The long and winding road to eating disorders

Anorexia caused her to "lose her human form" and forced her to create a "faux smile" that has hidden her struggles for years, Lucie explains at the hospital in Nantes, western France, where she is receiving treatment for her eating disorders. For eight years, she tried to control her weight and her body, losing weight until she "lost control."

"It's the loss of a human form, of energy, of life. In a moment, life is lost. That's what this disease brings ," says the 31-year-old.

Hospitalized in 2020, she is now receiving treatment at an outpatient addiction treatment center at Nantes University Hospital (CHU), called "Espace Barbara," which offers psychiatric consultations, family therapies, therapeutic meals, and creative workshops.

Sitting in a turquoise chair, 18-year-old Cléo explains that the disease "took everything away from her." "It dictates our actions and gestures; it becomes our identity," she describes.

Until she was hospitalized at age 14, the teenager was "unaware" of her illness. "When my doctor told me I was sick, I didn't believe him . I just told him what he wanted to hear, convinced that I was in control," she says.

Young patients share experiences of denial and self-loathing , common elements in eating disorders (EDs).

Currently, approximately 80 patients are undergoing treatment at the Barbara Center, with care processes lasting several months. The wait for an initial appointment is approximately four months.

Demand in Nantes has increased by more than 30% in three years, according to the University of Nantes (CHU), a trend seen throughout France. The French Federation for Anorexia and Bulimia (FBA) says nearly one million people suffer from eating disorders in the country, mostly young women.

"There are perhaps five centers like this across the country, not counting the full-service hospitals. In places where there is nothing, patients are left even more abandoned ," explains Bruno Rocher, a psychiatrist and head of the Bárbara center.

Among the possible reasons for the increase in consultation requests, he mentions the effects of the COVID-19 lockdown and the influence of social media on adolescents' lives.

TikTok is full of messages encouraging people to control or reduce their eating habits under the hashtag #skinnytok. "You're not ugly, you're just fat," "Your stomach isn't growling, it's clapping for you," some users repeat.

France and Belgium recently warned the European Union about the dangers of this content.

On her phone, Cléo saw an increasing number of videos promoting "diet culture," featuring "the 'clean girl': perfect life, beautiful body, exercise, healthy eating..." she says. "You say to yourself, 'I can do that too,' and then it goes too far," she says.

"It's not just on social media, it's something more general in society. We want to be thin, we become skinny, extremely skinny. We think that will give us a perfect life. But behind it all lies an illness and, at some point, a fall," adds Julia, 19.

It's not just on social media, it's something more general in society.

At midday, the patients share a "therapeutic meal," after which they must rest. A staff member always sits at the table with them.

"It's not just about monitoring, it's also about encouraging conversation during meals, so they look up from their plates . It's a challenge for them to eat things they didn't prepare themselves, without monitoring the use of fats, for example," notes Katia Drouet, a nurse.

" Here they face what they fear: food, emotions, letting go," he adds.

The path is sometimes tortuous: hospitalization, support, relapse, and a new treatment...

After being "forced" to confront the medical system seven years ago, 24-year-old Camille regained weight and found "some stability." But her condition reappeared, under "a different guise."

In the Barbara space, patients must set three goals to achieve every three months, at least one of which must be related to nutrition.

"Then there are the other aspects: for example, they suggested I work on my façade smile... trying not to smile if I don't feel well," says Lucie, with a fleeting smile. For her, "the fear of food is just the tip of the iceberg."