Too fat, too thin and too anxious

Two friends of mine have recently become concerned about their daughters' weight. There is no doubt that the girls are plump, alarming parents who are well aware of the prevalence of over-eating in the female population of this country. Government statistics published in the early 1990s concluded that nearly half the women in England were clinically overweight or obese, making them prone to premature death from cardio- vascular disease.

Bad eating habits formed early in life tend to persist. The likelihood of being overweight rises with age, with more than 60 per cent of women in the 55-64 age group falling into the risk category. So what should my friends do about their daughters' excess avoirdupois? The obvious answer, which is to encourage them to go on a diet, is fraught with danger, according to the results of a new study in Australia. The survey, of nearly 2,000 girls and boys aged 14 and 15, shows that teenage girls who go on even moderate diets are five times more likely to suffer eating disorders. Among young women who place themselves on strict diets, the risk is 18 times higher. More than half the girls in the study had already dieted moderately, and 8 per cent had adopted harsher eating regimes.

There is something profoundly depressing about these statistics, whether they relate to anorexia or obesity. Of course men over-eat too, and one of the reasons behind the over-abundance of flesh that plagues Western nations is a failure to adjust to conditions of plentiful supply. With food available at all hours, adults and children graze their way through the day instead of eating reasonable meals at regular intervals. The difference, when it comes to women and girls, is that they are represented at both ends of the spectrum. Slimming clubs and magazines are targeted mostly at women. Girls are four times more likely to develop eating disorders than boys, with 3 per cent of women suffering from anorexia and 8 per cent from bulimia.

What the figures suggest is that many women, perhaps the majority, have a tortured relationship to food which dates back to childhood. There has been a great deal of speculation about why this should be, especially after Diana, Princess of Wales revealed her experience of bulimia. The use of spectrally-thin models in glossy magazines is cited as a possible cause of anorexia, encouraging teenage girls to aspire to an unnatural body shape. One expert said last week that most women are designed to be size 14, but fashion encourages them to aspire to wear size 8 or 10. Another theory is that anorexia and obesity are tied up with discomfort about female sexuality. Women who are abnormally thin stop menstruating, while obese and anorexic women alike defy narrow cultural prescriptions of beauty and sexiness.

One of the findings from the Australian study casts new light on these questions. The team found a striking link between weight and psychiatric problems, reporting that girls who suffer from anxiety and depression are seven times more likely to have an eating disorder. This implies that over-eating and anorexia are symptoms rather than conditions. It also opens up a discussion about what might be distressing these young women, and why they are manifesting destructive effects on their bodies. What I am about to argue is an unfashionable view, and someone will no doubt cite evidence to the contrary: the higher rate of suicide among young males, for instance.

But I believe the answer lies in the fact that this is still a man's world, in which girls are taught from an early age to be both self-critical and painfully self-conscious. Every day we experience an avalanche of messages telling us that specific women are too fat, too thin, too old, too promiscuous, too ambitious, too noisy, too demanding. Anxiety is, in that sense, the quintessential female condition. (It is hard to imagine a man asking friends: "Does my bum look big in this?") The responses I have been talking about - over-eating and self-starvation - can be seen as different strategies to contain it. Many overweight women eat too much for comfort, using food as a substitute for affection. Anorexic and bulimic women demonstrate how well-behaved they are, how much in control, at least in this one intimate area.

The Australian researchers' advice, that overweight teenage girls should take more exercise instead of dieting, is sensible in that it avoids making them even more self-conscious about their eating habits. But I cannot imagine women abandoning a tendency towards eating disorders until we become more relaxed and confident. And that is not going to happen while so many people, from politicians on moral crusades to the multi- million-pound slimming and fashion industries, have a vested interest in maintaining our high levels of anxiety.