An epidemic wrecking so many female lives

Taken from a speech by the psychotherapist Susie Orbach at the Government's body image summit, held in London

In San Francisco, 80 per cent of nine-year-old girls are dieting, even though many of them are scrawny, because they feel themselves to be too fat. In Britain, over half of girls from the age of 12 to 15 said the biggest concern in their lives was appearance.

In San Francisco, 80 per cent of nine-year-old girls are dieting, even though many of them are scrawny, because they feel themselves to be too fat. In Britain, over half of girls from the age of 12 to 15 said the biggest concern in their lives was appearance.

Other studies show that girls and women consistently overestimate their size and see their appetites as a liability, their bodies as a source of anguish. They turn to dieting, intensive exercise programmes, smoking, in the attempt to control their eating behaviour and reduce their size.

While psychotherapists like me are often called upon to comment on the very dangerous problems of bulimia and anorexia, I want to focus on an equally serious phenomenon, which is often hidden and not therefore regarded as important - the sub-clinical phenomenon of females' worries about their bodies.

Thousands and thousands of girls wake up, feel their tummies before they've even brushed their teeth and then, if dissatisfied, cast their minds back to what they ate yesterday, promise themselves that they will be better, that they will not eat, not indulge their desire for food, but intensify attempts to curb their appetites.

They commit themselves to diet, to exercise, in the attempt to feel better about themselves. Their preoccupation with their appearance punctuates their relationships, schoolwork and the challenges of growing up, so that they come to believe that having the perfect body - the one they see represented for them several hundred times a day in our media-saturated culture - can solve the issues of living that perplex them.

Such a mindset permeates the lives of many. We should be deeply concerned about this. Concealed behind what is often seen as a trivial issue are painful, even tortured feelings that seriously undermine and interfere with girls' self-esteem.

If our young women were being bombarded with glamorised images of girls smoking and taking drugs, with the implicit suggestion that this was a way to get through the often explosive years of adolescence, we'd be horrified and alarmed.

There is no mystery where the pressures that descend on girls come from. Growing up in a moment in history in which beauty has been scaled down and represented by just one body-type - thin, very, very thin - it is extremely hard, almost impossible for girls, in the variety of sizes and shapes they come in, to find themselves reflected on the pages of the magazines they read, the TV shows they watch, the adverts that catch their attention. Add to this the fact that thinness has ben equated with success and with being valued, and we can see what a a lethal cocktail exists for girls today.

But while it is easy to blame the media, it isn't so simple. There is also the role of the diet industry, which stokes up the discomfort women feel with their bodies. Its message is: "If you restrict your food in this way, you will have a perfect body and a perfect life." There is no such thing as a perfect body, a perfect life. The diet industry is dependent on diets failing. And 99 per cent do. If the dieting industry worked on a long-term basis, it would not flourish economically!

We have an epidemic on our hands, of girls disliking their bodies and trying to change them through manipulating their food. It is not because they are foolish. It is because they, like all of us, absorb what is around them. We need a wider representation of images celebrating and glamorising women in a variety of sizes and shapes. It would be helpful if model agencies set aside a small amount of their profits for grants to designers to make gorgeous clothes in all sizes. We need to challenge the diet industry. And we need awareness-training for girls, around body image and eating, in schools and to teach them emotional literacy skills.

The problem is urgent. We must find a way to stop this tortuous relationship that girls and women have toward their bodies.