The eating disorder (DCA) not a whim, but a serious and complex disease that involves a sense of inadequacy. In Italy they suffer more three million people. What should parents say or do in the face of what is a real emergency? How to recognize i alarm signals and figure out what to do? We asked Renato Borgattidirector of child neuropsychiatry at the Mondino Foundation, Laura Dalla Ragionedirector of the network for eating disorders of the Local Health Authority Umbria 1, Stefano Erzegovesipsychiatrist, nutritionist and science popularizer e Florence SarzaniniDeputy Director of the Corriere della Seraauthor of a book on the subject.
What happened in the lockdown
The Covid period was a traumatic time for adolescents and pre-adolescents, he confirms it Laura Dalla Ragione, director of the eating disorder network of Usl Umbria 1. The lockdown was not technically the cause of eating disorders, but it did bring out the widespread discomfort. The visible result was in eating disorder diagnoses: 30% more than sick patients, especially in children between 10 and 11 years old. Bulimia nervosa and binge eating were the leading diagnoses. With one peculiarity: the eating disorder is no longer a gender disease: 20% of patients were males between 14 and 17 years old.
The hospital centers
Renato Borgatti, director of child neuropsychiatry at the Mondino Foundation, spoke of his multidisciplinary center, which takes care of patients (and families). This reality, hospital, is aimed at the most serious young people (the diagnosis of anorexia is the one that also involves the worst numerical data on the victims). The multidisciplinary center because often under an eating disorder there is a psychiatric disorder. Anorexia, in particular, a de facto psychiatric disease. The professor spoke of a lowered age of onset: it often starts at preadolescence (even from 8-9 years old).
The unawareness
The deputy director of the Courier recalled how the increase in the number of cases of eating disorders during the pandemic led her to the decision to tell about her experience with eating disorders in Hungry for love book (ed. Solferino) and in a podcast, with the aim of not leaving families facing the disease alone. Sarzanini recalled how the basic element is thick non-awareness to have a problem. Telling a story also serves to outline the path necessary to come out into the open. Sometimes people who suffer from these disorders do not feel weak, on the contrary: handle food a showdown, but also a way to get attention and ask for help, through the body.
Signs not to be overlooked
The signals not to be underestimated are difficult to interpret: the boy does not ask for help because he perceives his behavior as a solution to his problems. Once it is understood that there is an eating disorder, the disorder must be treated like a tumor in an adult – specific Stefano Erzegovesi, psychiatrist, nutritionist and science popularizer —. equivalent to a serious health problem. It requires long-term care and constant attention. What are the signals? The way of being at the table changes: conviviality is lost, one is at the table in a silent and concentrated way. Change the body image, there are guys who constantly ask for reassurance about their body. The brain of a fasting young man, then, in shortage: there are obsessive thoughts, fits of angerdesire to isolate oneself.
Bulimia is a more hidden phenomenon: because the person is normally of a normal weight. Also in this case, the following are recorded: A different way of being at the table, of running away after the meal and of paying attention to one’s body.
What to do and where
The obsession is the nucleus: patients think about this all day long, about food, weight, body, says Laura Dalla Ragione. The obsession linked to dis-perception, seeing oneself in an altered way. it is really the brain that sees in a sick way: even one of the last symptoms to disappear takes at least two years, which is why treatment is needed from centers that have various collaborating specialists inside. The causes of eating disorders are also multifactorial. The first figure to contact would be the general practitioner or pediatrician. need to ask for help even if in doubt. Once a diagnosis has been made there will be psychiatrists and nutritionists, always together with the family, because the whole family also falls ill and needs help, says the specialist. In 60% of cases, a good integrated clinic is able to respond to the most important needs. Then there are more specific centres, which go as far as life-saving hospitalization. The Italian offer is still uneven among the Regions. The Higher Institute of Health has a site that offers the list of the centers in the area. There is also a toll-free number: 800 180 969which offers a family orientation service.
Help for families
Speaking of the family, the need for a psycho-pedagogical service was mentioned: parents ask many questions which need to be answered. Secondly, she explained Renato Borgattineed one listening space precisely because the individual deals with his suffering. Sick kids are the weakest link in a family chain, says the specialist. We try to shift attention from eating behavior to analyzing emotions and problems.
The general problem there denial of the pathology by those involved: the adolescent must trust adults and trust that they can be helped.
Prevention would play a central role: build counseling centers where young people can express their discomfort. Mythologized adolescence: a tiring period, observes Borgatti. If the adolescent is able to express discomfort, she must not express it with her body.
Re-education and final appeal
From a nutritional point of view, the point from which to start the reconstruction of a familiar with foodremember Stefano Erzegovesi. It is done little by little, there are specific trainings on this. The second step is to eliminate the idea that there are forbidden foods, perhaps to use childhood memories to arouse curiosity about that flavour. With balance, however – concludes the expert – because in this era we talk too much about food.
The meeting ended with an appeal to the Institutions: from Florence Sarzanini been reminded that eating disorders they are not yet recognized diseases. there is an urgent need to intervene, to increase the number of centers where the most difficult cases can be dealt with, and not to underestimate the seriousness and diffusion of these pathologies.
November 10, 2022 (change March 18, 2023 | 11:53 am)
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