Anorexia

1. Some of us are just unhappy in our own skin, and that is where eating
disorders like anorexia start. Anorexia is a starving disorder whereby victims
choose not to eat because they believe they do not look the way they should
or the way they imagine they would be satisfied with. It is a deadly disease
that can affect a person in many different ways physically, mentally and
emotionally--eventually ending life if the victim does not receive help.

Force-Feeding

2. Choosing not to eat implies losing control of the right to feed oneself. It is
equivalent to attempting to commit suicide. Force-feeding means inserting a
feeding tube through the nose or mouth into a person's esophagus to give
them nutrients and, generally against their will at first (hence "force"), prevent
starvation and enable them to regain lost weight.

Why Is Force-Feeding Necessary?

3. Force-feeding is necessary in anorexia patients because they are

threatening their own life with a slow form of suicide. After going without food
for so long, the body begins literally to consume itself in its search for
nutrients. To prevent long-term injury or death, it is time for someone to step
in and help.

An article from the Scotsman describes the Mental Welfare Commission's

rules on when anorexics need force-feeding (see Resources).

Anorexia and Mental Health

4. Emotional and psychological issues help answer why a person has this
disorder in the first place. Anorexia reflects a person's self-esteem, and it is
considered a mental illness. When victims have to be force-fed, emotional
and mental stress like depression, anxiety and even suicidal thoughts
compound the condition. The reason patients go through these feelings is
that they feel they are being forced to "become fat" again. Self-esteem is a
powerful thing, and when individuals believe that they are fat or unattractive,
making them change their behavior is quite a blow to their mental health.

A person wanting or needing help has a number of options:

1. Counseling/Therapy
2. Hospitalization
3. Group Meetings
4. Family Support
For more information on treatments, see HelpGuide.org in Resources.

Role of Mental Health Therapy

5. Mental health therapy plays a significant role in healing a patient that has
been force-fed and being anorexic. Therapy will help the patient get through
force-feeding and overcoming the disease in the long run, but it is not an easy
road to travel. Epigee.com states that more than 60 percent of people who
suffer from anorexia can fully recover with treatment, and 20 percent of those
people will get better--but they still struggle. That is why therapy is so
significant for someone who is being force-fed. Therapy can make these
patients get through the storm and be one of the 60 percent who succeed.

• Anorexia Nervosa is an eating disorder defined as

severe, self- inflicted starvation and loss in body
weight to at least 15% below that expected for the
individual’s sex and height. In the UK (and many
other western countries) anorexia nervosa is classified
as a mental illness. Anorexia nervosa should not be
confused with Bulimia (cycles of bingeing and
vomiting). Anorexia is typically associated with
women and body image and is thought to be made
worse by unrealistic media portrayals of the female
body. Having said this, one in ten sufferers is male.
Mortality varies between 5% and 18%. Anorexia
nervosa has been detected in patients from 6 to 76
years of age and has a far higher incidence in the
Developed World, affecting 1% of female
adolescents.Patients who are dangerously thin are
sometimes force-fed through a naso-gastric (through
the nose) tube. Normally, medical treatment cannot be
administered without the consent of the patient,
 however, in the case of mentally ill patients, their
distorted perceptions of reality may render them
unable to make a choice. Despite this, medical ethics,
pragmatics and human rights call the treatment into
question.
Doctors get right to force-feed anorexic patients Glenda
Cooper, Social Affairs Correspondent
Doctors are legally entitled to force- feed anorexic patients to stop them from

dying, according to guidelines from the mental health watchdog.

The Mental Health Act Commission has for the first time prepared guidance for health
authorities and social services because of confusion over how far doctors can go to stop
patients from starving to death.

The legal position has not been clear and the commission took the decision to issue the
briefing note after the case of Nikki Hughes, who died in January 1996. Ms Hughes had
suffered from anorexia since her teens.

The Royal Shrewsbury Hospital, where she was treated, sought legal advice and was told
that feeding her without her consent could have led to assault charges. Doctors were told
they could not override her wishes not to eat.

In 1992, however, the High Court ruled that a 16-year-old orphan, known as "J" should
not be allowed to starve herself to death, but could be treated against her will to prevent
her suffering serious brain damage.

The commission's briefing note advises doctors that in certain situations, patients with
anorexia nervosa, whose health is seriously threatened, may be compulsorily admitted to
hospital.

While "the consent of the patient should always be sought", it goes on to say that some
patients "may not be able to make an informed choice as their capacity to consent may be
compromised by fears of obesity or denial of the consequences of their actions".

It adds: "The courts have ruled that feeding a patient by artificial means to treat the
physical complications of anorexia nervosa can reasonably regarded as medical treatment
for a mental disorder."

The move was welcomed by mental health experts and by pressure groups representing
sufferers. A spokeswoman for the Eating Disorders Association said: "Any guidelines
which help people interpret the Act surely must be good to clarify the situation for
people."

Dianne Jade, principal and founder of the National Centre for Eating Disorders, said: "I
have always approved of compulsory treatment for anorexics. In the condition the
thinking processes in the brain are changed by starving and the patient is not in control or
able to take care of herself."

Dr Jill Welbourne, an eating disorder specialist, said that it was a "step forward" for
treatment of anorexics. "It explains that anorexia is a mental illness, health and safety is
at risk and that voluntary treatment is not always possible or practicable."

June McKerrow, director of the Mental Health Foundation, said: "It makes the position
clearer for clinicians and carers." But she called for anorexics to have access to treatment
much earlier in their treatment: "Anorexia is a growing problem and unless ways of
treating people are sorted out we will see more and more people reaching this
unnecessary late stages of crisis."

As many as one in 20 people, of which the vast majority

are women, display symptoms of anorexia, although
most are never formally diagnosed. About one sufferer
in 100 needs long-term treatment, and of these one-fifth
die, half from starvation and half from suicide.

• If we decide that people have a right to prevent the suicide of other people, then it
naturally follows that an anorexic who will no longer eat would be forced to
receive nutrition through whatever means doctors deem prudent.

As a society, we have made that decision. The only time you can be admitted to a
psychiatric hospital against your will is when you're considered a danger to others
or to yourself (here in California, it's called a 5150). Policemen talk jumpers down
from high buildings and place nets to break their fall. Someone with a gun to their
head is told to put the gun down. And, thus, doctors who encounter an anorexic
who is literally starving him or herself are obligated to try to help.

Is that right, on a cosmic or moral level? I'm not sure. Maybe if someone wants to
die, we should let them. But I do know that without these laws, my mother would
not still be alive, most likely. And, depression now under control, she's had many
happy years and is now at a point where she feels at peace with the universe.
Should society have given in to her short-sightedness, let her destroy a perfectly
good life, and put the proverbial knife back in her hands?
 I don't think so. And I think doctors are perfectly justified in trying to keep an
anorexic from doing the same thing, by other means.

Anorexia has a component of mental illness. Like other mental illnesses, the illness can
cause poor judgment which can then cause the patient to resist treatment. Also, anorexia
can often strike the young, whom older family members have an obligation to nurture and
protect. In some cases, involuntary treatment may be necessary in order to bring the
patient back to a mental and physical state in which they can make sound decisions, just a
parent may force a child to take a medicine that they would prefer not to take. If a person
refuses food and has been diagnosed with anorexia, then they are, by definition, a "risk to
themselves".

This said, the mere idea gives me the shudders. It borders on a violation a civil rights. On
the other hand, watching a beloved family member grow ill and die and deciding not to
help when we are aware of the cause and the cure is readily available, also give me the
shudders.

I do believe that family members need more resources, including access to authority to
enforce involuntary treatment, with checks and balances, of course, to help their mentally
ill family members, such as anorexics and schizophrenics.

It's a horrible choice, and a slippery, slippery slope.

• I think it's ridiculous and shows authority of the state over the individual. Have
you ever seen them grab an extremely overweight person, lock him or her up, and
starve them down to a "healthy" weight? No, because they'd be up in arms about
it. But watch someone stop eating and fall below a healthy weight (rather than
above) and here come the body police. Whose body is it, anyway? It's sick.

I've seen them force feed protestors, whose entire point was to draw attention to
their cause. I don't care how many times someone says it's in that person's best
interest - it's about control.
• I think if they are hospitalized and are in danger of dying and can barely sustain
life, then it is the duty of the doctor to keep them alive, they would use a feeding
tube. It is a slow suicide, and that is something that we can not sit back and allow.

But on the flip side, Anorexia is a serious disorder and force feeding them is not
going to fix the root of the problem. It goes much deeper than food, starvation just
so happens to be their drug of choice. There are deep underlying issues that can
need to be worked out , they need counseling, maybe even a treatment center. If
parents are yelling at their daughter to eat , it is not going to make her "non-
anorexic"
•