Rocío Roses, psychologist: "Eating disorders are the most prevalent mental disorders in adolescents."

When COVID forced us all to stay home, Paula Valls began a process she never would have imagined. Her university and social life came to a standstill, and with it, her routine. In this disarray, a personality trait she herself was unaware of surfaced: obsessiveness . "I lost control of everything, and that's the worst thing you can do to someone who has an obsessive theme with food and exercise," she says.

Like many patients, she wasn't aware she had a problem at first. On the contrary: she poured herself into cooking for her family, but she wouldn't eat. She began exercising compulsively , a self-imposed effort fueled by confinement and fear. Her parents noticed the change, but it wasn't until the weight loss became evident that real concern arose. A blood test confirmed what was already serious. "You need help," the doctor told her.

Dr. Rocío Roses , director of the Mental Health Institute at Sagrat Cor University Hospital, is familiar with these cases. “In eating disorders, we find three main groups: anorexia nervosa, bulimia nervosa, and unspecified disorders,” she explains. All of them involve alterations in eating behavior, either due to restriction or excessive consumption accompanied by guilt. The majority of cases that come to the clinic, in fact, belong to this last group, the most difficult to diagnose because it doesn't fit neatly into traditional clinical categories.

“One-third of patients with eating disorders will be chronic”

One of the most worrying data provided by Dr. Roses is the chronicity of these disorders: “We know that approximately two-thirds of patients will recover, but a third will be chronic , that is, they will live with the disorder their entire life, although they can maintain a more functional life with clinical support .”

For most patients, the road to recovery is long and complex. Paula experienced it as a complete loss of freedom . “At first, I didn't want to recover, ” she recalls. She didn't understand the treatment, the restrictions, or the process. But little by little, she made progress, facing her fears in therapy and setting seemingly impossible goals, such as eating a food she had forbidden herself for months or returning to healthy exercise.

There are three levels of intervention in mental health centers: outpatient treatment, day hospital, and 24-hour treatment. Paula attended the day hospital, where, in addition to supervised meals, individual and group therapies are offered. There, they work not only on behavior but also on emotions, personal history, identity, and the relationship with the body. Dr. Roses points out that the diagnosis is always made with the patient and their family, as the environment is key to the patient's progress. "The family is a fundamental part; it's what we call their co-therapist."

"80% of teenage girls feel dissatisfied with their bodies"

Today, Paula looks to the future with a mixture of fear and caution. A “functional fear,” as she defines it. When she detects a warning sign, she returns to the day hospital, contacts the medical team, and seeks support. She's aware that recovery isn't linear , but she also knows she's not alone. “Your family can't recover for you, but they can support you and help you a lot,” she says.

Adolescence is the most vulnerable period. Dr. Roses emphasizes this forcefully: “It is the most prevalent mental disorder in adolescents . 80% of adolescent girls feel dissatisfaction with their body.” This self-criticism, combined with social pressure , beauty standards, and constant comparison on social media, paves the way for the disorder to grow.

Detecting it early is crucial, since with appropriate intervention, a solid support network, and specialized professional care , two-thirds of patients recover. Some do so with full recovery, others with occasional relapses, and many, like Paula, with a renewed awareness of their mental health. Addressing this type of disorder also involves learning to live with it and prevent its recurrence.