Bulimia and anorexia in adolescents: how to help?

During adolescence, some young people, both girls and boys, are affected by eating disordersalso called TCA. Anorexia mental and the bulimia are part of. According to the figures from Public Health Francethis would concern 1 in 4 teenagers and 1 in 5 teenagers. But in recent years, it seems that the phenomenon has increased with the health crisis linked to Covid-19, according to a recent study carried out by the team of the head of the nutrition department of the Rouen University Hospital, Pierre Déchelotte, and published in February 2022 in the review Clinical Nutrition and Metabolism. According to research, it has been found a “worrying increase in the prevalence of eating disorders among college students during the COVID-19 pandemic”due to the various lockdowns, distance courses, as well as the stress and food insecurity that this has caused in young people. What are the symptoms to watch out for? What should I do if my teenager suffers from bulimia or anorexia? What support ? The experts Nathalie Godart, child psychiatrist, and Corinne Blanchet-Collet, endocrinologist-nutritionist tell us about it.

At what age is a teenager affected by anorexia and bulimia?

These eating disorders can occur at any age, although “anorexia has a peak between 14 and 18 years old, bulimia on the other hand appears a little later, around 16-20 years old andhyperphagia bulimic, around 21 years old“, details the child psychiatrist.

Because they are more or less transient and more or less severe, “these eating disorders require early diagnosis and appropriate support”adds Dr. Corinne Blanchet-Collet, endocrinologist-nutritionist, “especially since these disorders can be cured in more than 80% of cases“.

What are the symptoms of bulimia and anorexia in teenagers?

THE symptoms of bulimia andanorexia nervosa are numerous and sometimes some are even common to both diseases.

Symptoms of Bulimia in Teens

Bulimia manifests as seizuresalso said of food cravings, which the adolescent cannot resist. This translates first into a almost vital need to eat in the momentto do so outside meals and in secret, to eat quickly without stopping and in large quantities, both salty and sweet. After the crisis, the person feels bad, regretted and has low self-esteem, which often causes vomiting.

In parallel with these crises, the adolescent control weight and diet. She may use laxatives or intensive physical activity to achieve her goals.

Symptoms of Anorexia Nervosa in Teenagers

anorexia nervosa settles in gradually, usually under the pretext of a diet. The teenager has a obsession with what he eats and what his relatives eat too. He also hides his weightloss, and does everything to show that he is fine by being hyperactive. Some young girls may also stop menstruating.

Several warning signs can predict a anorexic or bulimic behavior in a teenager and thus put the chip in the ear of the parents.

• Weight loss of 10% or more
• Sudden or gradual changes in behavior
• Loss of appetite
• Stomach aches
• Migraines
• Academic difficulties or over-investment in school
• Propensity to isolation
• disturbed sleep
• Amenorrhea
• Excessive concern with body image, food
• Low self-esteem
• Vomiting
• Rigorously followed diets
• Intense physical activity

What are eating disorders in adolescence related to?

Generally, eating disorders are associated with psychological problems impacting somatic and psychic health and social integration.

To understand where this suffering comes fromthe parents can first discuss with the teenager and ask him what is wrong, the possible problems he encounters at school, the image he has of him… Of course, all teenagers will not be inclined to talk about their suffering and talk about it with their parents.

So do not hesitate to consult a doctor, even his attending physician, and initiate a treatment process. Be sure to approach the subject gently, expressing your concern in a clear way: “we are worried about you and we need help“. Think that very few young people refuse to seek treatment. And indeed, “the greatest reluctance does not come from teenagers, it is rather the parents who find it difficult to accept the idea that their child is suffering“, certifies Marie-Rose Moro, professor of child and adolescent psychiatry and director of the Solenn house at Cochin hospital in Paris.

A teenager who is affected by eating disorders can benefit from a medical and therapeutic careand in some cases a treatment. This support is generally done in three stages. The teenager is received in consultation by a doctor who will assess, without judgement, the “repercussion” of his eating disorder on his overall state of health (height, weight, BMI, attitudes towards food, body experience, body image, self-esteem, etc.). In order to offer him an adapted ambulatory follow-up, a psychological or psychiatric assessment is carried out according to their needs. The coordinating physician then suggests to the teenager and his parents a global project (medical, psychological, psychiatric, educational and dietary). The care plan is individualized, scalable And negotiated with the young person and his family.

The goals of care? “Restore and maintain weight, treat psychological suffering and minimize social and relational consequences“, she specifies. The follow-up time will depend on the somatic, psychological and social sequelae, but “long-term care, for several months or even several years, is often considered“, in order to “minimize the risks of chronic eating disorders and promote long-term healing, ideally lifelong“, insists the director of the house of Solenn.

Parents, who have noticed signs or have questions about eating disorders as a teenager, can call the line “Anorexia, bulimia, listening info” at 09.69.325.900 (non-surcharged number).

Young people can go to a House of Adolescents (MDA), located in each department in France. It is a place of welcome and advice for young people aged 11 to 25 (the age may vary depending on the structure) and their families. Reception in these homes is completely free and anonymous if the teenager wishes and will allow him to meet different professionals (psychologists, doctors, nurses, nutritionists, social worker, etc.) according to his needs. To find the nearest teenage home, go to National Association of Teenagers website.

What are the statistics on anorexia and bulimia in adolescence?

According to the statistics health insurance, anorexia nervosa would affect girls more, at least in 80% of cases. About the bulimiathis disease concern 1.5% of 11-20 year olds and in particular three girls for one boy. Binge eating disorder, which is characterized by repeated bouts of bulimia, is more common with severe early forms.

“Teenagers can experience phases of anorexia, bulimia or binge eating at the same time.”

There bulimia and binge eating – which is characterized by the absorption of a very large quantity of food over a short period of time, but without eliminating it by vomiting, and which affects both men and women – are more widespread disorders, but much less publicized and therefore more difficult to grasp. Especially since young people affected by these disorders can “experience both phases ofanorexiabulimia or binge eating“, explains Pr. Nathalie Godart, a child psychiatrist specializing in the field of adolescents and young adults.

Interview by Nathalie Godart, child psychiatrist, and Corinne Blanchet-Collet, endocrinologist-nutritionist in 2018 during a round table at the Maison de Solenn (AP-HP) on eating disorders (TCA) in adolescents.