By speaking about her bulimia, the Rose of Tralee has given sufferers thecourage to tackle their disorder, writes Róisín Ingle.
Karen, a high-achieving 24-year-old administrator from Co Armagh, wants to say thank you to Tamara Gervasoni, the Rose of Tralee, who spoke publicly this week about her ongoing recovery from bulimia. Karen has suffered from the eating disorder for three years. "It gives you courage when you see someone like her speaking out," she says. "Hearing what Tamara had to say has helped me think more seriously about trying to get better."
Everything was fine when Karen was younger. She ate what she wanted when she wanted. But then she turned 13, and her big brother started teasing her about puppy fat. He called her Fatty, which is when things started to go wrong. She began to eat everything in smaller portions. Some days she wouldn't eat at all. Her dad began to notice. She thinks at this point she may have been on the verge of anorexia, whose sufferers starve themselves, but in her late teens she saw a programme about bulimia and thought she would try it out.
"I went from denying myself everything to bingeing on chocolate and biscuits and any food I wanted. The first time I made myself sick it was disgusting. But I had lost control of eating, and there was an emptiness I wanted to fill. So I had to get control back by vomiting," she says. Once sweet natured, she became moody and withdrawn. It was no longer about food or weight but the emotional comfort she derived from eating. Trapped in the secret cycle of bingeing and getting sick, she broke down a year ago and told her boyfriend. But he didn't understand and they split up. It's not so bad when she keeps busy and focused.
"I tell myself things are under control, but then I have a setback, or I am lonely, and I get sucked back in again," she says. "I am determined to get help, though. I can't go on like this any more."
It can take years for sufferers such as Karen and Tamara Gervasoni to recover, according to Dr John Griffin, director of the eating-disorders programme at St Patrick's Hospital in Dublin. "Recovery can be total, but it takes time," he says. Dr Griffin began working in the area more than 30 years ago. Anorexia was rare then, and bulimia was practically unheard of. It all changed, he says, when a teenager called Twiggy walked down the catwalk in London. "Suddenly, thin was in. Before Twiggy, the icons of the day had been fuller-figured women, such as Marilyn Monroe, but all of a sudden it was ugly and undesirable to be a certain shape, and the pressure to conform to this image has been relentless ever since."
When Anne Diamond took part in Celebrity Big Brother last year, she was castigated for having put on weight since her days as a daytime-television presenter. Putting herself in the spotlight wearing size 18 clothes was, for some, a crime punishable by jibes and ridicule.
Fashion designers seem to believe Eva Herzigova, the now skeletal model, is an attractive clothes horse, and newspapers devote pages to the debate about the merits of pop star Jennifer Lopez's generously proportioned behind.
Dr Griffin sees three or four new cases of bulimia a week. Ten years ago, the average age of his patients was 16. These days, he sees girls as young as 12. He regularly hears from GPs who need advice on how best to handle nine- or 10-year-old girls who think they are fat and ugly. Girls who are not yet menstruating are on diets, refusing biscuits and sweets. "I won't say it has reached epidemic proportions, but the number of eating disorders, especially bulimia, has increased significantly," he says.
In 1976, Dr Griffin wrote a paper on the need for a national survey of the scale of the problem. One has yet to be commissioned. There are only three designated public beds in the State - at St Vincent's Hospital in Dublin - for people with eating disorders. It is left to those working in the area to estimate the scale of the problem here based on UK statistics.
Donna O'Connor of the Eating Disorders Association of Ireland believes numbers have trebled in the past decade and estimates that more than 15 per cent of Irish adolescents have eating disorders. She knows of six-year-old girls who are worried their thighs are too big. "The message that is enforced from an early age is that the way to be a woman is to deny yourself food," she says.
For many girls, First Communion brings their first brush with eating distress. "You hear stories now of children going on diets for their First Communion. Parents are putting their children on sunbeds in the build-up to the day; they must have the best dress, the best everything. The church aisle is being turned into a catwalk, and it can have a terrible effect on children," she says. "Little girls are not being allowed to be little girls."
And it is not only young girls who have food issues. Men and boys make an increasing number of the 10,000 calls Marino Therapy Centre, in Dublin, receives each year. Its director, Marie Campion, says portraying anorexia and bulimia as exclusively female problems is dangerous. "Men are even less likely to come forward for help, because the stigma is even greater for them," she says. About 200 people receive help at the centre each week. Eating-distress symptoms have been found in children as young as four, she says; her oldest clients are in their 70s.
"The amount of stigma associated with these disorders is enormous . . . . It takes tremendous courage for people to put themselves first and access help," says Barbara Doyle of Bodywhys, the organisation set up in the mid-1980s to support sufferers and their families. The media, she adds, have a positive role to play.
"Newspapers and television programmes can work to break down the fat-phobic culture and create a society where all shapes and sizes of people are celebrated," she says.
"We have to look seriously at our values. If we don't, eating disorders will become rampant in society. And with such a high mortality rate among those with eating disorders, it is literally a matter of life and death."
For help with or information about eating disorders, contact the Eating Disorder Association of Ireland on 01-4126690, Bodywhys on 01-2835126 (www.bodywhys.ie), or Marino Therapy Centre on 01-8333063 or 01-8333126