Lady Gaga has struggled with eating disorders in the past, so it's indefensible that she's glamourising bulimia in her SXSW set

There is nothing about showing an attractive woman vomiting that is 'art'

Thanks to Lady Gaga, bulimia has a glamorous new poster girl, showing a fresh generation of teenagers that eating disorders are cool.

Two minutes into Gaga's performance of the song Swine at SXSW in Texas, vomit artist Millie Brown trots on stage, slurps up some green liquid, then repeatedly stuffs her manicured fingers into her mouth and vomits all over Gaga’s cleavage. Later Brown crawls on top of her and vomits black goo onto her again. Then they both writhe around in it.

It’s provocative, grotesque and utterly indefensible. Hundreds of vulnerable people die from eating disorders every year, many of them from conditions they developed while they were teenagers. Around the same age as many of Gaga’s fans, in fact.

Gaga has admitted to suffering from bulimia and anorexia since she was fifteen. She won’t have incorporated Brown into her act without realising its resonance. Yet whatever her reasons, she is wrong to think that showing an attractive skinny woman making herself sick is anything other than misleading, damaging and dangerous.

I lived with people who had eating disorders when I was a teenager. I went to an all girls boarding school and somebody very close to me suffered from bulimia for many years. It’s a much misunderstood disease. Because people who have bulimia don’t lose as much weight as those suffering from anorexia, it’s difficult to spot. But there are signs.

A filmy layer of froth floating on top of the toilet bowl is actually stubborn stomach acid that won’t flush. Thin cuts on the knuckles from where fingers have caught the teeth after being rammed down the throat. Retching sometimes causes burst blood vessels in the eyes. And then there's the crippling anxiety and depression. But if you aren’t watching closely, sufferers will try and explain these symptoms away. Often by the time family and friends get involved, the eating disorder is well and truly entrenched.

It’s likely you will know someone with bulimia. Around one in 100 women have it in the UK. It’s much more common than anorexia (around 40 per cent of people with eating disorders have bulimia, compared with 10 per cent who suffer with anorexia) and is therefore much more of a risk. It can start seemingly innocently, with people making themselves sick because they feel uncomfortably full, or a bit anxious. Your body releases endorphins when you vomit so it can feel like “purging” releases tension, boosting your mood and putting you back in control. It might feel enjoyable, a release. Soon being sick ‘every so often’ after a big meal turns into a routine after every meal. Then it becomes a duty. And on stage with Gaga, Millie Brown shows us how to perfect this ‘art.’

Brown has said that her vomit art doesn’t affect her health or diet, but is “like a cleanse for body and mind”. I lived with somebody who was throwing up six times a day, crying whilst vomiting, unable to take anti-depressants to get better because they’d be floating in the toilet within half an hour. I found half-digested vegetables clogging up the sink, cups of sick hidden in cupboards and you could always catch the cloying smell of vomit and stomach acid lingering round the bathroom. It is estimated treating eating disorders costs £80-£100million a year with costs of reduced GDP up to £2.9bn, and costs of reduced length of life and health up to £6.6bn. There is nothing cleansing about bulimia, either for body, mind or pocket. Approximately five per cent of bulimia sufferers go on to develop anorexia nervosa. One in five anorexia sufferers die. Eating disorders to one side, Lady Gaga’s latest stunt makes me sick.