh Ahead, a Glasgow-based programme run by a South African doctor and therapist, Cherie Martin, that transformed Christine Haig's attitude to food. Twenty-four years of 'successful' diets, followed by binges which put back more weight than she had lost, piled on the weight. At 19 1/2 stone she says she was, literally, a 'couch potato'.
Like all sufferers from eating disorders Christine had lost touch with real, physiological hunger. Cherie Martin helped her to rediscover it. Clients are taught to reintroduce all foods back into their lives, to eat when they're hungry, and stop when they're satisfied. They get practice during sessions when they eat a meal of hitherto forbidden delights. Dr Martin explains: 'When you approach a box of chocolates as something you're not allowed, you want to eat the whole box. If you approach it thinking: 'Am I hungry for a piece of chocolate?' you eat one or two. It's human nature to want what we can't have. When you have permission you can say no.'
She believes it's essential to confront the root causes of the compulsion to overeat, which in her view are invariably found in childhood. Though this is looked at during the course, many participants, like Christine Haig, are referred for therapy to examine the reason for their overeating in greater depth.
'We have to look back at what happened to us as children. Children look to their parents for unconditional love, and I would say that in 95 per cent of families they don't get this. They get raised on a diet of criticism - 'Don't be who you are, be who I want you to be.' If a child gets a sense of not being good enough, from a very early age he or she starts to look to the outside to make them feel better.'
Other anti-diet gurus are less convinced of the need to delve so deeply. Paulette Maisner, who founded her centre for compulsive eating 12 years ago, believes that most people overeat out of habit, and that it's their lifestyle that needs looking at, not their childhood. 'In the same way that a smoker lights up as soon as the phone goes, compulsive eaters have a binge if anything goes wrong. Most people who come here suffer from stress, or from not being assertive enough; or they're unhappy, or bored, or they get overtired. We get to the underlying problems as of now - not problems in the distant past.'
Once again, the idea is that when you forget about diets you get to your 'ideal' weight naturally. Success is when people say they haven't thought about food for a month, and they don't care that they're two pounds overweight.
The irony is that many women who want to be rid of their obsession with food are not overweight - or weren't until they started dieting. It's no wonder the diet industry makes Mary Evans Young, the driving force behind National No Diet Day, so angry. 'The diet industry has a vested interest in us not liking ourselves as we are. They encourage us to hate our bodies - and unfortunately, in my experience, most women do.'
Mary Evans Young's story is a familiar one. To maintain a 'socially acceptable' size, she adopted an anti-social way of eating for 25 years: she made herself different meals from the rest of her family, avoided eating out, or with friends, and kept a running total in her head, all day, every day, of what she had and hadn't eaten. 'What astounds me is that I did these things for so long without questioning it. It became the norm. But the more you deprive yourself the more you're likely to binge.'
Mary Evans Young's Diet Breakers is a pressure group which campaigns against the diet industry and challenges prejudices against fat people. She also runs workshops to help people develop strategies to stop dieting. 'I work from a basis of self-acceptance and self-respect. It can be frightening to give up dieting. People put whole areas of their lives on hold - they're going to do this or that when they lose weight. It's a real diversion from doing anything that actually makes us feel better about ourselves.'
Men also go on anti-diet programmes in increasing numbers. Overeaters Anonymous, part of the fellowship that includes Alcoholics Anonymous, now has men's meetings (although men have always been welcome). Julie, a member of OA for 12 years, says: 'It's quite common for men in AA to go off the booze and straight into food. Often, if people don't deal with the underlying issues they will keep throwing up different symptoms, whether it's alcoholism or overeating.'
But as Michele Hantler, a therapist who specialises in eating disorders, points out: 'Compulsive eating is different from other addictions like alcohol or drugs in that you don't have to take them to survive; you do have to eat to survive. People can get better, but they need constant reminders. And there are still a lot of external pressures.'
So, although more men than women are overweight, weight obsession remains a predominantly female problem. Susie Orbach is most disturbed by recent studies which show that 70 per cent of 10-year-old girls in Britain have already dieted. She thinks there is a great deal that parents can do: 'They can present more or less relaxed attitudes towards food - it doesn't help if parents use food as a reward, or say these are good foods and these are bad foods. And if parents can manage their children's emotional difficulties, and tolerate them, they don't have to get translated into issues around food. But as parents you can't tell your children it doesn't matter what they look like because clearly it does.'
For further information, write with sae to Diet Breakers, 18 Durham Terrace, London W2 5PB; Weigh Ahead, 2 The Crescent, Busby, Glasgow G76 8HT; Maisner Centre, Box 464, Hove, East Sussex BN3 2BN.