Ameli reclassifies myalgic encephalomyelitis and chronic fatigue syndrome

Myalgic encephalomyelitis, also known as chronic fatigue syndrome, is affected by the change. France’s Health Insurance body has altered the category assigned to the condition on its Ameli website. More than 200,000 adults in France are affected.

From now on, appointments should no longer result in “nothing”. On the Ameli government website, run by France’s Health Insurance body, chronic fatigue syndrome - known as myalgic encephalomyelitis - is no longer classified as a psychiatric or psychological disorder. Although French authorities had identified at least 200,000 French adults with the condition, in 2026 it was still a disease often attributed to something “in the head”.

Since 6 August, as France Inter has just reported, Ameli’s page on myalgic encephalomyelitis has included updated information, particularly concerning its cause.

It now states that “its exact cause remains unknown. In most cases, the illness begins after an infection, often viral. It has been observed following infections with the Epstein-Barr virus, other herpesviruses, cytomegalovirus, enteroviruses or coronaviruses. It may also be triggered by a range of events (surgical operation, exposure to toxic substances, trauma or disturbances to the immune system).”

The Health Insurance body also clarifies the figure of 200,000 French adults on the same page. These figures date from before the pandemic and “the number of people affected may have increased sharply since then”, although “there is currently no national epidemiological study”. Ameli notes that women are primarily affected and that chronic fatigue syndrome occurs among people “of all ages and all social backgrounds, including children and adolescents.”

All symptoms updated on the Ameli website

As well as the uncertain causes of the condition, the syndrome has numerous symptoms, making diagnosis more difficult. The foremost symptom is “profound, disabling fatigue, chronic for several months, unexplained and not relieved by rest and sleep”. This initial symptom leads to the following consequence: “the fatigue is accompanied by a major reduction in leisure, work, family, physical, cognitive and other activities.”

Other signs of myalgic encephalomyelitis include cognitive difficulties, such as memory problems, trouble concentrating, brain fog and even difficulty remaining upright. Indeed, being in this position can worsen the symptoms of the illness. Ameli also lists other potential issues, including heart palpitations (tachycardia), flu-like symptoms, muscle and joint pain, and headaches. Frequent urination, increased sensitivity to noise and light, and digestive problems may also occur.

No more “do some exercise so that you feel much better”

Speaking on France Inter, Pietro Tomé, president of Afemise, the French myalgic encephalomyelitis association, said this institutional recognition represents a real step forward for patients. They had often been advised to “do a little sport, a little effort and a little meditation” so that they would feel “much better”. In a statement published on its website on 8 August, the association said that the Health Insurance body “recognises in particular post-exertional malaise as a central symptom, the different levels of severity, the importance of pacing [energy management] and the risks associated with graded exercise programmes.”

It remains to be seen how this illness will be managed in the workplace. Until now, patients have had to take sickness absence. Yet, as the Ameli website acknowledges in the summary of its chronic fatigue syndrome page, there is currently no treatment capable of curing the condition; therefore, “an adapted activity rhythm” will need to be established, “with help in daily life”.