Children and adolescents: are eating disorders on the rise in France?

Anorexia nervosa does not only affect girls and its increase is worrying. This is shown by a study published in December 2023 in the journal JAMA (Journal of the American Medical Association) which reveals alarming results with the increase in eating disorders (or eating disorders) among adolescents in Ontario, province of Canada, between 2002 and 2019. Concerning values ​​with a 139% increase in ACR among adolescents aged 5 to 17, particularly a 416% increase among boys. The increase is also noted in American, English and Norwegian studies. Eating disorders include anorexia nervosa and binge eating disorder. In 2017 Inserm showed that 5% of patients died from anorexia nervosa and that 50% of cases treated during adolescence recover. Is the worrying increase highlighted in Canada observed in France? Le Figaro carried out the investigation.

Public Health France (SPF) has published monthly data on these eating disorders since 2019. According to the organization, we have not observed a significant increase in cases between 2019 and 2023. Before 2019 SPF describes that “despite the media attention that they provoke, they (the TCA, Editor's note) therefore only concern a small proportion of young people and did not increase between 2005 and 2010. For SPF there are no alarming signals but a rigorous study of the statistics of disorders between 2002 and 2019 is lacking. Contacted by Le Figaro, public health France is not able to provide the evolution of the disease on the Last 20 years.

Professor Patrick Tounian, head of the pediatric nutrition and gastroenterology department at Trousseau hospital in Paris, reports that “we are seeing an increase in anorexia nervosa in all industrialized countries. In our department which deals with severe forms requiring renutrition, 20 years ago we had one case of anorexia nervosa per year, today we welcome between 10 and 20 patients per year. The professor therefore testifies to an increase in cases, in his department, among adolescent girls over the last 20 years. However, we cannot generalize this sample finding to the entire French territory. Concerning boys, Professor Tounian reports: “I have never had boys in my department with anorexia nervosa. The boy's anorexia nervosa reveals a very serious underlying psychiatric disorder, the causality in boys is different.” His department has not noticed an increase in problems among boys.

Professor Catherine Massoubre, head of department of the psychiatry center and the TCA referral center at the Saint-Étienne University Hospital, reports that “we have no studies over the last twenty years at the Saint-Étienne center because the latter opened in 2015 ". Even if “since 2015 we continue to have an influx, like a bottomless pit”, she adds that “since 2015 the number of new patients per year remains the same”. Before 2015, patients were spread across several different departments.

Despite a different observation between the two specialist professors, how can we explain the increases in Ontario and in the service of Professor Patrick Tounian? We cannot exclude hypotheses such as better detection of illnesses by health professionals, reduction of stigma linked to mental health or better knowledge of illnesses by patients ensuring better detection. For Professor Tounian, “there is a genetic predisposition to develop anorexia nervosa, environmental elements are triggering factors, not causal”. The worsening anxiety-provoking nature of adolescents' environment could therefore play a role. “Food scandals, eco-anxiety and wars form a disrupted global context,” recalls Professor Tounian. A 2021 Lancet study on the impact of eco-anxiety among young people showed that 56% of Europeans aged 16 to 25 considered that humanity was doomed.

For Patrick Tounian, “we are observing an explosion of dietary deviations with the increase in veganism and flexitarianism. A Credoc study questioned a sample of individuals on the words referred to in the term “quality food”. In 2000 we found “good” and “taste” at the top, the same study carried out in 2018 gives different results with “organic” and “without” at the top. In two decades, the pleasure of eating has been replaced by the fear of eating. Chemical products such as preservatives or pesticide residues worry the population.

Are teenagers doing poorly? On March 7, 2023, the High Council for Family, Childhood and Age pointed out “the prevalence of consumption in the pediatric population between 2010 and 2021 increased by 35% for hypnotics and anxiolytics; 179% for antidepressants, 114% for antipsychotics; and 148% for psychostimulants.” “These levels of increase are out of proportion (2 to 20 times higher) with those observed in the general population. Children are therefore significantly more exposed than adults to mental suffering and psychological difficulties, but also to medication.” A situation clearly worsened by the effects of confinements during the Covid pandemic.