It makes people argue the appeal launched a few days agothrough the pages of Corriere della Sera, from the father of an 11-year-old girl from Ferrara, seriously ill with anorexia and unable to receive adequate care due to the lack of places available in specialized centerseven outside of Emilia-Romagna.
An emergency situation, that of the high number of requests for hospitalization for eating disorders compared to the availability of facilities, which continues to be given too little weight and which follows a pandemic that has seriously compromised the state of health, physical and mental, of young and very young people. Just think that only in the first year of the pandemic, the Italian Society of Pediatrics recorded an increase in admissions to the emergency room for neuropsychiatric disorders of over 80%with i eating disorders (anorexia and bulimia) among the main causes.
We talked about it with the doctor Leonardo Mendolicchiopsychoanalyst psychiatrist specializing in the treatment of eating disorders and Director of the DCA Rehabilitation Department of Auxologico Piancavallo.
Are we really in an emergency of beds for the treatment of cases related to eating disorders?
“The answer is yes: it was there before Covid let alone now! We found a shortage of places for treatment for eating disorders already in 2019: compared to 4% of the population affected by food problems, we had about 900 beds throughout Italy, often concentrated only in some areas “.
And now?
“Now the denominator has changed and we are not talking more than 4% of the population but of who knows how much more. It would be interesting if the Ministry of Health began to carry out an epidemiological study to understand how many Italians really have this type of problem, because it is a fact that we currently lack. On this denominator that has changed – since Covid has inevitably played a decisive role in the increase in eating disorders – there is then the numerator which varies, in the sense that many beds have been committed and many resources have been used for the management of Covid. And it is not yet clear when and how these resources will return to address eating disorders. We know that in Italy logical operations are not always so linear, we need to be careful and understand how to re-establish places, procedures, personnel. The problem of the lack of facilities exists, it is there for all to see and seriously concerns eating disorders, in fact ».
Why is there a need for specialized facilities to adequately treat these ailments?
«Anorexia and bulimia and all eating disorders are very complex pathologies. We could compare them to oncological pathologies of great complexity, because they concern the psyche and the body and this is already an aspect that makes the question even more difficult. In addition, they are disorders that we still know very little, in the sense that anorexia is a relatively new disease, will have about a century of history and we are still learning to discover it. The point is that specialized doctors have cutting-edge tools from a diagnostic point of view but which are purely within their competence and inevitably they are the only ones able to recognize and deal with the complexity of these disorders. In Italy, our goal, between now and the next few years, should be to be able to spread the knowledge we have about these complex and young pathologies as much as possible, making sure, in the meantime, that people who already have skills on this kind of ailments are put in the conditions to be able to cure as many people as possible ».
Is it true that the age threshold for these disorders has dropped?
“Yes, it went down a lot. Today we are witnessing an average onset that is around 11-12 years old and there are also cases of children who fall ill with eating disorders at 10 years of age. The new patients, ie those who have had their onset in the last two years, are all adolescents and pre-adolescents ».
What is the cause of this boom in cases? Only the pandemic or is there something else?
“There is an enormous fragility in the adolescent area, in Italy. Today, children unfortunately have a very precarious psychophysical balance due to a whole series of factors: cultural, social, even economic. Ours is a country where adolescence manifests – from many points of view – areas of fragility. What happened during Covid, the trauma of the Dad, the social isolation, the fears, the anguish, the uncertainties produced this response in the children, which in this age group is very typical, in the sense that adolescents very often they project their anxieties onto food and their body. Putting the ingredients together, that is: fragility of an age group in a world that makes it even more fragile for a series of more pandemic issues, an explosive match was created that detonated the system ».
Looking at the bright side, is it true that there is a high cure rate?
«Anorexia is a strange disease: it has a very high mortality but also a very high cure rate. This paradox explains that if we start the treatment well and immediately, healing is always possible. If, on the other hand, we start the treatments badly and late, the disease gets complicated and can produce harmful effects. We have to play the game in the best possible way, because if we are quick, we work well and expose these guys to the best possible treatment they will recover in a very high percentage. To date, we can say that 75% of patients suffering from anorexia, if they start treatment within 2 years of onset, recover completely 5 years after the disease “.
What can parents do when they find themselves facing this kind of problem with their children?
«We must not be afraid and at the first signs they must rely on competent people because most of the time it is a diagnosis that excludes the presence of an eating disorder. However, if we manage to make an early diagnosis, the intervention will be much faster, less tiring and much more decisive, so parents must have courage and know that there will still be, with all the limitations of the case, a series of professionals on the territory ready to take them by the hand and help them take care of their children. The sooner we start, however, the better ».
What can be done, on the other hand, at the political-institutional level to deal with an emergency like the current one?
«I would suggest a ministerial control room on the specific theme of eating disorders. A booth that can plan and monitor what the regions will have to do, because unfortunately Covid has taught us this: the fragmentation of regional systems is a serious problem and does not make the assistance offer homogeneous. Often delegates decisions to regional bureaucratic apparatuses which instead must have clear guidelines. In Italy it is necessary to spread outpatient clinics for eating disorders throughout the national territory and in every region there should be hospitalization and rehabilitation centers. Even the regions most equipped with health facilities dedicated to eating disorders, compared to the number of patients today, find themselves deprived. Lombardy is in the lead, but the Lombard therapeutic communities are dramatically insufficient: there is a one-year waiting list for patients and we know how important timely action is for a complete recovery ».
Other stories of Vanity Fair that might interest you are:
Eating disorders from 0 to 6 years: what to do when they occur at an early age
Anorexia, bulimia, binge eating: the «imperfect muses». The photographic project
“Men also suffer from eating disorders. Here’s how I overcame them “
“I’m 40, I’m anorexic and can’t find the courage to talk about it”
“I was throwing up 40 times a day”
Source: Vanity Fair
