Bulimia may be caused by hormones, according to new research, which suggests that up to a third of women suffering from the condition could be treated with the contraceptive pill.
Scientists investigating the causes of food disorders have discovered that one in three patients who had bulimia also suffered from hormonal disorders which gave them unusually high levels of testosterone, the male hormone.
Bulimia, which causes sufferers to eat excessive amounts of food and then regurgitate or purge it out of their systems by throwing up or use of laxatives, was widely accepted to be caused by depression, stress or self-esteem issues.
However, because testosterone hormone levels are directly linked with the regulation of appetite, scientists believe that higher levels of the hormone are directly linked to increased levels of hunger.
The researchers tried reducing testosterone levels by giving sufferers the Pill, which boosted their levels of oestrogen, the female hormone. Half of the women who were given the Pill saw decreased levels of sugar and fat cravings and their feelings of hunger lessened. By the end of the trial three of the subjects were free of bulimia.
Dr Sabine Naessén, who led the research at the Karolinska Institute in Sweden, the world's largest medical research school, said yesterday: " We have shown that one third of female bulimics have metabolic disorders that may explain the occurrence of the eating disorder. These disorders may in certain cases express the hormonal constitution of a patient, rather than any mental illness."
British experts gave a cautious welcome to the research yesterday. Steve Bloomfield, a spokesperson for the Eating Disorders Association (EDA), said: "The danger I would foresee is lots of people thinking that this will cure bulimia in the way an aspirin may cure a headache."
Claire Evans, clinical director at the Riverdale Grange Hospital, Sheffield, a specialist centre in the treatment of eating disorders and alcohol, also welcomed the research. She called for more work to be done before the Pill is accepted as a treatment for bulimia, saying "in many cases the psychological aspect would still be there" even if hormonal imbalances were corrected.
Most bulimics are treated with antidepressants and cognitive behavioural therapy (CBT) - a treatment that tries to change the behavioural patterns associated with over-eating.
According to Dr Joan Brunt from the Eating Disorder Service, St George's Hospital, London, around 2 per cent of the population in the UK suffers from the condition. Some 85 per cent of these will be girls in their late teens.
High-profile figures such as Diana, Princess of Wales, Oprah Winfrey and Sharon Osbourne, have spoken of their battles with bulimia. Like the majority of sufferers, they attribute their illness to emotional trauma.
Former bulimic Lesley, a 37-year-old lecturer, yesterday said the cause of her illness went back to her family life and her mother, who was a " secret eater": "I was bullied by my brother and was a tag-along at school. Family life was not easy either," she said.
At the lowest point, Lesley, who began forcing herself to throw up at the age of 14, found she could make herself vomit on cue, up to five times a day. With no one to talk to, she felt alone: "Every time a medical magazine would come through the post I would search to see if I could find answers to what was wrong with me."
Lesley's bulimia continued through university. She saw many psychotherapists who helped her cut back on vomiting, but the core psychological issues were still tightly locked away: "I took safety from everything in the toilet and I managed to hide it for a long time."
Today, she is a lecturer in drama at a British university and has learned how to overcome bulimia through performing arts.
Lesley can relate her own experiences to Dr Naessén's research: " They may have a point about the hormone imbalance - during my periods, when I was emotional, happy or sad, I would vomit. It became my life... it didn't matter what the emotion was; I would be sick."
Mother of teenage girl who died of anorexia, weighing just four stone, blames Victoria Beckham
The mother of a teenage girl who died from anorexia has singled out Victoria Beckham as setting a bad example to young, impressionable girls by leading them to believe thin is glamorous.
Rosalind Ponomarenko-Jones, whose 19-year-old daughter, Sophie Mazurek, weighed just four stone when she died, condemned skinny models and thin celebrities such as Mrs Beckham for promoting an unhealthy image.
Ms Ponomarenko-Jones, 46, said: "These girls and celebrities such as Victoria Beckham are very negative role models. Sophie knew that but she wanted to be like them."
Originally 8 1/2 stone, Sophie developed anorexia at 17. She died last month from heart failure caused by malnutrition.
"Sophie spent a fortune on celebrity magazines showing who was looking thin or fat," said Ms Ponomarenko-Jones, a housing support officer from Snead, Powys. "She was just a normal girl but the anorexia got out of her control."
A spokesperson for Mrs Beckham said it would be "inappropriate to comment on somebody's loss".
* Bulimia is an eating disorder that leads to a cycle of binge eating andpurging - usually by vomiting.
* Recognised by Professor Gerald Russell in 1977, the condition is often less about food and more to do with psychological issues and feelings of a lack of control.
* Rates of bulimia are highest in Western countries. The disorder, almost non-existent in Eastern cultures, is seeping into other cultures through Western movies and television.
* Women account for 90 per cent of bulimia patients, with gymnasts, dancers and cheerleaders most at risk because their roles make it imperative that they be extremely thin.
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