Food bloggers may be fuelling eating disorders in 'perfectionist' schoolgirls
Facebook, Instagram and other social media enable those with no medical or health backgrounds to ‘market’ recipes or diet-and-exercise regimes which are unscientific - and potentially dangerous.
“A common theme we are seeing is where school friendship groups decide to follow someone they see on Instagram or Facebook,” said Alexia Dempsey, an eating disorders specialist at The Priory Hospital Roehampton in south-west London.
“Most of the group gives up shortly afterwards. However those who are perfectionist and anxious, with low self-esteem, may adhere to the diet to an extraordinary degree and develop a disorder.
“It is astonishing how many of our patients have Instagram accounts and follow their dietary gurus on social media, believing that what is written is gospel.
“We have girls who come in saying they are drinking green vegetable juices to oxygenate their blood, or eating spiralised courgette pasta with avocado, which cannot be considered a nutritionally complete meal.
“They have been told all sugar is bad and are drinking lots of green or diuretic teas. Last week I was informed by a patient that ginger cures cancer. It’s all come from the internet and this advice is dangerous, it’s not scientifically accurate or based on robust evidence.
“Many schoolgirls concerned about their image as a result of bullying, or some inadvertent remark from a school nurse during a health check, start by cutting out ‘treat’ food like crisps, cake and biscuits. They then reduce fats and carbohydrates. Inevitably protein then is reduced, with meat and dairy being targeted until they become vegan. It’s a familiar pattern. Invariably they talk about ‘clean eating’ with its emphasis on raw food, and cutting out sugar and dairy, although its definition can vary from patient to patient and health guru to health guru.”
Her comments come after Oxford University research suggested anorexia could be “contagious” in girls’ schools, with pupils at single sex schools twice as likely to have an eating disorder compared with those educated elsewhere. Experts said the findings suggested that such conditions were more likely to spread amid “aspirational cultures” which encourage perfectionism, and in female-dominated environments.
And so called ‘clean eating’ is raising particular concerns among specialists, and even among celebrity chefs like Nigella Lawson, with one study published by the British Nutrition Foundation finding that one in 10 teenagers is at risk of nutritional deficiencies, with half of teenage girls falling short on iron and one in five at risk of inadequate calcium.
Miss Dempsey said: “We spend a lot of time in patient groups urging people to be more critical of the food authors they are reading, because those promoting their lifestyles on social media – who are often sponsored by the products they are using - don't appear to be invested in the long-term effects they are having. They are not their readers’ friends, although the photo updates and emails multiple times of the day may make it feel like it. They are often not experienced or registered health care professionals, and yet their influence on vulnerable young girls is enormous. There’s an awful lot of bad science out there.
“It’s not unusual for my clinic to be entirely school-aged patients where every one of them is influenced by social media to some degree or another and it’s hard to combat this social media narrative.
“We are going into schools now to talk to teachers and to warn girls not to believe everything they read on the internet but to ‘critique’ it.”
Soaring numbers of children and young people are being taken to hospital, for sometimes months at a time, because of eating disorders, NHS figures show, prompting Priory’s consultant child and adolescent psychiatrist, Dr Pippa Hugo, to publish a guide on eating disorders in young people, aimed at parents.
Dr Hugo said: “Above all, the most important thing any parent can do is to keep talking to the young person. However awkward it might seem, the very first thing to do is to talk to the young person about the issue in a calm, non-judgemental way. Try to discover what they're anxious about and to understand their state of mind. And remember, there's a good chance that they'll be relieved to be able to talk.
“There's a long list of physical effects that an eating disorder can have on a sufferers' body. For anorexia these can include dangerous weight loss, low blood pressure, brittle bones and infertility and in bulimia internal organs can be damaged by not getting the right nutrients and there can also be throat and tooth damage caused by frequent vomiting.”
While 658 under-19s in England needed a spell in hospital in 2003-04 to treat an eating disorder, by 2013-14 that number had increased to 1,791, up 172%. More than 90% of them were girls and young women, with teenage girls among the likeliest to become an inpatient, usually because they were suffering from anorexia nervosa.
The figures also show that the number of 14-year-old girls ending up in hospital because of an eating disorder jumped from 74 in 2003-04 to 336 a decade later, with a similarly steep rise – from 87 to 336 – among 15-year-olds.
Just 135 of those under 19 who were admitted last year because of eating disorders were boys, or 7.5% of the 1,791 people admitted. The biggest leap in that age group was from six to 50 among 13-year-olds.
The numbers are a significant underestimate because many patients receive outpatient treatment and are not therefore included in the figures.
Priory admitted 121 patients under the age of 18 for eating disorders in 2015, up from 85 in 2010. Of those admitted in 2015, the most common age of admission was 14.