Dr Agnes Ayton, the chair of the Eating Disorder Faculty at the Royal College of Psychiatrists, has even warned that services are now overstretched that they are “unable to treat the sheer number of people needing help”.

Alina, 41, a mother-of-three, says: “From the start of lock-down, I could see there was a problem because Karina never finished what was on her plate. She’d say she wasn’t hungry, was too bloated or felt sick.

“I also started to realise she was exercising a lot because I could hear her breathing heavily from her room.

“I’d go in and ask her to stop but she’d say: ‘But Mum, there’s nothing else to do. It’s healthy.’ Changing her body became her project.”

There were other factors too. When Karina caught Covid, she lost her sense of taste – another reason she gave for not eating.

But as Karina did not yet meet the weight criteria for more serious psychiatric intervention, Alina and her husband, a professional driver,  had little choice but to try and manage their daughter’s anorexia on their own. “I couldn’t physically force Karina to eat – and she started to lose a serious amount by autumn. She was so pale and weak. You could see every bone. It looked like the wind would blow her over.

“Then one night in October, I heard Karina in her bedroom on the phone at about 11.30pm. I knew something was not right. I went in and heard she was talking to the ambulance. 

“At first, I thought it was for her friend and then I realised I was for herself. I couldn’t believe it. It felt like a punch to my stomach. The paramedic asked her why she did it. She said it was to get help.”

Karina, who is speaking out because she feels there is still a stigma around teens talking about eating disorders, says: “I don’t remember much about that night except that I felt manic and I thought I wanted to die. 

“I had painkillers in my room and took all the pills I had. But then I panicked and phoned a friend. He said that I didn’t call an ambulance, he would. I was very lucky I didn’t take enough to die,” she says. “But although I am very sorry and no one should ever do anything like that, I felt like no one cared enough to intervene until I got to the hospital.”

In December, Karina was referred to specialists at the Maudsley Hospital and given blood tests and anorexia medication to help boost her appetite. However, Alina says she had to keep pressing until the following May for antidepressants for her daughter – which Karina says was the real turning point in her treatment.  

Karina, who has also followed a prescribed eating plan to help return her to health, said: “They made me finally stop wanting to kill myself.”