Last year, teenage girls' magazine Bliss launched a Love Your Body campaign to encourage its readers to develop healthier attitudes to food and body shapes. In its February issue, the magazine published the findings from a survey that showed that nearly three-quarters of its readers wanted to lose weight and nearly 20 per cent had an eating disorder.

Some might argue that it is glossy magazines, with their images of airbrushed celebrity bodies, that create problems in the first place. But while celebrity images do contribute to young people's feelings of low self-worth, it is the coming together of a number of issues around stress and self-esteem that contribute to young people developing eating disorders, such as bulimia, anorexia nervosa and binge eating.

A new way of thinking

The Eating Problems Service was set up by a group of eating disorders professionals, to offer alternatives to the traditional medical model of services. It is usually approached through school counsellors, mentors or the Connexions service when staff are worried that problems may be developing. It offers counselling, training for staff and workshops for girls aged 13 to 16.

Mary Wood, director of the service, says: "We don't go in with charts about anorexia but things that are relevant to young people's lives. Our aim is to provide education on issues concerning weight, exercise, healthy eating and body image, and to teach them how to live more fulfilled lifestyles."

In a typical workshop, Wood and her colleagues ask girls to select images from magazines and talk about how the media influences their ideas about body image. "But another important way is through music. We play CDs that mean something to them, to help them articulate their feelings," she explains.

"For example, Christina Aguilera's very positive song, with the words 'I am beautiful, no matter what they say'. And we use role-play - for example, what advice would you give to a friend who says she's too fat and has to lose 10 pounds before the end of term."

Wood says that while girls are influenced by media and peer pressure, there are always complicating factors such as family problems, rejection or bullying behind an eating disorder. "There are a lot of kids you'd look at and think, they look fine, but inside they're in such pain."

The Eating Problems Service is currently seeking charitable status so it can gain funding to develop its work. Wood says it's often the schools in the middle - that is the ones that don't qualify for special funding or have private funding - that find it most difficult to afford their services. "The Government is pathetic, and there's no space in the curriculum for work around self-esteem and responsible decision-making," she explains. "So we want to make our services accessible to more schools, and to do workshops for boys."

Phoenix High School in Shepherd's Bush, London, recently invited the Eating Problems Service to put on a workshop, using Neighbourhood Renewal funding. School counsellor, Judith Robertson, says: "There's always a student in the school who you're worried about, it's not a problem that goes away. The girls told me they benefited from it and we'll probably run more."

Bypass the system

Outsourcing eating disorders workshops can have a positive effect as, like sex education, young people can be more comfortable talking about sensitive issues away from their teachers. "I don't think there's much that schools can do," says Nicola Coghlan, aged 14. "You don't want schools interfering. Even if people talk to the whole school it still embarrasses the people that have eating disorders," she adds. "If someone said I was fat it wouldn't bother me. But one of my friends was anorexic and bulimic because people were calling her names. All her friends gave her support and people realised she was getting thin and stopped the name-calling."

Nicola's twin, Gemma, on the other hand, thinks that schools could do more. "They should provide information and people to talk to those people who have problems," she says. "And at the moment all we get at school is greasy food like chips; we don't get proper food any more."

Colchester Eating Disorders All Round Support (CEDARS) has worked with schools through personal and social education sessions, and hopes to gain funding for a worker to develop this. Sue Azar, family support worker, says that there's a high level of eating distress among girls around the age of 15, because of the pressures of GCSEs.

"I think it's around fear of failure, and wanting to succeed at something," she adds. "But young people are becoming more aware that they can use food to maintain a sense of being in control." With additional problems, such as family separations, young people may lose a sense of who they are. "So we must help them look at how to gain control in more healthy ways," she says.

It is important to provide alternatives to the sufferer of the eating disorder, such as a safe space to talk about problems. Azar emphasises the need to approach the young person carefully, asking if there are things they'd like to talk about, rather than saying, "You're getting thinner - or fatter", which can cause a fear reaction. She encourages schools to find out about the support available in their area.

The Eating Disorders Association is working to build relationships with young people to provide responses tailored to their needs. It runs a Youthline and an email support service.

It is also developing a service for mobile phone texting. Emma Healey, head of individual support, says she is always keen to be emailed by young people about their views.

Steps to success

Healey's advice to anyone wanting to prevent eating disorders is to look at the ethos of the environment. "Make sure the youth group or school feels safe and young people know they won't have to hide difficult issues," she recommends. "Ensure there are posters around showing young people of all shapes and sizes. And build self-esteem by promoting messages that young people can achieve. Have discussions with young people about their ideas around body image, and work in groups doing activities such as paying each other compliments." She says the most important thing is to be careful about the impact of messages on young people. "Young people who ring our helpline often remember a comment their parents or a teacher made about them being lazy or not fit enough."

As someone with personal experience of an eating disorder, Helen Davies, a personal adviser with Connexions in Northwich, Cheshire, believes that young people really benefit from having someone to listen to them. "It's about mentoring or befriending young people so they feel comfortable to talk to you when the time is right for them," she says. "We need to help them build up confidence by reminding them of the positives in their life.

And encourage them to pursue things they enjoy, and get involved in clubs or art and leisure activities, so that food does not become the focus of their life."

FIND OUT MORE

Eating Problems Service 020 7602 0862 www.eatingproblems.org

Eating Disorders Association Youthline 0845 634 7650 (Mon-Fri 4-6.30pm and Saturday 1-4.30pm).

Or email the Youth Team at talkback@edauk.com. Young people are also invited to email Emma Healey at e.healey@edauk.com with their views about eating disorders.

CEDARS 01206 710017, www.colchestereatingdisorders.org.uk

www.purplechocolate.co.uk is a helpful web site about eating disorders

YOUNG PEOPLE'S VOICES

I said to my friend I was going on a diet and she got worried and lent me a really depressing book about some girl whose body starts digesting itself, I think you should enjoy food otherwise you'll get anorexic.

Michelle Wright, 13

People like Kylie and Britney - they're like an icon everyone has to follow, but we do realise that someone spent a lot of time getting them to look like that. I like my food and I don't worry.

Nicola Coghlan, 14

Going to an Eating Problems Service workshop at school helped me realise we should be happy with the way we are. It made me feel as though I was just as important as everyone else. I got lots of great advice.

Sivanna Sherry, 14

I'm not very confident and pretty confident - both at the same time. I think pressures come from TV and the media. I look at magazines and think, 'I wish I looked like her'.

Gemma Coghlan, 14

FACTS AND FIGURES

- An estimated 1.15 million people in the UK are affected by an eating disorder (EDA)

- Eating disorders can affect anyone but are most common in girls aged 14 to 21

- It's estimated that anorexia affects one to two per cent of young adult women and bulimia affects one to three per cent (EDA)

- About 10 per cent of cases of eating disorders affect men, but among school children this may be 25 per cent (EDA)

- The Schools Health Education Unit found that 41 per cent of 14- to 15-year-old girls admit to missing breakfast and more than 60 per cent of 14- to 15-year-old girls want to lose weight. Up to 21 per cent of 14- to 15-year-old boys also want to lose weight

- In its February issue, Bliss magazine (aimed at teenage girls) published a reader survey showing that 69 per cent of respondents said they were an average weight (under nine stone) but 67 per cent of respondents wanted to lose weight. Only 13 per cent claimed to be happy with their bodies.

Nearly 20 per cent had an eating disorder and 26 per cent had considered diet pills or cosmetic surgery.