L’anorexie : un trouble grave et souvent mortel.
Aujourd’hui, je voudrais parler de l’anorexie mentale. Elle touche 0,3 % de la population féminine, avec une mortalité élevée (entre 5,1 % et 13 %). Elle concerne 10 fois plus les femmes que les hommes.
L’anorexie : un trouble du comportement alimentaire.
Ce trouble fait partie des troubles de l’alimentation comme la boulimie et l’hyperphagie. La personne atteinte d’anorexie lutte contre toute prise de poids.
L’appétit est souvent conservé, mais elle lutte contre le besoin de manger. Elle est prise de peurs irraisonnées liées à la nourriture, comme la peur de grossir.
Le résultat est une restriction alimentaire obstinée. La perte de poids qui s’ensuit apporte une satisfaction passagère. Mais très vite, elle veut reperdre encore plus.
Cette perception altérée du corps s’appelle la dysmorphophobie. Cela entraîne des complications médicales : malaises, attaques de panique, absence de règles… La personne finit par s’isoler socialement.
Les causes multiples et complexes de l’anorexie.
Les causes de l’anorexie sont nombreuses et imbriquées : génétiques, hormonales, psychologiques, sociales et familiales.
Des études montrent que les femmes ayant une proche atteinte d’anorexie ont quatre fois plus de risques d’en souffrir. Chez les jumelles identiques, si l’une est malade, la probabilité que l’autre le soit aussi est de 56 %. Elle chute à 5 % chez les jumelles non identiques.
Un déficit hormonal (LH-RH) est observé. Mais ce déficit semble consécutif à la perte de poids, et non la cause.
Par ailleurs, un dysfonctionnement de la sérotonine est souvent constaté. Cette substance agit sur la satiété.
Le terrain psychologique prédisposant à l’aronexie.
Sur le plan psychologique, une estime de soi négative et un perfectionnisme excessif sont souvent présents.
Les jeunes touchées évitent les situations à risque, sont très sensibles au jugement d’autrui. Elles rejettent leur corps, souvent comme objet sexuel. Inconsciemment, elles souhaitent rester petites filles. Elles peinent à construire leur identité.
Trois types de personnalités sont souvent concernées :
- Personnalité évitante (peur du jugement)
- Personnalité dépendante (besoin d’être protégée)
- Personnalité obsessionnelle (perfectionnisme, rigidité)
Ces profils adoptent des pensées automatiques négatives, comme :
- “La minceur est un gage de bonheur”
- “Toute graisse est mauvaise”
Une pathologie culturelle et sociétale.
L’anorexie touche principalement les pays industrialisés. Les critères de beauté imposés par les médias, les mannequins trop minces, influencent fortement les jeunes. Le culte de la minceur est omniprésent. Magazines, réseaux sociaux, régimes miracles… tout contribue à cette pression sociale.
Le dépistage précoce : un espoir.
Le test EAT-26 est un outil de dépistage. Il comporte 26 questions. Le patient le remplit seul. Il aide à repérer les comportements à risque, comme les diètes, vomissements, obsessions alimentaires.
Les complications physiques.
Les conséquences physiologiques de l’anorexie peuvent être graves. Chez l’enfant, on note un retard de croissance.
La perte de poids entraîne une fonte musculaire, anémie, hypotension, ralentissement du cœur. Le calcium chute, ce qui provoque de l’ostéoporose.
L’absence de règles (aménorrhée) est fréquente.
Les vomissements répétés causent :
- Inflammation de l’œsophage
- Dents abîmées
- Glandes salivaires gonflées
- Déséquilibres électrolytiques
La prise de laxatifs peut provoquer :
- Déshydratation
- Constipation
- Œdèmes
- Diminution du sodium
- Insuffisance rénale
Une issue parfois tragique.
La complication la plus dramatique reste la mort. Celle-ci survient par complications ou suicide. Les cas chroniques sont les plus à risque.
Plus l’anorexie est détectée tôt, meilleures sont les chances de guérison. Si le trouble est pris en charge rapidement, les symptômes peuvent disparaître en 5 à 6 ans après le début des soins.
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