Dans l’anorexie mentale, les préoccupations corporelles sont un enjeu clé de la pathologie, mais aussi de la thérapeutique. Il est, à ce jour, établi que la perception de soi serait modulable par des interventions centrées sur le toucher.

Dans ce contexte et avec l’appui de recherches en psychiatrie et en psychologie, nous posons la question de la place de l’ostéopathie en tant qu’aide à la remédiation physico-psychique.

Nous avons réalisé le suivi de 40 patientes souffrant de troubles du comportement alimentaire et réparties en quatre sous-groupes de dix sujets non randomisés durant dix semaines afin d’évaluer la valeur ajoutée de l’ostéopathie vis-à-vis de la psychomotricité sur les préoccupations corporelles.

À l’issue de la prise en charge, nous observons une diminution des préoccupations corporelles pour les sujets du groupe psychomotricité (p<0,05) et ceux du groupe de double suivi ostéopathie-psychomotricité (p<0,05). Le groupe ostéopathie ne montre pas d’amélioration suffisante vis-à-vis du groupe témoin (p>0,34).

Les résultats et les limites de la présente étude sont discutés, ainsi que les recommandations pour des recherches ultérieures.

Anorexia nervosa is a psychosomatic disorder that mainly concerns women where body image and corporal sensations are questioned. For these patients, their morphology is an obsessional issue and they tend to ignore sensorial perceptions such as hunger or pain. Treatment remains extremely complex, in spite of the vast expanse of relevant specialities, and a close coordination of soma and psyche mediations is required. In fact, it has been proven that for anorexics, there is a strong link between the image of their degraded body and sensorial disorders. These phenomena also concern the structures of the interceptive system. Therefore, the body's perceived shape is a key issue not only in the pathology but also in the therapeutic intervention. To date, it has been established that self-perception can be modulated by interventions focused on touch. In this context and with the support of research in child psychiatry and psychology, we raise the question of the place of osteopathy as an aid in physico-psychic remediation. Our goal is to develop a therapeutic mediation covering the somatic phenomena induced by the muscular frame so as to demonstrate a possible improvement in how anorexics perceive their own morphology.

We included 40 patients suffering from eating disorders in our experiment forming a heterogeneous age-group and respecting the minimum threshold. During the ten weeks of the trial, the group was divided into 4 subgroups of 10 non-randomized participants each and based on voluntary participation with one subgroup of 10 patients as a control group, one subgroup of 10 patients treated exclusively using psychomotricity, a third subgroup of 10 patients evaluated exclusively using osteopathy, and a fourth subgroup of 10 patients using a mixed approach. We relied on the “Body Shape Questionnaire” (BSQ-34) to conduct our comparative measurements. It is a reference psychometric tool for measuring bodily concerns, and the French version has been validated and is commonly used.

At the end of our ten-week treatment period, we observed positive results for psychomotricity (P < 0.05) and a double osteopathy-psychomotricity follow-up (P < 0.05), but osteopathy alone does not show sufficient improvement compared to the control group (P > 0.34).

In view of the results obtained with our patients, the modulations of bodily concerns among those participants treated by touch appear to be effective in the intra-group, but our approach could require extended treatment for more than 10 weeks with regard to intergroup comparisons. Osteopathy must, like the other bodily mediations already involved in the follow-up of anorexia nervosa before it, establish the extent of its contribution to and value in this pathophysiology.