• We are pleased to announce Welldoing's Book of the Month for April is Good Girls: A Story and Study of Anorexia

  • It will be popular with fans of its author, columnist Hadley Freeman, and also with anyone who has a person with an eating disorder in their family or friendship group

  • We have therapists and counsellors who see clients with eating disorders such as anorexia – find them here

Eating disorders, such as anorexia and bulimia, are responsible for more deaths than any other mental health condition. Hospital admissions for eating disorders increased by 84% in the last five years, up to 24,268 in a single year. Children and young people are the worst affected with a rise of 90% in that five-year period, and boys and young men now make up around a quarter of that number.

While we may fret about the growth of eating disorders, most of us probably don't know much about them, or those who have suffered. There is something furtive and unseen; if not hospitalised, those affected will often wear clothes that disguise their shrunken limbs, if in facilities, they are out of sight, out of mind.

One of those invisible young girls was Hadley Freeman, 14. Recently moved from New York with her family, Freeman was at a London private girls school when a chance remark by a friend triggered her first step along the road to a serious eating disorder. She was treated in a total of nine hospitals in and around the capital, and five years of her life had elasped before she was well enough to finally be free of treatment.

Freeman, now 44, is a punchy, good-humoured journalist who spent several decades at The Guardian, where her opinionated weekly column was a Saturday must-read. Recently she moved to the Sunday Times, because -- as she announced to the media -- she could not interrogate issues around transgender where she was. She had things she wanted to say, and she wasn't afraid to stand up and shout them.

This means that when Freeman opts to write a book on her experience and the larger subject of eating disorders -- Good Girls: A Story and Study of Anorexia -- she doesn't hold back. No matter that it is wretched to read of the feeding regime on eating disorder wards, and how the patients would connive to avoid putting anything at all in their mouths, it is still told in Freeman's trademark honest, dry style. 

As well as telling the story through her pubescent eyes, she talks to current psychiatrists, scientists, therapists and eating disorder experts, including the woman whom she credited with getting her over the disorder. She asks Professor Janet Treasure, why does anorexia happen? "There's genetic disposition, a bit of brain disorder, some metabolic factors. Then there are things that interact with development and time, such as people being perfectionist, high-achieving, having a few social problems."

The biology of anorexia is explained too. "Starving your body affects your brain chemistry so that you become more depressed, more emotional, and more confused in your thoughts. The knock-on effect aggravates the cause. Anorexia starts as a psychological, becomes a physical one, and the physical problem then exacerbates the psychological one, and vice versa. As Professor Treasure put it to me 'Not eating damages the organ needed for change'," she writes.

Freeman tells the stories of the other patients she meet in the 1990s, and then traces them to find out how their lives have progressed. Tragically, they have not all survived, and none of those who had have fared as well as she did. In all the time she was being treated, she was the only teenager still trying to go to school, pass her exams, get to university, and -- eventually -- grow up.

Freeman does not pretend to understand everything about anorexia, or even her own experience. She says she was encouraged to write it because friends and colleagues came to her for help with their own adolescent girls shrinking before their parents' eyes. She doesn't think the media bogeymen of fashion industry or social media is sparking the increases we are now seeing, but she believes they definitely feed them. And she also believes that while anorexia can be overcome, those who do may still stumble. "I strongly recommend to anyone who is recovering from an eating disorder to find a therapist once they stop seeing their eating disorder specialist. You might not be underweight any more, but you still need help."

Good Girls: A Story and Study of Anorexia by Hadley Freeman is Welldoing's Book of the Month for April 

Further reading

Eating disorders awareness: a client and a therapist share their experience

How we coped with our teenage daughter's anorexia

Misconceptions around eating disorders make my recovery harder

Reclaiming your life from anorexia: discovering the real you