In France, nearly 600 adolescents and young adults between 000 and 12 years old suffer from an eating disorder (ADD). Among them, 35% are young girls or young women. Early management is essential to prevent the risk of the disorder progressing to a chronic form. But feelings of shame and isolation often prevent victims from talking about it and seeking help. Also, they do not always know where to turn. Several possibilities are open to them.

We speak of eating disorder when an individual’s usual eating habits are disrupted by abnormal behavior with negative consequences on his physical and mental health. Among the eating disorders, there are:

• Anorexia nervosa: the anorexic person restricts himself to eating for fear of gaining weight or becoming fat despite being underweight. In addition to dietary restriction, anorexics often make themselves vomit after ingesting food or resort to laxatives, diuretics, appetite suppressants and physical hyperactivity to keep from weight gain. They also suffer from an alteration in the perception of their weight and the shape of their body and do not realize the severity of their thinness.
• Bulimia : the bulimic person absorbs much more food than the average, and this, in a short time. She also takes care not to gain weight by implementing compensatory behaviors such as induced vomiting, taking laxatives and diuretics, physical hyperactivity and fasting.
• Binge eating or binge eating: the person who suffers from binge eating eaten much more food than the average in a short time (less than 2 hours for example) with a loss of control of the quantities ingested. In addition, there are at least 3 of the following behaviors: eating quickly, eating until you have stomach discomfort, eating a lot without feeling hungry, eating alone because you are ashamed of the amounts ingested, feeling guilty and depressed after having eat. Unlike anorexia and bulimia, hyperphagic patients do not set up compensatory behaviors to avoid weight gain (vomiting, fasting, etc.)
• The other so-called “food ingestion” disorders: orthorexia, pica, merycism, restriction or avoidance of food intake, or compulsive snacking.

The SCOFF questionnaire, developed by scientists, can detect the presence of an eating disorder. It consists of 5 questions intended for people likely to suffer from a TCA:

1. Would you say that food is an important part of your life?
2. Do you make yourself throw up when you feel like your stomach is too full?
3. Have you recently lost more than 6 kg in less than 3 months?
4. Do you think that you are too fat when others tell you that you are too thin?
5. Do you feel like you’ve lost control over the amount of food you eat?

If you answered “yes” to two or more questions, then you may have an eating disorder and should talk to those around you for possible management. ACTs can have very serious health consequences if they become chronic.

The management of TCA is not easy because patients do not dare to talk about it, consumed with shame. Their unusual eating behaviors also encourage them to isolate themselves in order to eat. As a result, their relationships with others weaken as the disorder sets in. Shame and isolation are therefore the two main obstacles to the care of people with an eating disorder.

They are fully aware that what they are doing to themselves is wrong. And yet they cannot stop without help. Shame is not only social, that is to say that patients know that their eating behaviors are considered abnormal by others. But also interior, that is to say that the people who suffer from it do not support their behavior. It is this shame that leads to isolation: we gradually refuse invitations to dinner or lunch, we prefer to stay at home to ingest large quantities of food and / or make ourselves vomit, going to work becomes complicated when the disorder is chronic …

To his attending physician

The attending physician is often the first medical interlocutor in families. Talking about his eating disorder with his general practitioner seems easier than with another practitioner who does not know us and with whom we have not yet established a bond of trust. Once the diagnosis is made, the general practitioner will offer several options for the management of the disease, depending on the patient’s condition.

To his family or relatives

The family and loved ones of a sick person are in the best position to detect the problem because they may find that their behavior is abnormal at mealtimes or that their weight gain or loss has been excessive in recent months. They should not hesitate to discuss the problem with the person concerned and to help him find medical and psychological help. Just like this one should not hesitate to ask for help from those around him.

To associations

Several associations and structures come to the aid of patients and their families. Among them, the National Federation of associations linked to eating disorders (FNA-TCA), the Enfine association, the Fil Santé Jeunes, the Autrement association, or the French Anorexia Bulimia Federation (FFAB).

To other people who are going through the same thing

This is probably the easiest way to admit that you have an eating disorder. Who better to understand a person suffering from a TCA, than another person who suffers from a TCA? Sharing your experience with people who suffer from TCA every day (sick and close to sick) shows that you want to get out of it. There are discussion groups and forums dedicated to eating disorders for this. Favor the forums offered by associations fighting against eating disorders in which the discussion threads are moderated. Indeed, one sometimes finds on the Web of the cats and the blogs making the apology for anorexia.

Has multidisciplinary structures dedicated to TCA

Some health establishments offer a structure dedicated to the management of eating disorders. This is the case of :

• The Maison de Solenn-Maison des adolescents, attached to the Cochin hospital in Paris. Doctors providing somatic, psychological and psychiatric management of anorexia and bulimia in adolescents from 11 to 18 years old.
• The Jean Abadie Center attached to the Saint-André hospital group in Bordeaux. This establishment specializes in the reception and multidisciplinary care of children and adolescents.
• The TCA Garches Nutrition Unit. This is a medical unit dedicated to the management of somatic complications and severe undernutrition in patients with TCA.

These specialized units are often overwhelmed and limited in terms of places. But be aware that if you live in Ile-de-France or nearby, you can turn to the TCA Francilien Network. It brings together all the health professionals who take care of the TCA in the region: psychiatrists, child psychiatrists, pediatricians, general practitioners, psychologists, nutritionists, emergency physicians, resuscitators, dieticians, teachers, social workers, patient associations, etc.