When cakes are good for you
There are raw cuts down the arm of the gaunt 17-year-old munching joylessly on a bar of chocolate. Next to her, a 16-year-old with wide eyes and hollow cheekbones works her way through a plate of cakes labelled "650 calories".
This is part of the daily ritual at Rhodes Farm, north London, a residential clinic which charges pound;335 per day for school-age anorexics and bulimics.
Between bites of her calorific tea, 16-year-old Lois* explains how she arrived here. "I was always the bright one," she said. "My brother is dyslexic, so I was put under pressure by my dad to do well at school. I would concentrate on work and forget about food.
"I'd get up at 4am and run for an hour. Then I'd go to the gym for an hour and a half. And I'd ride my horse in the afternoon. I could control that.
If I didn't exercise, I'd get panicky and violent. I got so underweight, I couldn't concentrate on work. I'd go to school and just sit there. In the end, I had to leave. Then I had more time to focus on exercise and food."
Her case illustrates a trend highlighted in a study, conducted by researchers at Loughborough and Cardiff universities.
They claim that the Government's obsession with exams and results, along with its focus on the danger of obesity, is leading to an increase in eating disorders.
Emma Rich, of Loughborough university, said: "In a highly- charged competitive environment, some children gradually feel that they are continually being asked to achieve the unattainable."
Much of their work was based on interviews with teenage residents at Rhodes Farm. Dee Dawson, medical director at the 32-pupil clinic, says that these findings confirm many of her own beliefs. "These children have obsessive, perfectionist personalities," she said. "They are their own worst enemies when it comes to succeeding. They've got to be number one, whether it's passing exams, playing an instrument or achieving at sports.
"They have a genetic predisposition to anorexia. Things that trigger it include problems at school, problems with the family. Within that could certainly be the idea that they must reach certain targets at school."
The majority of Rhodes Farm pupils come from high-achieving girls' private schools. But Dr Dawson insists this reflects anorexics' perfectionism in all areas, rather than shortcomings at the schools.
The research also concludes that the healthy eating drive, led by the Government and the media, is in danger of creating as many problems as solutions. Dr Rich said: "The messages children receive are: be or get thin, exercise more, diet if you can, with no accompanying health warning that all these activities, in certain circumstances, can be bad for you."
Dr Dawson agrees. Her patients, she says, are proof that some children cannot process healthy-eating guidance sensibly. "You trap children who already have an obsessive-compulsive personality. For them, when you recommend a low-fat diet, they think a no-fat diet is perfection."
Next to Lois, 17-year-old Claire finishes her glazed cupcake with grim determination. Her sparkling eyes, too large for her face, belie the fresh red scars on her arms. "Healthy eating is very big at the moment," she says. "It gets into an obsession. It's bad enough when magazines say it, worse when the Government does.
"You want to be the Government's idea of what you should be. But how far do they want to take it? We didn't eat chocolates, we didn't eat crisps. Look where we ended up."
She pauses, then adds: "Cherie Blair's not exactly skinny, is she?"
International Studies in Sociology of Education, Vol 15, no 2. *The girls'
names have been changed