Anorexia and bulimia, problem of numerous teenagers

For each of us, alimentary behaviour is determined at the same time by a set of instinctive mechanisms and by a certain number of habits acquired from childhood. Gustative pleasure quest play equally a fundamental part.

Between pleasure, instinct and habits, the majority of individuals succeed to compound an alimentary diet balanced enough to allow to their body to function without conflicts. But it occurs that, under the weight of factors, at the same time psychological and physical, the machine halts…

Phenomenon more elaborated that it appears, appetite presides to alimentation of the most developed organisms whose it permits to regulate precisely energetic contributions. In the heart of this process, the mechanism that we call « hungry-satiety » conditions the meals rhythm and more or less important aliments taking, according to modulations of glycaemia rate in blood.

To those mechanisms purely physiological add certain social habits – number and hours of meals, menus elaboration… - as well as very important « pleasure » factor. However, this mechanic well-oiled would not be human if it would not occur to us from time to time to commit, as contingencies like, a few table excesses or circumstance privations. But when those small difference turn to permanent malfunctioning, when we never feel satisfy hunger or at the contrary, hunger does not make feel anymore, pathology is installing.

Anorexia is not an appetite loss strictly speaking, but corresponds rather to a deliberated refused and often unconfessed to feed. Inappetence only occurs in a second time and manifests as the consequence of this restriction. Very grave, anorexia presents a mortal rate elevating at 5% for restrictive anorexia and at 10% for anorexia of bulimic type. In 44% of cases, nevertheless we remark a good recuperation on four years.

Who does it affect?
It affects essentially girls (six girls to one boy) aged from 12 to 20 years, with two peaks occurring towards 12-14 years and 18-20 years. One young girl to two hundreds would suffer for anorexia today.

How does it manifest?
Three main clinic signs identify this trouble: alimentary restriction, loss of weight and perturbation of menstrual cycle. We distinguish then anorexia of restrictive kind and « anorexia-bulimia » accompanied by gavage crisis and recourse to forced vomits, even to purgatives.

Treatment
Medical assistance is necessary and imposes sometimes a separation with family environment. This treatment intervenes at the same time on nutritional and psychological plans. Signs which do not mislead: extreme fear of getting fatter, troubles denial, physical hyperactivity, dissimulation, depression...

Bulimia manifests by drive impulse uncontrollable opposite food followed by anguish crisis linked to the fear of get fatter and accompanied of diverse restrictive practices (forced vomit, fast time, laxatives taking...).

Who is affected by it?
We count five to seven bulimic girls to a boy. It occurs generally at the end of adolescence, towards 18-20 years.

How does it manifest?
It results in a feeling of control loss, gavage times more and less closed, an obsession for weight and appearance, as well as a guilty feeling and self-disgust.

Treatment
A psychological assistance associated sometimes to anti-depressors taking will help patient to surmount his compulsive need of food.

Signs which do not mislead:
Obsessional fear to get fatter, repetitive diets, turning in on oneself, secret behaviour.
 

Contrary to bulimia, hyperphagia does not present under the form of crisis and does not induce of compensatory behaviours. It assimilates rather to a permanent nibbling form and to an excessive food taking often linked to bad alimentary habits.

Here again, only a psychological assistance can resolves the problem.