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Eating disorders in social institutions

Dr Anne JOLY Centre Jean Abadie University Hospital of Bordeaux France. Eating disorders in social institutions. Introduction. Eating behavior : defined by three orders of factors - neurophysiological (hunger/satiety regulation, hypothalamus...) - socio-cultural (learning)

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Eating disorders in social institutions

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  1. Dr Anne JOLY Centre Jean Abadie University Hospital of Bordeaux France Eating disorders in social institutions

  2. Introduction Eating behavior : defined by three orders of factors - neurophysiological (hunger/satiety regulation, hypothalamus...) - socio-cultural (learning) - related to the development of personality (related to nutritious function, orality) Symptoms affecting nourishing behaviour Multifactorial etiopathogeny Observed in many psychological and psychiatric diseases (mood disorders, melancholia, psychosis…) Mental Anorexia and bulimia

  3. Eating disorders Eating disorders could appear across the entire life “Pathologies of links” in a psychoanalytic approach Higher frequency : early childhood, teenage, third age, moments of life crisis… Early childhood : precocious anorexia, rumination, pica, psychogenic vomiting Adolescence : - mental anorexia (anorexia (loss of appetite, weight loss under 15%, amenorrhea) - bulimia : with or without vomiting Adult age : the inheritance of previous periods

  4. Anorexia – bulimia during adolescence Two faces of the same suffering, frequently associated Key words : deny of symptoms and excess of self-control Obsessive preoccupations for alimentation, weight, calories counting (even child), dysmorphophobia Physical and intellectual hyperactivity Social abilities restrain and isolation Identity and self-image trouble

  5. Consequences Somatic : due to undernutrition, vomitings (cardiac disorders), overnutrition; development delay, sterility, osteopenia etc… Psychological : due to the impact of obsessive ruminations and social life impairment at key moments of development

  6. Eating disorders and deprivations in early childhood Eating behavior related to the quality of primary care and early interrelations Trauma =>insecure attachment Self-deprivation reaction observed in social institutions : can be paradoxal for care-givers We have to always consider attachment impairment to help those children, even they seem in refusal

  7. Treatment Difficult to overtake the deny Specialized care if possible Understanding of the sense of those symptoms Three axes : a somatic reactivation (refeeding, adapted physical training) A psychological reactivation (emotions, perceptions, self-image, psychotherapies) A social rehabilitation, at first with close environment, family therapy…

  8. Thank you for your attention anne.joly-burglen@chu-bordeaux.fr

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