People are often conscious of their body image especially in this era when wellness and a healthy lifestyle is a concern. Fitness centers, spas, dance clubs and diets are popular since men and women alike search for various ways to be physically fit. H…

I found your entry interesting do I’ve added a Trackback to it on my weblog …

I’m sorry this woman died. Yes, this is sad, and yes, it would have been wonderful if she could have gotten meaningful treatment and recovered. Do I think that this woman could have been better served by the professionals in her life? Yes. The care she did receive sounds pathetic at best. But I just don’t think it’s ok to make the leap from this story to the idea all patients with EDs should be forced into treatment, fed against their will, or tied to a bed so they can no longer exercise.

There are many people with EDs, myself included, who are more than capable of participating in their own treatment without having been weight restored and through a forced course of recovery for 12 months. This kind of statement again does a real disservice to ED patients who, surprisingly, do vary from one to the next. Yes, anosognosia is a feature of AN. Yes, patients often have a hard time recognizing or appreciating how ill they are. But that does not mean that they cannot ever recognize this. Nor does it mean that they cannot participate in treatment. And every individual’s insight and ability to participate in treatment is considerably different.

And your analogy to MR has a number of flaws. People with MR vary greatly in their ability to make their own decisions and to care for themselves. Many of them are perfectly capable of functioning on their own and are quite mentally competent to make their own decisions. Like the commentator above said, they form intimate relationships, have meaningful careers, function quite independently and make meaningful contributions to society. I really am disturbed at your assumptions that all people with MR should have their decisions made for them. And then to suggest that we should use the shoddy institutionalization and treatment of people with MR as a model for ED treatment is really chilling. There has been little to applaud in the treatment of people with MR.

Do I have an answer to the problem of adult patients with anorexia who refuse treatment? No. I think it’s a very, very hard situation. But I think automatically assuming people with EDs (or people with any other disability) are incapable of making informed decisions and should have their treatment determined for them is an extremely dangerous position to take. The truth is that I would rather live in a society where some patients with EDs, despite the best attempts of professionals to encourage them into treatment and provide them with evidenced based information about their illness, refuse treatment and die, than to live in a society where someone has the authority to one day decide that I am incompetent solely because of a diagnosis and that I should be strapped to a bed and plied with tubes.

We allow people with treatable illnesses such as diabetes to make the decision to refuse treatment and die if they so choose. And I really think that people with EDs deserve the same dignity. I understand that treatment refusal is a characteristic of EDs and may be symptomatic, not reflective of the person’s actual wishes. But this to me doesn’t mean forced treatment. It means we need to give people with EDs the full range of available information about their illness and make significant and very intensive efforts to help them engage in treatment, and if in the end, they do not, we need to respect that.

And honestly, I’m just really, really tired of the constant infantilization of people with EDs.

Thanks for your response. I appreciate you correcting me about people with MR. I have not worked with this population, so I am not well informed about their capabilities.

I would presume that it really isn’t fair to generalize about all people with MR like I did in my post. Some people with MR can form intimate relationships; others cannot. Some can have careers; others aren’t able to. Some can live independently, and others need life-long assistance. And what constitutes “contributions to society” is subjective.

I had no intention of short-changing people with MR in this post, so I am very sorry that I came across that way. My point was simply to compare two groups of people (AN ad MR) who have special needs resulting from biologically-based brain conditions, and point out the discrepancies in how society views and treats these two groups of people.

I guess eliminating the phrase “unlike people with MR,” or substituting it with “like many individuals with MR,” would have made my point well enough without being inaccurate or insulting.

Thanks again for your post and your corrections.

Yes, I have read “Slim to None.” What a horrible story. Unfortunately, you’re right – death certainly seems preferable to such bad treatment.