Writer and broadcaster

I’m 13 and worried about being fat. The Guardian.

Dear Annalisa

I’m overweight for my age (I’m 13 and 60kg or 9.5 stone) and it’s consumed my life. I can’t go shopping with my friends in town because I can’t let them know my clothing size. If I sit down I’m always conscious that I look fat. If I take off my coat I feel people judging my waist. I dread it when my mother buys me clothes and I have to fake a smile to not upset her, all the while knowing the clothes will be bigger than hers. It takes up everything: my whole life revolves around how I look to other people.

I know you will say I should talk to my parents or an adult I trust, but I don’t trust my mother and my dad isn’t someone I talk to about anything other than what’s going on right at that second and I want it to stay that way, because I don’t want to burden the relationship.

I’ve tried to ask if I can speak to someone at school but both times I asked I got shut down and ignored.

My friends are all very different from me – they never seem to have anything wrong with them. They are very skinny, happy and cheerful. I know I’m lucky to have them but sometimes I feel the differences isolating me. They’ve noticed I’ve been skipping lunch and breakfast but, other than tell me I’m unhealthy for doing so, they’ve not said much else. I tiptoe around anything that’s related to weight or looks – it’s something I avoid talking about at all costs, mainly because I don’t want to draw attention to my weight.

It’s driven me to the edge. Sometimes I get so consumed with self-loathing I can’t help but lash out at myself, by whatever means possible. It’s not something I’m proud of and I would never admit it to someone who knew me. There’s a cycle that goes round my head at any comment or thought that comes into my head. It goes round and round reminding me of all my failures, preying on my insecurities. The worst is that it all comes from me. I am truly my own worst enemy. But I can’t stop it.

I don’t know what to do. I understand most people don’t have this obsession with images and I probably come off as quite superficial, and also a hypocrite, by judging anybody else. I’d be so grateful for any help.

I don’t think you are superficial. I understand what it’s like to hate yourself, and your body, and be obsessed with images. I was when I was your age. It was horrible and I wasted a great portion of my adolescence worrying about what I looked like and generally hating myself, until I got help when I was in my early 20s. I wish I hadn’t left it so long because my life changed after that and I felt better. So I really want to try to help you.

First, it shows incredible maturity to have written, aged 13, to me. You are obviously very intelligent and articulate and along with that may also come some sensitivity, which can be an incredible asset, but being sensitive can also hurt sometimes when you turn it against yourself.

I showed Cathy Troupp, a child and adolescent psychotherapist (childpsychotherapy.org.uk), an anonymised version of your letter. Troupp works at Great Ormond Street children’s hospital with children and teenagers who have eating disorders.

The first thing she said was that you don’t say how tall you are, so you may not necessarily be overweight. I realise you feel overweight, but there seem to be two issues going on here: your weight and the way you feel about yourself.

I am going to tell you to talk to someone, because it’s very unlikely this problem will go away by itself. It’s a shame you don’t feel you can talk to your mum; when you say you don’t trust her, I wondered if you meant you didn’t trust her with your feelings, or was it something else? As for not wanting to burden your father with this – I would imagine, hope, he would care very much and wouldn’t see it as a burden. All of that said, if you don’t feel you can talk to them at the moment, I get that. But you do need to talk about this.

Troupp also emphasises that you need to talk to someone. “Go and see your GP,” she says. “He or she can refer you to someone else, maybe a dietician if it’s needed, who can look at your weight and height and advise you accordingly, or maybe someone in CAMHs [Child and Adolescent Mental Health Services] who can help you, too. Missing your breakfast and lunch is not good and you are in danger of getting an eating disorder. You need to take yourself seriously and talk to an adult. If not your mum, is there someone else you can talk to? Maybe the mum of one of your friends, or an auntie?”

I’m sorry you were “shut down” at school. I’d like to know the circumstances. There is no excuse for it but perhaps the adult you spoke to didn’t realise how serious this is for you. Is there a counsellor, someone you can make an appointment to go and talk to? Most schools would take this very seriously. But I can understand that, when you feel like this, it is very easy to get knocked back.

Troupp and I were concerned with you talking about being “on the edge” and “lashing out at yourself”. “Sometimes,” says Troupp, “all the bad feelings are attributed to your weight, but sometimes that can be a smokescreen.”

I wondered about your self-esteem, about why you felt so bad about yourself and where this comes from – if you don’t feel good about yourself, you can start to look at differences between you and others and pick on what is the most obvious difference to you. This then becomes the reason you are not happy when, in fact, the real reason is something else and until you find out what that is and work on it, whatever weight or size you are, you won’t feel happy about yourself. Talking to someone else can really help with working out what is at the root of this, even if it takes time. What does make you happy? What makes you feel good about yourself?

I can promise you that all your friends – skinny, athletic, big or small – won’t all be happy, all the time. No one is. It seems an easy equation to make at times, that thin equals happy. But, actually, happiness comes from feeling good about yourself and that comes from all sorts of other things, not just – in fact rarely – the size you are (I know this seems unbelievable). It’s absolutely brilliant that you have such good, supportive friends who seem to be looking out for you – they clearly think you are worth looking after.

I understand going to the GP can seem like a really big step. I sat in the waiting room of mine ready to bolt. But I’m really glad I went in the end because your GP is the gateway to all sorts of services, even if you may have to wait a while for those services. Ask at reception for a doctor who is really good at listening and take a friend or other family member if you want for moral support.

In the meantime, Troupp recommends some websites for you to look at. One is Young Minds (youngminds.org.uk), which is all about young people’s mental health. It’s so important to look after this part of yourself and so worth investing in. There is a section I’d particularly like you to look at called Looking After Yourself, under which there are lots of smaller pieces that I think you will find really interesting. The other one is Beat (b-eat.co.uk), which is a website about eating disorders and if you look at the section About Eating Disorders you’ll find lots of stuff about the different types of eating disorders and about emotional eating.

I think reading about this will make you realise you are absolutely not alone in how you feel. But you do also need to get help, because you don’t have to feel like this and life really can be different for you.

Troupp also wonders about thinking about “rebuilding a relationship with your mum? She may not realise you need her”. Parents can get terribly busy with things and sometimes need a really clear heads up to say: “I need you, please help me.” But if you don’t feel ready for that, that’s fine. I hope there is lots here for you to take a small, first step to getting some help.

This article was first published in The Guardian Family section on 20 January 2017.