Is social media fuelling eating disorders in teenagers?

There are three main types of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder[1]. Psychiatrist Aurore Guy-Rubin, coordinating doctor at the Villa Montsouris clinic (France) and a specialist in these disorders since 2009, has observed a marked increase in the number of cases among teenage girls: "Since the Covid-19 pandemic, there has been a marked increase in eating disorders, particularly among young girls. A study by the Fédération Française Anorexie Boulimie (FFAB)[2] documents an increase of around 30%."

The social withdrawal imposed by successive confinements has exacerbated the psychological distress of young people, particularly those who had not yet developed lasting social relationships. The physical and psychological consequences of binge eating can be serious: malnutrition, heart complications, type 2 diabetes in cases of hyperphagia, but also depression, anxiety and suicidal thoughts.

These disorders have many causes. Depression, dietary constraints imposed by societal norms and traumatic experiences are major contributors: "Around 40% of patients suffering from eating disorders have suffered psycho-trauma, often of a sexual nature. The #MeToo movement has lifted taboos, liberated speech and encouraged many women to seek help," explains Dr Guy-Rubin.

The young people concerned generally hide their illness from those around them, which makes diagnosis more difficult. This silence makes vigilance essential, because there are certain warning signs: withdrawal, loss of interest in usual activities or an abnormally self-effacing attitude. "An overly quiet adolescence can be suspicious, warns the psychiatrist. It's a period marked by the search for bearings and conflicts. If a teenager is too well-behaved or withdrawn, this should arouse attention.”

The challenges of accessing care : the example of France

In France, access to healthcare is another major obstacle, particularly for minors.  The use of the "carte vitale' and the sending of reimbursement statements prevent any discretion for those who wish to consult a doctor without informing their parents. However, there are free, anonymous care structures, such as the Maison des Adolescents (MDA)[6], and the "Anorexie Boulimie Info Écoute" helpline 0810 037 037), but these services are still too little known.

Multidisciplinary care, combining psychological, nutritional and medical monitoring, is essential, but expensive. This specialist care is rarely reimbursed, making it inaccessible to families on modest incomes. What's more, rural areas also have fewer specialist facilities, and existing centres are often saturated.

However, mild cases can be treated by GPs, who have tools such as the SCOFF questionnaire[7] to detect these disorders. "The earlier an eating disorder is diagnosed, the better the chances of recovery. Early treatment often results in remission within one or two years. Around 50% of eating disorders are cured, but some cases become chronic," concludes Dr Guy-Rubin.