Like many older women, I have an eating disorder. Time to remove the stigma | Gillian Harvey

As the cookie crumbles in my mouth, delivering a shot of much-needed sugar, a sudden urge flashes across my mind. I am tempted to grab another, and another, before dashing to the loo to purge. Stilling myself, I engage rationally with my feelings and manage to move on without giving in.

I’m not always so successful.

As a mother of five, and at 38 years of age, I’m under no illusions: I know I’m never going to be strutting down the catwalk; time has taken its toll on my once toned body and I’ve been through four stressful pregnancies. I want to be healthy, not excessively thin. But my anorexic and bulimic urges have always been more about control than any misguided notions of vanity.

That’s why I was unsurprised to read that recent research by UCL revealed that around 3% of women in their 40s and 50s have suffered from an eating problem in recent years. The number, which equates to tens of thousands, is probably just the tip of the iceberg – many sufferers, like myself, do not seek help when they experience problems. Instead, I have learned over the years, that I have to forgive myself when I slip up, pick myself up and focus on something else until the feeling passes.

My first foray into extreme dieting came at the age of 15 when, over the period of a few months, my weight plummeted from a healthy 55kg (8st 7lb), to just under 38kg (6st). What started as a vague wish to compete with my skinnier friend became an obsession that led to me skipping breakfast and lunch, and throwing most of my dinner into the bin.

I have come to believe that eating disorders, like a virus, lie dormant in our system, waiting to strike

Although I was initially motivated by the desire to be thin, looking back I can see that there was more to my illness than simple vanity. A combination of GCSEs, financial worries and feelings of inadequacy led me to focus on the one thing I felt I could control. And once on that path, the feeling of triumph I experienced every time the scales revealed weight loss was addictive in itself.

Despite the fact that I believed I’d beaten my anorexia back in the 1990s, it has resurfaced in various guises throughout my life: at university in my early 20s as an obsession with exercise; as bulimia in my mid-20s when I struggled with the stress of my first teaching post; even in my 30s, when adjusting to the demands of motherhood, I had to fight against the desire to make myself sick.

Since my original bout of anorexia, I’ve never weighed less than 44kg (7st). Something – my long-suffering husband, the thought of my children, or the realisation that I am hurting myself – always drags me back from the brink. The thought of passing on any tendencies to my children also plays on my mind, and I make sure I eat a healthy diet and encourage them to do the same.

But I’ve come to believe that eating disorders can never truly be cured; instead, like a virus, they lie dormant in our system, waiting for the right moment to strike. For me, the urge to diet excessively or – more commonly now – to binge and purge, comes when I’m moving house, am overworked or stressed. The disease is not a silly childhood blip that I can grow out of, but something that I will struggle to keep at bay throughout my life. Like an alcoholic, I am “on the wagon”, never free.

For women like me, the perception that anorexia is a disease of the young and is linked to narcissism is damaging. It’s embarrassing to admit, when teetering on the brink of your fourth decade, that you’ve just gorged on chocolate and found yourself hunched over the toilet bowl. But it shouldn’t be. Eating disorders are a mental illness; and while they may start with a wish to have the perfect body, the pattern of damaging behaviour that emerges is akin to a drug addiction.

The knowledge that disorders can flare up repeatedly throughout life, or even appear for the first time at middle age, should not lead us to despair, but give us greater understanding of what drives the anorexic brain and how sufferers can be helped. Eating disorders are often hidden, only noticed when a sufferer displays obvious physical signs; this is something acknowledged by the report’s lead author, Dr Nadia Micali, who noted that many of the women questioned told her that this was the first time they had ever spoken about their eating difficulties.

But bringing them out into the light, admitting that we have suffered or are suffering, is one of the keys to addressing the problem. Removing the stigma and challenging the assumptions that persist about eating disorders is the route to greater understanding and better health for those of us who struggle.

Like many older women, I have an eating disorder. Time to remove the stigma | Gillian Harvey

French mothers don’t suffer from bladder incontinence. And nor should you | Gillian Harvey

This morning, my three-year-old daughter uttered seven words that fill many mothers with dread: “Mummy, can you come on the trampoline?”

As a mother of five children, having been through four vaginal births, an episiotomy, and natural twin labour (with one breech) – and having had more stitches than Frankenstein’s monster – I should be no stranger to the world of embarrassing leaks and incontinence pads. After all, an estimated one in three women suffer from bladder incontinence, a condition that can come about due to weakened pelvic floor muscles after childbirth.

In fact, having read Nadia Sawalha’s recent admission that she has suffered from incontinence for 13 years, since the birth of her daughter, it seems nothing short of miraculous that, while my stomach might have seen better days, my pelvic floor is as reliable as a Dyson.

Why? I live in France. Here, at each of my eight-week checks following the birth of my children I have been prescribed 20 sessions of physio to “re-educate” my pelvic floor.

The first time this procedure was prescribed (alongside a prescription for something called “vaginal probe”), I did what most sane women would do. Put it at the bottom of my in-tray and tried not to think about it. However, on speaking to French friends I decided to give it a go.

As a nervous, body-conscious Brit, I was terrified when I first walked into the local physio’s office for my appointment. He strolled up, all dark eyelashes, stubble, and the kind of casual chic that only a French man in an unbuttoned white coat can carry off, and instructed me to disrobe and lie on the bench – covering my modesty with a towel – while he left the room.

So far, so dignified.

Then, on his return, he attached my “probe” to the wires on a little machine, covered it in a generous serving of lube and asked me to “put it in”, while he casually averted his eyes.

Fiddling around under my towel, in a desperate attempt to remain dignified in this most disconcerting of situations, I had to blush as I squished the probe into place. I was then asked to squeeze my pelvic muscles, making little lines on the screen jump – measuring the strength of my overworked undercarriage.

Unperturbed by this most awkward of situations, the physio looked at me with his brooding eyes. “I am sorry,” he said. “But if you turn it. It will be better.”

Cue more fumbling; followed by the mother of all squelches.

The physio remained blase. Me, slightly less so. However, after a couple of sessions, I could feel the difference in my pelvic floor. I no longer felt the worrying bounce of a threatened prolapse when I went jogging; I developed a cold and hacked to my heart’s content without fear of urinary feedback.

My embarrassment tipping point, too, became more robust. I was able to whip off my knickers and scoot under the towel as if it were the most natural thing in the world.

Then came part two of the treatment. Stimulation.

The physio adjusted two buttons on the screen and suddenly I could feel a pulse of electricity where no pulse of electricity should ever be felt. “Say when it is too strong,” he said, turning a dial. I duly did. Then lay there for five minutes as my muscles were worked in the manner of a Slendertone, just in a very different place.

Why in the UK are we encouraged by adverts to accept incontinence pads as inevitable?

Of course, while the embarrassment or comic potential of this kind of procedure is high, there is a serious point to make. Although electrical stimulation can be prescribed on the NHS, referrals to special “continence centres” aren’t routine. And an estimated 50% of women don’t seek treatment in the first place. But with the necessary, fairly small equipment, this treatment could even be offered – as it is in France – by local professionals rather than at specialist centres.

So, why in the UK are we encouraged by adverts to accept incontinence pads as inevitable when in France doctors routinely prescribe this treatment (as well as physio for the abdomen)? And since when did incontinence get euphemised with the term “sensitive bladder”?

Whether the problem is our inability to talk about it, or simply that the treatment isn’t commonly offered, it’s hard to say. But, if I, as a serial birther, can now leap on the trampoline with glee – surely British women, too, should be offered the chance to swap a few hours of embarrassment for a lifetime of dry knickers?

French mothers don’t suffer from bladder incontinence. And nor should you | Gillian Harvey