The tragedy of adult anorexia nervosa: A neglected disease

Our objective is to report the work we have carried out for about 20 years in a specific unit dedicated to eating disorders in the adult, to question the particular place this disease has in our care system and analyse the reasons for it: patients' opposing behavior, separation of physical and mental diseases in Occidental medicine, social-cultural context of our society which focuses on performance and individualism, dictatorship of appearance and thinness... Our aim is also to describe the system we have put in place, based on pair work involving both a doctor and a psychiatrist, family participation, and very long monitoring over several years with or without hospitalisation. This is a strategy that conforms the recommendation of the Haute Autorite de Sante but we think it is worth emphasizing the lack of means dedicated to this pathology which however represents a real public health issue. A lot of patients do not have access to treatment, which weighs very negatively on the disease evolution. (C) 2016 Published by Elsevier Masson SAS.