ACTs should be taken seriously and treated as quickly as possible, as they are associated with significant psychological distress. Suicide attempts are not uncommon in people with AIT.

Anorexia is the disorder associated with the highest death rate: some studies estimate that 10% of people with anorexia die within 10 years of diagnosis⁹.

Medical treatment

ACTs should be taken seriously and treated as quickly as possible, as they are associated with significant psychological distress. Suicide attempts are not uncommon in people with AIT.

Anorexia is the disorder associated with the highest death rate: some studies estimate that 10% of people with anorexia die within 10 years of diagnosis⁹.

Psychological care

The management of TCA is based on psychological interventions (individual, family or group) which target abnormal behavior, but which should also improve self-esteem. Among young people, the involvement of the family is often necessary. There is not really a codified psychological treatment (even if several learned societies have issued recommendations) and the treatment is often punctuated by relapses.

ACTs also have similarities with addictions such as alcoholism. Food compulsions have addictive potential, which often affects the will to cope. However, it is possible to recover completely, especially if the diagnosis and management are made quickly.

The goals of treatment differ depending on the disease. In case of anorexia nervosa, the urgency is to regain a normal weight and to stabilize it (the recommended body mass index is at least 18,5 kg / m²).

In all cases, the treatment is aimed at normalizing the eating behavior. No study shows the superiority of one therapy over another. Treatment must continue for several months to be fully effective. The most recognized therapies are the following^10,11 :

Cognitive behavioral therapy (CBT)

The cognitive-behavioral psychotherapies have been shown to be effective in most eating behavior disorders.

They are not intended to understand the causes of the disorder, but rather to establish new

eating habits and changing beliefs about weight and food. By confronting the patient with situations that distress him, in particular through practical exercises in situation scenarios or role-playing games, CBT gradually makes it possible to desensitize the person to his own fears and to restore a eating behavior centered on sensations. physiological (hunger, fullness, satiety).

In general, therapy is based on weekly sessions, alone or in a group, for 3 to 4 months. It is often asked to keep a food diary which helps to define bad behavior and to control it.

Interpersonal therapy (IPT)

Interpersonal therapy is a form of psychotherapy originally developed to treat depression. Several studies show that it is also effective in some people with TCA¹².

This type of therapy focuses on identifying the person’s current social conflicts and interpersonal relationships, rather than focusing on eating disorders.

It is a brief therapy (12 to 16 sessions), which is unfortunately still not very widespread in Europe.

Psychotherapy

Psychotherapy, the goal of which is to carry out a deep work on oneself, has an interest in the treatment of TCA, generally in addition to the therapies mentioned above. Taking place over a long period of time, it allows us to better understand the causes of the disorder, and therefore to profoundly modify the beliefs and fears that can fuel the eating problem.

It is important to choose a therapist who is familiar with this type of pathology.

Group therapies

Support groups supervised by a therapist have demonstrated their effectiveness, especially if the impairment is not too severe, or as a complement to personal therapy. These groups allow you to feel supported, understood, and to motivate yourself to follow the treatment over time.

Family therapy

When the eating disorder affects a child or adolescent, family therapy is strongly recommended. This type of disorder affects everyone in the family, as parents struggle to understand and communicate with their child. The objective of this type of therapy is to mobilize the whole family and to optimize the chances of recovery, and to increase vigilance in the face of possible relapses.

Other therapies

Several therapeutic approaches, such as art therapy, music therapy, can be offered in combination with the main therapy. They are often a source of motivation and increase adherence to treatment.

hospitalization

In severe cases of anorexia or bulimia, when the person is severely malnourished or at risk of suicide or self-harm, hospitalization is sometimes necessary. If possible, hospitalization should be in an establishment or service specializing in the management of TCA, which will benefit from a multidisciplinary team (psychiatrist, nutritionist, psychologist).