“Many people hide the problem until they are so thin it becomes obvious. These days we get fewer cases – but their condition is far worse. It’s as if people already know what anorexia is – but don’t come to us until they are on the brink,” Papezova says.

A recent study conducted by HBCS shows that out of 35 countries, the Czech republic has one of the highest numbers of 15 year old girls who say they are on a diet.

Another Kristina, 21, one of Dr. Papezhova’s patients, developed bulimia a few years ago, after originally being treated for anorexia.

“I started by missing school lunches, and exercising instead of dinner. I have a sister who’s the total opposite to me – tall and blond – she was my ideal. Although I know many other girls here in the clinic who saw their ideal image in the pages of fashion magazines, believing those models are successful and have their lives under control,” she says.

One point of contention is the ‘Body Mass Index’ or ‘BMI.' While doctors say comparing a person’s weight and height more or less reflects the norm – the fashion industry says that's nonsense.

“We have one model – she is 15. Very tall, very thin. If I use her BMI – it would be under everything and everybody would say she should go to the hospital, but she is ok, she is eating,” says Adriana Repkova, head booker from the Central European Models agency.

Lenka Cornova, a former model herself, says things are different in the Czech republic.

“Especially for underwear modelling – a thin woman is not the Czech mens' ideal. They prefer women who look like women, and not hangers for clothes,” Cornova says.

But the doctors insist the agencies are playing games.

“You know if I had my own agency, I would probably also be against any rules or restrictions – after all, it’s a very lucrative business,” Papezova comments.

They say here the image of ultra-thin girls comes from the West – as Czech men apparently prefer curvier body shapes. But such is the strength of the modern beauty concept that the vast majority of Czech women say in the polls that they feel they need to lose weight. And doctors fear the cases that they know about may be just the tip of the iceberg.