Eating too much or too little – bulimia and anorexia, two extreme pathologies in our relationship with food, affect primarily adolescent girls and young women. A combination of factors lies at the origin of eating disorders, and the psychological aspect is the most important of these.

The example of anorexia illustrates the point. Like all illnesses of a psychological nature, anorexia is difficult to pin down or treat. However, since words have meaning, what exactly does the term mean? The etymology is Greek, with a negative prefix so that it means the absence or loss of appetite. Somebody suffering from anorexia will impose dietary restrictions on themselves so that they lose their appetite. The most visible and spectacular result is loss of weight, in some cases up to 50% of the person’s previous weight.

This relationship with food is often linked to taking laxative medication, or to crises of bulimia which are usually mixed in with self-induced vomiting. It’s not unusual, either, for anorexia to be linked to intensive sporting or intellectual activities.

Anorexia and psychology

The thing that makes treatment and prevention rather delicate matters is the psychological aspect of these conditions. The experts agree that this illness stems from a lack of self-confidence. Excessive perfectionism, a need to be in control of everything, or a rejection of the image of the adult woman, jostle for position in the mind of a teenage girl. An attitude of rejection is encouraged by the disastrous image of feminine beauty represented by fashion models in western societies. Idealised skinniness has fortunately been in retreat for some time, but it took a while before, as part of draft health legislation in France, the government forbade modelling agencies from employing young women who are too thin. “I was already slim when I was chosen. From that moment on, I never ate more than an apple per day,” says one ex-model.

Although belated, this initiative may be beneficial. After all, how can you make a young girl aware that she is underweight, if the image given her by the media emphasises exactly this underweight appearance? And how can you treat somebody who is ill if they think they’re not ill?

The prevention of anorexia

All these factors make the treatment of anorexia nervosa a delicate matter. Attempts to deal with the condition generally require multidisciplinary expert intervention, perhaps involving a psychiatrist, a child psychiatrist, a paediatrician and a psychologist. Hospitalisation is often necessary. To avoid reaching this stage, prevention is essential. The role of family and friends will be crucial. It’s necessary to help the teenager’s development by working on his or her self-esteem and confidence. There’s no law against calling on the help of a psychologist in case of conflict with an adolescent. It’s also good to keep a discreet watch on his or her eating habits. In all cases, dialogue and a spirit of openness are often the best allies.

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