ARFID: When Eating Becomes a Sensory and Emotional Challenge
You're Not Alone in This Journey
If your child has refused to eat anything beyond plain pasta for years, or if you yourself can only tolerate a handful of "safe" foods without experiencing paralyzing anxiety, please know this: you're not alone, and it's not your fault.
This reality – far from being a simple "picky eating phase" or a "lack of willpower" – has had a name since 2013: ARFID, or Avoidant/Restrictive Food Intake Disorder. And if you're reading this from Paris as an expatriate, international student, or member of the international community, you may be facing unique challenges that make this condition even more isolating.
The numbers tell a compelling story: between 0.5 and 2% of the general population lives with ARFID, with prevalence rates reaching up to 22% among children consulting in pediatric gastroenterology. Unlike anorexia nervosa or bulimia nervosa, ARFID doesn't stem from a fear of weight gain or body dissatisfaction. Rather, it's a complex neurological, sensory, and emotional reality that deserves an approach as compassionate as it is scientific.
As a bilingual dietitian nutritionist specializing in eating disorders in Paris, I regularly support people of all ages confronting ARFID. My approach is progressive, pressure-free, and profoundly respectful of individual sensitivities. Because the goal is never to "force" eating, but to gradually and gently befriend food.
The Expatriate Factor: Unique Challenges for International Patients
Living with ARFID is challenging enough, but navigating this condition while adjusting to life in a new country adds unique layers of complexity. Consider these specific challenges faced by expatriates and international students in Paris:
Cultural food expectations: French culture places enormous emphasis on gastronomy and shared meals. The social pressure to participate in multi-course dinners, try new foods, and appreciate culinary experiences can be overwhelming when you're already struggling with severe food restrictions.
Language barriers in healthcare: Explaining the nuances of sensory aversions, specific food fears, or lack of interest in eating requires precise language. Many expatriates struggle to communicate these complex experiences in French, leading to misunderstandings or inadequate care.
Distance from familiar support systems: Far from family, friends, and healthcare providers who understand your history, you may feel isolated in your struggles. The absence of your usual "safe foods" or familiar meal routines can exacerbate symptoms.
Access to specialized care: Finding healthcare professionals who not only understand ARFID but can communicate effectively in English is challenging. Many international patients have told me they delayed seeking help for months or years simply because they couldn't find appropriate English-speaking care.
Dietary differences: The foods you grew up with may not be readily available in France, forcing you to find alternatives within your already limited repertoire. This can trigger nutritional deficiencies or increased anxiety around meals.
The good news? Specialized, bilingual support for ARFID exists in Paris. You don't have to navigate this alone, and you don't have to struggle through care in a language that isn't comfortable for you.
Understanding ARFID: Beyond Simplistic Appearances
A Disorder With Multiple Faces
ARFID is defined by a persistent disturbance in eating or food intake leading to a chronic inability to meet appropriate nutritional and/or energy needs. But behind this clinical definition lie three distinct profiles that recent research has identified:
The Sensory Profile: These individuals present hypersensitivity to textures, tastes, smells, or appearances of foods. A vegetable puree might trigger uncontrollable gagging, the texture of a banana might be unbearable, the smell of fish might provoke real nausea. This aversion isn't "in your head" – it's neurological.
Recent brain imaging studies show that the brains of people with sensory ARFID process food stimuli differently, activating areas associated with disgust and aversion much more intensely than normal. One international patient described it to me this way: "It's not that I'm being difficult. My brain literally interprets certain textures as threatening or repulsive. It's like asking someone with a spider phobia to hold a tarantula – the fear response is immediate and involuntary."
For expatriates, sensory sensitivities can be triggered or exacerbated by unfamiliar French foods or cooking methods. The strong flavors of French cheeses, the textures of pâtés or terrines, or the visual presentation of whole fish can be particularly challenging for those with sensory ARFID.
The "Lack of Interest" Profile: Some people simply experience no interest in food. They might "forget" to eat, feel no pleasure at mealtimes, and consider eating a necessary chore rather than an enjoyable moment. This disinterest is often accompanied by early satiety and low overall appetite for eating.
For busy expatriates adjusting to a new work culture, this profile can go unnoticed initially – skipping meals might seem like a time management choice rather than a symptom. However, the nutritional consequences accumulate over time.
The Anxious Profile: Here, fear dictates restrictions. Fear of choking (dysphagia phobia), fear of vomiting (emetophobia), fear of allergic reactions, or anxiety related to a past traumatic experience with food. A groundbreaking American study from 2025 reveals that 47% of people with ARFID admitted to residential treatment also presented post-traumatic stress disorder (PTSD), a figure that rises to 60% for those with sensory profiles and 80% for those with comorbid autism spectrum disorder.
This anxious profile can be particularly prevalent among expatriates who've experienced food-related trauma or illness during international travel, creating lasting associations between eating and danger.
These three profiles aren't mutually exclusive – a single person can present characteristics of multiple profiles, creating a unique and complex clinical picture. Understanding which profile(s) you or your loved one presents is crucial for tailoring the therapeutic approach effectively.
The Real Consequences of Restricted Eating
ARFID isn't just "difficulty eating well." The consequences can be significant and multiple:
Nutritionally: Vitamin deficiencies (particularly B12, D, iron, zinc), deficits in essential macronutrients, weight loss or failure to achieve expected weight gain in children, growth delays in the youngest, and in severe cases, dependence on enteral nutrition or oral supplements.
Psychosocially: Social isolation (refusing meal invitations, anxiety during group meals), relationship difficulties (family tensions around mealtimes), impact on schooling or professional life (school or work cafeterias becoming sources of major anxiety), and often very strong feelings of shame or difference.
For international students at American University of Paris or other English-language institutions, ARFID can severely impact social integration. Many cultural and networking opportunities in France center around shared meals, making food restrictions a significant barrier to connection.
Medically: Bone fragility, weakened immune system, chronic fatigue, concentration difficulties, and for children, impact on cognitive and physical development.
A 2024 British surveillance study of 319 newly diagnosed children reveals that anxiety and autism spectrum disorders are the most frequent comorbidities, and that 54.8% of cases improve with appropriate support. This is an encouraging message: ARFID is treatable.
ARFID Across Cultures and Ages
Recent research has begun exploring how ARFID manifests across different cultural contexts. While most studies still center in North America and Europe, emerging data suggests cultural factors significantly shape ARFID's presentation:
Food neophobia variations: Cultural attitudes toward trying new foods vary dramatically. In some cultures, food selectivity in children is normalized; in others (including French culture), it's viewed as problematic, potentially leading to delayed diagnosis or misdiagnosis.
Gender and identity considerations: A 2024 study found that gender-diverse youth with ARFID reported higher weight/shape concerns than cisgender peers, suggesting that identity-related stress may interact with eating difficulties in complex ways.
Age of onset and duration: Research shows ARFID typically begins around age 6.2 on average, but many adults live with the condition for decades without diagnosis or appropriate support. International patients often report that their ARFID went unrecognized until they moved abroad and faced new food-related challenges.
Deconstructing Misconceptions: What ARFID Is NOT
No, it's not a lack of willpower
"You just need to try harder." "It's just bad willpower." These phrases, heard countless times by people with ARFID, reflect a profound misunderstanding of the neurobiological reality of the disorder.
Recent neuroscience research shows that people with ARFID present emotion regulation difficulties comparable to those observed in other eating disorders. A 2024 study using the Difficulties in Emotion Regulation Scale (DERS) reveals that adults with ARFID score significantly higher than non-clinical participants, with a large effect size. Their difficulty managing emotions is no less than that of people with anorexia or bulimia.
Moreover, sensory profiles present real hypersensitivity to food stimuli – their brains process sensory information differently, creating disgust or aversion responses that are absolutely not under voluntary control. Telling someone with sensory ARFID to "just eat it" is like telling someone with a severe allergy to "just try the peanuts." The physiological response is real and involuntary.
For expatriates already managing the stress of cultural adjustment, adding the cognitive burden of "willpower-based" eating strategies can be overwhelming and counterproductive. What's needed isn't more willpower – it's specialized, compassionate support.
No, it's not related to body image
Unlike anorexia nervosa, ARFID doesn't stem from a fear of gaining weight or body dysmorphia. Food restrictions aren't motivated by weight or physical appearance, but by the intrinsic characteristics of foods themselves or by specific fears related to the act of eating.
However, a recent 2024 study nuances this view: among youth with ARFID who are overweight or obese, weight-related concerns can coexist without being the primary cause of the disorder. Similarly, youth identifying as non-binary or gender-diverse present more body concerns. These nuances underscore the heterogeneity of the disorder and the necessity of individualized assessment.
For international patients navigating multiple cultural perspectives on body image – from their home culture, French culture, and global media – these intersecting concerns require sensitive, culturally-informed care.
No, ARFID doesn't only affect children
While often diagnosed in childhood (average onset age: 6.2 years according to some studies), ARFID can persist into adolescence and adulthood. Many adults live with this disorder for decades without ever receiving diagnosis or appropriate support.
The observed incidence in the United Kingdom and Ireland is 2.79 per 100,000 children and adolescents, slightly higher in boys (2.98) than girls (2.58). However, adult ARFID remains significantly underdiagnosed, particularly in international populations who may attribute their eating difficulties to cultural adjustment rather than a treatable condition.
One American patient in Paris told me: "I'm 35 years old. I thought I'd just been a 'picky eater' my whole life. It never occurred to me this was a disorder with a name and treatment options. When I moved to Paris and couldn't find my safe foods, everything fell apart. That's when I finally sought help and got my ARFID diagnosis."
Taking Action: Toward a Progressive and Compassionate Therapeutic Approach
The Central Role of the Specialized Dietitian
In ARFID management, the specialized dietitian nutritionist plays a pivotal role. My approach structures itself around several complementary axes:
Comprehensive nutritional assessment: Precisely identifying existing deficiencies, evaluating current intake without judgment, understanding the person's "safe food" repertoire, and establishing an objective assessment of nutritional needs to address.
For international patients, this assessment includes understanding which of your usual safe foods are available in France, which need substitutes, and how to navigate French food labeling and grocery shopping.
Exploring individual mechanisms: Is it primarily sensory? Anxious? Related to lack of interest? This fine understanding of mechanisms allows for personalized adaptation of the therapeutic approach.
Progressive food repertoire expansion: No rushing, no pressure. We work in stages, using techniques like "food chaining" which consists of starting from an accepted food and progressively creating "links" with similar foods.
For example, if someone tolerates plain pasta, we might progress to pasta with a drizzle of olive oil, then with dried herbs, then with a light sauce, etc. Each step respects the person's pace and builds confidence progressively.
For expatriates, we might use food chaining to bridge between familiar foods from your home country and similar French alternatives, making the local food environment more accessible while respecting your nervous system's needs.
Gradual sensory exposure: Inspired by exposure therapies used in psychology, this approach consists of progressively exposing the person to avoided foods, beginning with non-food interactions (looking, touching, smelling) before considering tasting. This exposure hierarchy respects everyone's rhythm and significantly reduces anxiety associated with new foods.
One British patient described her progress this way: "We started by just having carrots on the table during sessions – not eating them, just being near them. Then touching them. Then smelling. It took six weeks before I felt ready to try a tiny bite. That might sound slow to others, but for me, it was revolutionary. I'd avoided carrots for 20 years."
Progressive desensitization: For sensory profiles, we work on gradual habituation to textures, tastes, and smells. This can involve sensory games, adapted cooking workshops, or mindful eating exercises.
Family psychoeducation: Especially for pediatric ARFID, parental support is essential. Understanding that forcing a child to eat is counterproductive, learning to create a positive environment around meals, knowing how to recognize small progress and validate it – all of this is an integral part of care.
For international families, this includes navigating French school lunch programs, communicating with teachers who may not understand ARFID, and managing cultural expectations from extended family back home who might not comprehend the disorder.
A Necessarily Multidisciplinary Approach
ARFID often requires close collaboration between several professionals:
The psychologist or psychotherapist: To work on specific fears (emetophobia, choking phobia), past traumas related to eating, or emotion regulation difficulties. Cognitive-behavioral therapies (CBT) adapted to ARFID show promising results.
Finding an English-speaking therapist in Paris who understands ARFID is crucial for effective treatment. The ability to express subtle emotional experiences related to food in your native language makes a significant difference in therapeutic outcomes.
The speech-language therapist: Particularly for associated oral-motor difficulties, mastication or swallowing issues.
The occupational therapist: To work on sensory and motor aspects of eating, especially in children.
The general practitioner or pediatrician: For medical follow-up, deficiency assessment, and exclusion of organic pathologies that might contribute to eating difficulties.
The gastroenterologist: If gastrointestinal symptoms are present (reflux, functional digestive disorders), as these symptoms can be both a cause and consequence of ARFID.
For international patients, I often serve as a coordinator between these various specialists, ensuring clear communication across language barriers and cultural differences in healthcare approaches. The French medical system can be complex to navigate, and having a bilingual professional who understands both the clinical and cultural aspects makes accessing comprehensive care significantly easier.
Promising Therapeutic Innovations
Research on ARFID is evolving rapidly. Among emerging approaches:
Adapted Family-Based Therapy (FBT): Inspired by protocols used for anorexia, this approach actively involves the family in the therapeutic process and shows encouraging results, particularly for all three ARFID profiles.
For expatriate families, FBT can be modified to address cultural differences between parents' expectations (often influenced by their home culture) and the realities of raising children in France.
Specific cognitive-behavioral protocols: Protocols like CBT-AR (Cognitive-Behavioral Therapy for Avoidant/Restrictive Eating) are developing with modules adapted to each profile (sensory, anxious, lack of interest).
Playful approach and food reparenting: Particularly effective in children and adults with a history of childhood ARFID, this approach consists of "relearning" to play with food, exploring foods in an unconstrained and joyful way. I've developed a specific approach 📚 on playful food therapy that can complement traditional dietary management.
Interoceptive exposure: Newer approaches focus on helping people with ARFID become more comfortable with internal sensations associated with eating – hunger cues, fullness, digestive sensations – which can be particularly dysregulated in this population.
Hope: Recovery Is Possible
Encouraging Data
Recent studies offer a message of hope: ARFID isn't a life sentence. The 2024 British meta-analysis shows that 54.8% of diagnosed children improve with appropriate support. Other research emphasizes that early intervention and a multidisciplinary approach are key success factors.
For adult international patients, recovery is equally possible, though it may require more time given the duration you've lived with ARFID. However, many of my expatriate patients report that the distance from their home environment and family dynamics actually facilitates change, allowing them to rebuild their relationship with food on their own terms.
The Recovery Journey: Realistic Steps
Phase 1: Recognition and acceptance (variable duration)
Understanding it's a legitimate disorder, not a character flaw
Identifying your own mechanisms (sensory, anxious, lack of interest, or mixed profile)
Accepting the need for professional help
For expatriates, this phase may include grieving the idea that moving to France would "magically" resolve your eating difficulties, and acknowledging that specialized support is both necessary and available.
Phase 2: Nutritional stabilization (generally 2-6 months)
Ensuring adequate intake with current "safe" foods
Addressing identified deficiencies (through supplementation if necessary)
Creating a secure and predictable food environment
We work to identify French equivalents of your safe foods, establish reliable shopping locations, and create meal routines that accommodate both your ARFID needs and your lifestyle in Paris.
Phase 3: Progressive exploration (6-24 months, sometimes longer)
Very gradual introduction of new foods
Work on sensory exposures
Development of strategies for managing food anxiety
Celebration of every small progress
This is often the longest and most challenging phase, but also the most rewarding. One Australian patient told me: "After 10 months of weekly sessions, I tried a strawberry for the first time in 18 years. I cried. My dietitian cried. It wasn't about the strawberry – it was about proving to myself that change was possible."
Phase 4: Consolidation and autonomy (variable duration)
Continued expansion of food repertoire
Improvement in food flexibility
Development of a more serene relationship with eating
Maintenance of gains and relapse prevention
These phases aren't linear – there can be back-and-forth movements, periods of stagnation, and that's normal. The important thing is maintaining a compassionate approach and never blaming yourself.
For expatriates, recovery may include learning to enjoy aspects of French food culture that initially felt threatening, participating more comfortably in social meals, and perhaps even finding unexpected pleasures in culinary exploration.
Stories of Hope from the International Community
"I'm a 28-year-old American who moved to Paris for work. I'd lived with ARFID since childhood without knowing it. I only ate pasta, rice, and chicken. After 18 months of support with a bilingual dietitian and an English-speaking psychologist, I've been able to progressively add vegetables, then fruits. I'm not 'cured,' but my life has changed. I can now go to restaurants without panic, and I've discovered the pleasure of tasting new flavors. More importantly, I no longer feel like a failure for struggling with food. I understand it was never about willpower – it was about neurobiology and needing the right support." – Thomas, American expatriate in Paris
"My 9-year-old daughter was only eating 5 different foods when we moved from London to Paris. Between the stress of relocation and her ARFID, mealtimes were a daily nightmare. Finding an English-speaking dietitian who understood both ARFID and the challenges of being a British family in France was life-changing. Thanks to compassionate, pressure-free care, she's gradually expanded her eating. Two years later, she eats about 20 varied foods and continues to progress. Most importantly, she's regained her smile at the table and is thriving at her international school." – Sophie, mother of Léa, British family in Paris
"As an international student from Japan studying at Sciences Po, I struggled silently with ARFID for two years before seeking help. The combination of academic pressure, cultural adjustment, and severe food restrictions left me exhausted and malnourished. Working with a team that included a bilingual dietitian and a therapist who understood both eating disorders and cross-cultural issues transformed my experience. I'm now in my final year, eating a much more varied diet, and most importantly, I've connected with other international students through food rather than avoiding social situations. Recovery isn't linear, but it's absolutely possible." – Yuki, Japanese student in Paris
For International Patients: Navigating Healthcare in France
Understanding the French System
The French healthcare system can be complex, especially when seeking specialized eating disorder care. Here's what you need to know:
Social Security (Sécurité Sociale): As an EU citizen, student, or long-term resident, you likely have access to French social security, which reimburses a portion of medical consultations. Dietitian consultations may be partially reimbursed if prescribed by a doctor (parcours de soins).
Complementary insurance (mutuelle): Most French residents have additional private insurance that covers the portion not reimbursed by social security. Check your policy for coverage of dietitian consultations and potential support for eating disorder treatment.
Direct payment and reimbursement: Unlike some healthcare systems, French specialists often require direct payment at the time of consultation, with reimbursement following. I accept various payment methods and can provide documentation (feuille de soins) for reimbursement claims.
Video consultations: For international patients who travel frequently or prefer remote care, I offer video consultations via secure platforms. This ensures continuity of care regardless of your location.
Finding English-Speaking Support Networks in Paris
Beyond individual therapy, connecting with other English speakers facing similar challenges can be invaluable:
Support groups: I facilitate periodic support groups for international patients with ARFID, providing a safe space to share experiences in English without judgment.
Online communities: Several international eating disorder support communities operate in English, offering peer support and resources.
School counselors: Many international schools in Paris (American School of Paris, British School, etc.) have counselors familiar with eating disorders who can provide additional support and accommodations.
📚 For comprehensive information on support networks, see my English-Speaking Resources Guide
Conclusion: A Human Approach to a Complex Challenge
ARFID is far more than an "eating disorder" – it's a neurological, sensory, and emotional reality that profoundly impacts the daily lives of those who experience it. Contrary to common misconceptions, it's neither a whim, nor a lack of willpower, nor a trend. It's a legitimate disorder that deserves recognition, understanding, and specialized support.
Science is advancing: we better understand the mechanisms, we're developing more effective therapeutic approaches, and the data clearly shows that recovery is possible. But beyond numbers and studies, it's the human approach that makes the difference: compassion, patience, respect for individual pace, and the complete absence of judgment.
If you or a loved one is affected by ARFID, know that you're not alone. Specialized help exists, in your language, and every small step counts. The goal isn't food perfection, but a more serene and free relationship with eating.
For international patients in Paris, remember: the distance from home, the cultural challenges, and the language barriers you're facing are real obstacles – but they're also surmountable. With appropriate support, many expatriates and international students find that their time in France becomes an opportunity for healing and growth they didn't expect.
Living and eating are two sides of the same coin. Lighten your relationship with food and free yourself from what hinders you.
Contact and Appointments
I consult in Paris (6th and 20th arrondissements) and Le Raincy, with video consultation options to facilitate access to care for international patients.
📞 Phone : +33 6 22 41 55 21
💻 Online booking : Doctolib - Alexis Alliel
Professional information:
RPPS: 10007258733
ADELI Number: 75 95 0878 1
Languages: Consultations available in English and French
📚 To Learn More
Related Articles on This Site:
Resources and Associations:
ARFID Awareness UK - UK-based ARFID support and resources
National Eating Disorders Association (NEDA) - US-based resources
Phobie Alimentaire - French ARFID association (some English resources)
FFAB - French Eating Disorders Federation - Directory of specialized professionals
SOURCES INSERT
Medical and Scientific Sources
Recent Scientific Publications (2024-2025):
Kambanis, P.E. & Thomas, J.J. (2025). "Advancing the Science of Avoidant/Restrictive Food Intake Disorder (ARFID): Six Key Questions." International Journal of Eating Disorders, 58(6), 1001-1007.
Synthesis of 6 key questions in current ARFID research
Analysis of 30+ articles on mechanisms, diagnosis, and treatments
Highlights critical gap in understanding ARFID across diverse cultural contexts
Brewerton, T.D. et al. (2025). "Avoidant restrictive food intake disorder, traumatic events and PTSD in adolescents and adults admitted to residential treatment." Journal of Psychiatric Research, 187, 174-180.
47% of ARFID patients present comorbid PTSD
60% for sensory profile, 80% with comorbid ASD
Link between trauma and ARFID development
Presseller, E.K. et al. (2024). "Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults." International Journal of Eating Disorders, 57(11), 2143-2155.
Validation of NIAS on 9,148 participants
Possible overlap between ARFID and body-image-driven eating disorders
Jhe, G.B. et al. (2024). "Weight/Shape concerns in youth with Avoidant/Restrictive Food Intake Disorder (ARFID)." Eating Disorders, 33(5), 651-665.
Body concerns among youth with ARFID and overweight/obesity
Higher concerns in gender-diverse youth
Challenges traditional ARFID definition assumptions
Willmott, E. et al. (2025). "Considering a Functional Conceptualisation of Avoidant/Restrictive Food Intake Disorder: A Systematic Scoping Review." European Eating Disorders Review, 33(4), 730-750.
Systematic review of 25 references
Proposal for functional conceptualization of ARFID
Bottom-up approach identifying 6 conceptualization categories
Haidar, E. et al. (2024). "Incidence of avoidant/restrictive food intake disorder in children and adolescents across the UK and Ireland: a BPSU and CAPSS surveillance study." BMJ Open.
First UK and Ireland incidence study
319 diagnosed cases, incidence of 2.79/100,000
54.8% improvement at 1-year follow-up
Most common comorbidities: anxiety and ASD
Duffy, F. et al. (2024). "Difficulties in Emotion Regulation in Avoidant/Restrictive Food Intake Disorder." International Journal of Eating Disorders.
Adults with ARFID show significantly higher emotion regulation difficulties
Large effect size (d = 0.87) compared to non-clinical participants
Comparable difficulties to other eating disorders
Zickgraf, H.F. et al. (2025). "Toward a Specific and Descriptive Definition of Avoidant/Restrictive Food Intake Disorder: A Proposal for Updated Diagnostic Criteria." International Journal of Eating Disorders.
Proposes updated, more specific ARFID diagnostic criteria
Addresses confusion in current DSM-5 definition
Aims to enhance research through more homogeneous samples
French Official Sources:
Feillet, F. et al. (2020). "Risques nutritionnels des troubles d'alimentation sélective et/ou d'évitement (ARFID)." Perfectionnement en Pédiatrie, French Society of Pediatrics Nutrition Committee, 3, 40-45.
French pediatric recommendations on ARFID
Systematic evaluation recommended in consultation
Prevalence up to 3% in general population
Micali, N. et al. (2019). "ARFID - Trouble de restriction/évitement de l'ingestion d'aliments." Revue Médicale Suisse, 638, 394-398.
Presentation of DSM-5 criteria
Illustrative clinical cases
Heterogeneous disorder requiring individualized assessment
International Associations and Resources:
ARFID Awareness UK - www.arfidawarenessuk.org
UK-based ARFID support and awareness organization
Patient and family resources
National Eating Disorders Association (NEDA) - www.nationaleatingdisorders.org
US-based eating disorders resources
ARFID-specific information and support
Phobie Alimentaire - www.phobie-alimentaire.fr
French ARFID association with some English resources
Community support and information
Vivre et manger sont les deux faces de la même pièce
Lighten your relationship with food and free yourself from what hinders you!
+33 6 22 41 55 21
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RPPS : 10007258733
N° ADELI : 75 95 0878 1