Why is there so little talk of adults with anorexia? Perhaps because they are less at risk than teenagers, because their illness is more moderate and more socially acceptable. Yet these women need to be listened to. And neat.
It is a community about which little is said: adult anorexics, those that doctors qualify as “late”. Discreet, almost invisible, we nevertheless meet them in the sports clubs that they frequent assiduously, the children’s shops where they dress and even in the celebrity pages of magazines. “I receive it every week,” confirms Vannina Micheli-Rechtman, psychoanalyst, psychiatrist, and responsible for a consultation on eating disorders. But we talk about it much less than young girls, perhaps because their anorexia is often moderate, more socially acceptable. Unlike teenagers, they put themselves less in danger and end up little in the hospital. »How many adult anorexics are there in France? Difficult to say because there is little epidemiological data, deplores Philip Gorwood, professor of psychiatry and head of department at the clinic for mental and brain diseases at Sainte-Anne hospital in Paris. “Globally, anorexia affects 0.4% of French women, and I would say that 10% of them are adults. If this disease is very old, with clinical descriptions dating back to the first century AD, the current valuation of thinness, social pressure, he assures, means that it now affects all circles. “Thus, a recent study from University College London shows that 3.6% of English quadras and quinquas experience eating disorders, including anorexia.
Anorexia, an inner enemy that sets in early …
Some have suffered from this strange ailment from an early age. Valérie, 49, has only allowed herself a yogurt in the evening since her high school years. She knows she is hurting herself but can’t seem to change. “A part of me, she confides, realistically, is delighted at my age to continue to fit into my size 34 jeans!” “For Alain Meunier, psychiatrist and founder twenty years ago of La Note Bleue, a multidisciplinary care center in Paris,” the internal enemy sets in early and they can do nothing but starve. It is always a symptom of an underground suffering ”. Pathology of refusal, adult anorexia remains a disease of adolescence, affirms Alain Meunier, even at 40 years old. “Whether they are 17 or 47 years old, anorexics suffer from a failing self-esteem, which they hope to fill with a flawless perfectionism, a control of their needs and their desires. »Anorexia then seems both their best friend and enemy number one. “I call him ‘my angel’, testifies Violaine, 47 years old. When I see other people stuffing themselves or cooking for my family, I feel stronger, freer. There is a real pleasure in losing weight, in remaining in permanent control when so many complain about their weight without being able to act. Not easy at my age to give up this feeling of superiority. But it is obviously also about a prison, of which they are at the same time prisoners and jailers. The psychiatrist and psychoanalyst Didier Lauru, author of Body weight in adolescence (Albin Michel), explains: “In these women, the refusal to eat frequently goes hand in hand with hyperactivity, excessive sports practice which allows obsessive food thoughts to fade away. They come to me often exhausted but, unlike teenagers, they are not in denial, they know their disease very well, we can even say that the affected quadras are pros of their syndrome. ”
Anorexia: when to worry?
… or which is triggered after a trauma
For others, anorexia starts after a hardship, a traumatic event. According to Didier Lauru, it can be the sudden loss of a parent, that of the mother in particular, a separation, a financial difficulty that makes you plunge. Here again, the notion of control is essential. “During our divorce, explains Violaine, now healed, my husband turned the children against me. The rage I was feeling, I turned it around: I took revenge on my body by starving it. I weighed myself a hundred times a day and every morning I ran for two hours until I collapsed. No matter how offended the others (a kid refusing all food would have been sick; at my age, I was only having a whim), it was the only means found to scream my pain. ”
Take back control of what hurts
The quarantine also marks a particular stage in a woman’s life, that of the end of fertility, experienced by some as mourning for seduction. “The myth of eternal youth is never far away among those who fight against time, the extra pounds, synonymous with age”, indicates Didier Lauru. Violaine gets carried away: “Look at the people, from Laeticia Hallyday to Victoria Beckham, we praise their silhouettes without thinking about the hardships endured! The zeitgeist is for anorexics who camouflage their situation and stick to the aesthetic ideals of the moment. ”
A bout of anorexia in mature women often hides an already complicated younger relationship with food. “Even in those of recent date, assures Didier Lauru, when we search, we often find undiagnosed seizures, phases of restriction in adolescence. The return of these symptoms echoes something old, out of tune. While the causes are always multifactorial, he adds, sometimes it’s a problem with the mother that, even after all these years, has not been resolved.
In adolescence as later, anorexia remains a disease of the link, a way of regaining control over what hurts. In his work With our teens, let’s dare to be parents! (Bayard), Marie Rose Moro, child psychiatrist and director of the Maison de Solenn, reports receiving (and this is new) mother-daughter couples both anorexic. A phenomenon of mimicry of the young towards the adult, but undoubtedly also, for the latter, a mirrored way of becoming a girl again, of returning to childhood and to the time when one was formless. “At the Maison de Solenn, we work on the position of parents, on the echo of adolescence to understand what happened, with family therapy to put everyone in their place. ”
Anorexia nervosa, an insatiable quest for control
Music therapy to the rescue
Anorexia, as we know, has serious physiological and psychological consequences. It causes more suicides than any other mental illness. At 20, the situation is very worrying; at 40 and after, the consequences of undernutrition also bring early menopause, osteoporosis, cardiac fatigue. “My dentist is appalled by the state of my teeth, recognizes Valérie, and I am permanently tired, I am always cold, even in summer. I had to refuse a trip to Portugal, I didn’t have enough energy to leave my apartment. “Apart from emergency cases that are treated in hospital (France has an exceptional network in this area), treatments are multifaceted. As with adolescents, it is impossible to envision recovery solely in the form of pounds gained or calories ingested. We must listen to what is expressed, deconstruct and reconstruct personal and family history. “Psychoanalytic treatment, sometimes associated with family therapy, gives good results,” recalls Vannina Micheli-Rechtman.
Having become anorexic at the age of 37 after harassment at work, Hélène testifies: “Anorexia is already a confinement in itself, I never wanted to be hospitalized. Even at thirty-seven kilos and when I couldn’t walk. Thanks to music therapy, I finally had the impression of being listened to, heard, of no longer being the walking skeleton that people laughed at behind my back. Say it well: the view of others on this disease is very hard, especially for those who are older. Today cured, I want to eat life! ”
Annie, 49, librarian
“The violence of my family is inscribed in my body”
“When I was 8, I was touched by my grandfather and I was not believed. Additional dread: he died the day after I told it all. I felt responsible and I followed a typical course: classical dance to the limit, enormous deprivation and anorexia which dominates my life. I weighed thirty-five kilos for one meter seventy at the age of 15 and I was still too fat! Today my brain is still a counter, it can indicate the calorie content of any food, I weigh myself up to a hundred times a day and I take medicine for obese people to eliminate. At the restaurant, to be sure not to eat, I order meat when I am a vegetarian! I had two cancers and, in order to be able to cure myself, I had to gain weight, which was very painful, more than the disease. Everything is inscribed in my body like a hot iron. ”
Eating too healthy is not healthy
Two new ways to get better
Electricity. In Israel, the United States, and Germany, techniques involving electricity are regularly used against anorexia. With transcranial magnetic stimulation, a magnetic coil is applied against a point on the skull to modulate neuronal activity and decrease symptoms of the disease. Direct current transcranial stimulation uses a helmet or a headband, which also delivers an electric current at very low intensity. Ten hospitals in France are testing this method. But Bogdan Galusca, endocrinologist at the Eating Disorders Reference Center in Saint-Étienne, remains cautious: “It works for depression, but for anorexia we are still testing. The results are disappointing because the studies cover all anorexias combined. Neurostimulation should be adapted to each person’s biology. “Same circumspection in Anne Sauvaget, psychiatrist at the University Hospital of Nantes:” These methods seem to work on bulimia but little on anorexia. And beware, with helmets, of the side effects in case of “wild” use. ”
Cognitive remediation. It is a playful cerebral gym on which the professor of psychiatry Philip Gorwood and his team are working at Sainte-Anne hospital in Paris. Their June 2016 survey shows that anorexics feel more pleasure in losing weight than fear in gaining it. It is therefore less a phobia than an addiction. However, this can be relieved by exercises: participants are asked to change their beliefs along the way in order to avoid automatic thoughts. The goal ? Give them back a certain cerebral plasticity, that is to say, freedom.
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Is food your friend?
Between us and food, relations are not always good. Nutritional recommendations from experts, slimming dictates, compulsive behaviors… all of this ended up turning our plate into a real headache. Just like our races. Between obsession with calories, labels or quest for flavors, discover what reveals your fork! And how to sign a new peace treaty with food.