« In the time of the refeeding »
Anorexia nervosa is an eating disorder listed in the DSM-V with bulimia. These eating disorders are called « pure syndrome ». They affect respectively 1% and 5% of the French population.
Anorexia is a disorder that will require a lot of care; multidisciplinary care to reach a possible healing that will in most situations be reality. Even if a full healing wouldn’t be possible, care and improving quality of life will always be possible (take for example diabete type 1!). It’s important to remember that healing is possible so to stay in the care continuity.
I propose here an analogy between care and functional rehabilitation type of care practiced by physical therapists.
Indeed, after an injury, all the rehabilitation work will be to strengthen muscles around the affected joint while trying to overcome pain (you know when the physical therapist insists on that point and that we suffer). It is important to do this regularly to avoid sclerosis of the joint, resulting in loss of suppleness and flexibility.
That is why it is important to confront the pain, the pain that can be felt in the stomach after an increase in food intake, accompanied by the weight gain anguish. It is necessary to go to the pain and then overcome it! It is important to act as quickly as possible otherwise the suffering person will lose any possibility of food enlargement.
Sometimes the pain is so difficult to overcome (weight gain fear after eating starchy foods such carbohydrates) that healing can no longer be achieved at home as outpatient but only in hospital. The role of caregivers will be to accompany this fear on a daily basis / the pain caused by increased food intake, not only to put on weight but to limit the risk of “sclerosis eating” and feed the malnourished body. And indeed, most we come late, more adhesions (hear them eating rigidities) are important and difficult to overcome.
Healing anorexia nervosa is identical to this type of rehabilitation. We will have to confront the pain and go beyond, confront the pain to avoid the risk of “freezing” the disease in its rigidity.
The care in anorexia will respect temporality and pain, a time to overcome it and a time to breathe back. Here’s how you can slowly overcome an eating disorder, because the first thing is to fight tiredness generated by the lack of food energy in the body. And remember: body is not the weight, the weight being a characteristic of the non-significant body.
Caregivers will always take care of the body not the weight, healing is for body not for weight.
By Nicolas Sahuc (France)
Translate by Nathalie Decoo from Anorexie Boulimie Ensemble (Belgium)