Anorexia nervosa: take charge quickly at home rather

Written by Sandeep Nehra

Anorexia nervosa, which affects tens of thousands of people in France, is an eating disorder need to detect and take charge as soon as possible to prevent it from becoming chronic, but not necessarily go to hospital.

“This is a complex disease, insidious and destabilizing, whose diagnoses are hard to bear,” he said at a press conference Dr. Cedric Grusha, the High Authority for Health (HAS), independent public authority that issued its recommendations Thursday good practice.

Anorexia affects 1% of the young female population, about 40,000 girls in France, but also, according to experts, more and more children of 8-9 years and young people. With older people in whom the disease has become chronic, it is estimated that it affects some 70,000 people.

“Anorexia is not copying the models of fashion, followed by a regime that went wrong,” said Christine Chiquet, president of a federation of associations of eating disorders, FNA-TCA.

She says doctors can sometimes through ignorance, aggravate the disease.

To put an end to their “wandering” HAS – which made its recommendations developed with Afdas-TCA, a professional association of eating disorders – has provided physicians and families a “framing”.

For early detection, it suggests”vigilance” to signs suggestive: severe weight loss, absence or cessation of menses, physical hyperactivity. It provides physicians with simple questions on food problems, the emesis on how someone’s body.

Once the disorder is detected, should be avoided in favor of a hospital outpatient care, which includes the family in the course, said the HAS.

“Change can be gradual, sudden hospitalization reinforces the patient’s resistance,” says Jean-Luc Venisse, psychiatrist and director of the university of addiction and psychiatry of the University Hospital of Nantes.

The management must be conducted by “at least” a general practitioner and a psychiatrist or psychologist, and psychotherapy should be undertaken during extended “at least one year.”

Only in cases of “real emergency” HAS calls the hospital, even against the advice of the patient to “give itself the means to not let someone put to death,” says child psychiatrist Philip Jeammet. And sometimes to separate the anorexic’s family environment, critical or anxious.

For psychiatrists, anorexia is an addictive behavior as well as drug or alcohol abuse. “This is involuntary behavior that is necessary, adapting to a situation of anxiety,” notes Professor Jeammet. “It is a cry of distress, but there are other ways to express themselves: we must create a dialogue, restore confidence,” he said.

Half of anorexics recover fully, 30% had partial remissions, and in 20% of patients, the disease becomes chronic, according to Professor Venisse. Chronicity that fact that nobody cares about anything and expensive for the body, with premature menopause and osteoporosis.

“Once installed in anorexia, it becomes increasingly difficult to escape,” he notes. Followed over a period of 20 years, anorexia is 10% of deaths. But anorexia is treatable, even after ten years.

Three fact sheets for doctors and two for the general public are downloadable on the site of HAS (www.has-sante.fr).

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