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Eating disorders in adolescents: Recognize anorexia and bulimia in adolescence

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Eating disorders in adolescents




Recognize Eating disorders in adolescents


Our daughter is fixated on food: invaded in a tyrannical fashion by the conviction that her figure is too rounded, she considerably restricts her diet ... Meals are hell ...


Dialogue is impossible ... We no longer recognize our daughter, until 'so almost a model little girl ...


The classic scenario


"We said to each other with my husband:" It is no longer possible ... too much change for a few weeks without seeing any triggering cause ...


Everything was going well until then ... The weight for our daughter has become an obsession, an idea fixed causing massive food restriction (sometimes cleverly concealed) with sorting on the plate, interminable meal, flight to the toilet after the meal (does she secretly make herself vomit?), unstable mood, bursts of voice alternating with long moments silent withdrawal, tyrannical discussion completely inaccessible to our warnings, her social life is confined to the family, while she over-invests in school (on that side we even notice a perfectionism) ...


The height is that she cooks for everyone, prepares tasty meals that she doesn't touch,and we are not talking to you about the races which are a nightmare of indecision… and when we have the misfortune to point out to her her galloping weight loss, she aggressively sends us back that it's just the opposite and that she is definitely too fat… !


We oscillate between feelings of helplessness and guilt (where have we failed?) And authoritarian forcing… ”


Eating Disorders (ED): what are we talking about?


Beyond a simple passing ( "I'm on a diet ..." but who can predict what will happen next?), Eating Disorders can constitute a solution to a deep discomfort, risking to settle permanently.


This fixation on weight masks the underlying psychological suffering. It is not a question of capricious behavior, but of behavior which is inexorably reinforced for lack of an adjusted response.


Several expressions are found among the ED:

  • The most classic, restrictive Mental Anorexia (AM) 

  • Bulimia, defined by a massive absorption of food in a limited time with loss of control and followed by inappropriate compensatory behaviors (vomiting, physical exertion, laxatives, etc.), the weight in the end not being affected.


There are forms of passage between the various expressions of ED: the adolescent can thus go from a form of pure restrictive anorexia to bulimia, or even binge eating. These forms of passage are mainly observed in the first years of the disease.


Does Your Teenager Suffer From AIT?


To answer this question, the questionnaire developed by Scoff, initially intended for adolescents, was reformulated for parents:


  • Does she make herself throw up because she thinks she has eaten too much?
  • Does she worry about losing control of what she eats?
  • Has she lost more than 6 kg in the last 3 months?
  • Is she convinced that she is fat when you tell her that she is thin?
  • Are questions of food massively invading his field of thought?

Two positive responses are strongly suggestive of a ED.

(Luck et al 2002, Garcia et al., 2011)


Eating Disorder: how to establish a dialogue with the adolescent?


The conditions for dialogue

  • Choose the right time
  • Avoid dramatization such as " I have to talk to you ... "
  • Avoid face to face (coast to coast encourages more to talk to each other: interest of car trips)
  • Benevolence, non-judgment, avoid moralization
  • Start sentences with "I feel that ..." rather than "you should ..."
  • Be clear about your own reactions: anger, sadness, helplessness, ...
  • Consistency of the “parents” posture: harmonizing your positions as parents
  • More than the why, talk about the how… not to look for fault…
  • Be convinced that TCA is not a teenager's choice, but a bad solution ...
  • Avoid harmless sentences that may prove inadmissible for the teenager:

        • It would make us happy ...
        • It's your grandparents who would be happy
        • How can you not eat it: it's delicious ...
        • Do you know that you risk die…


  • Beware of counter-productive attitudes:
        • Intrusion, overprotection, coping, threats,
        • blackmail, promises, sentimentalism,
        • wanting to be right, the last word ...
        • looking for a fault


Our parents ruminations


If we play firm, we tell ourselves that we do not give him the possibility of opposing: adolescence, isn't it?


We have the impression that we no longer recognize our daughter: this is something we would never have imagined.


It is so difficult to maintain a firm position: our daughter is so in the arm wrestling, authoritarian, domineering, tyrannical, as soon as we approach the question of food and weight ...


We come to doubt the validity of our attitude so much his arguments are expressed with force, insistence even fanaticism ...


If we give in, deep down we know that this is not the solution and feel great anger against ourselves ... even shame.


We are in great disarray - despair: breakup, feeling of loss of our daughter, as if we were betrayed by our daughter who does not share her suffering with us… Some days, we think that she could die…


Overflow of a movement of anger and revolt at the behavior of our daughter: if only she wanted ... if only she dared ...


There is no grip, as on a smooth wall… we try softness, persuasion, anger, constructed arguments… nothing helps, it's a dead end… the pressure is mounting: it's difficult to control yourself. Threats do nothing ...


And what about the fallout for siblings? What these send back to us: feeling of abandonment, jealousy, worry, incomprehension, guilt… even aggressive rejection or conversely rivalry and overbidding in food restriction.


Anticipate the dialogue with your teenager


Prepare for this type of response:


  • It is you who make it a problem: for me I only adopt the right measures for my figure.
  • I'm quite tall.
  • I can do well on my own.
  • It is a failure to gain weight and I blame myself terribly… It is a victory to lose weight.
  • The fear of putting on weight prevents me from moving forward… I only think about it all day…
  • No one can understand ...


References:

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pdf2 Let's Talk About Eating Disorders

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