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Are our children destined to be obsessed with body image? According to Susie Orbach, author of seminal 1970s text Fat Is A Feminist Issue, future generations are likely to see going under the surgeon's knife as a completely normal part of lifeSusie has always been a crusader when it comes to body image.
"I was terribly strict with anyone who looked after my children," explains the 62-year-old psychotherapist. "I'd say to babysitters, 'You cannot stand in front of the mirror and criticise yourself or talk about good food and bad food to my kids. There is only one question - Are you hungry?"
The mother-of-two has never been shy about talking food. She was just 31 when she suggested that food and body image were emotionally linked in Fat Is A Feminist Issue.
Now, her latest book, Bodies, tackles issues of body 'dis-ease' that are fast becoming commonplace. "Thirty years ago, the environmental movement was just thought of as a load of hippies," she says. "It's the same with bodies. It will take a long time for this idea of body distress to enter into the public imagination as a devastating social issue. When I started work there wasn't even something called eating disorders. Bulimia was something you never saw."
In her new book, she writes that the body 'is becoming a site of serious suffering and disorder'. "Millions struggle on a daily basis against troubled and shaming feelings about the way their bodies appear."
These days, not only does she take it for granted that her clients will have food issues, but she knows their concerns may go far beyond fad diets and binge eating. With the worldwide market for cosmetic surgery and facial cosmetic rejuvenation now valued at over £9 billion, Orbach is concerned about our obsession with the 'perfectible body'.
She says our bodies have become a form of work, and this focus has become second nature to us, an almost natural and invisible process. In Argentina, for example, cosmetic surgery is such a part of everyday life that it is covered in health insurance.
Orbach, who lives in Hampstead, north London, is concerned that in a world where post-pregnant women rush to lose their baby weight, every magazine model image is airbrushed into conformity and increasing numbers of men and women are taking on internet avatars, our desire to change, or escape, our own bodies is reaching disastrous proportions.
In her surgery, new and complicated psychological body issues such as body dysmorphia, teenage aggression, harmful sexual behaviour, impotence, eating disorders and incurable body ailments reflect the new battlegrounds.
She discusses how she personally managed to raise her daughter - 20-year-old Lianna, who now lives in New York - to love her own body. "I did it the wrong way round," she says.
"I developed these arguments in Fat Is A Feminist Issue and then had to think, what does this mean in relation to the rearing of my own children? How can I get them not to enjoy their food and not be body obsessed. How the hell do you do it?"
Orbach believes that body issues are transferred from one generation to the next. "It's impossible to completely stop the transmission of the anxiety about body image from mother to daughter," she explains.
"The most mothers can do is be aware of their neurosis. If you want your child to have joy in a certain area, then you need to try and find joy in there yourself. Have awareness of where you might be passing on damaging habits. "There's really only one question when it comes to eating. Are you hungry?"
While Orbach says this technique freed her from years of yo-yo dieting, she recognises that mothers could do with some help. "The next real step is for the government to do something more imaginative than traffic light systems for food being good or bad. They need to actually put some real resources into helping young mums."
At the end of last year, Orbach wrote to the Chief Medical Officer, Sir Liam Donaldson, asking for better training for health visitors.
"Helping mothers to come to grips with their own eating difficulties is surely the sanest and most effective way to help two generations in one go," she wrote. She thinks children should be introduced to food in a way that isn't loaded with emotional connotations.
"I remember struggling with my daughter's primary school," she says. "They said they couldn't have biscuits, chocolates or sweets. Now, I understand where they're coming from, but that just means that when the children leave school they want sweets and chocolate, because they've made them special."
The Jamie Oliver fan likes to imagine schools as food palaces, where food is delicious and nothing is forbidden. But she says that finding the line between allowing kids choice and encouraging healthy eating isn't as hard as it sounds. "If you can just demonstrate that hunger is something like peeing, life becomes much less fraught," she says.
"It was only difficult when my kids went to school and school lunches were just so revolting. They adored them of course, so you had to let them do that."
Orbach points out that for women especially, learning positive relationships with food and their bodies helps in later life. "It's a new world for girls in which beauty, as we have seen, and sexuality become important early on," she writes in Bodies. "They are scanned and evaluated as they endeavour to make the grade as 'hot'. Attraction is all."
It might seem like uphill work, but Orbach remains positive. "I don't think our consumer culture will change overnight, but I want to challenge that idea that young people think they have to have a body which is a brand, rather than a body," she says.
Bodies by Susie Orbach is published in hardback by Profile Books, priced £10.99. Available now.
