To ask someone to explain to me a little more about anorexia?

[weetus]

I'm just watching a documentary on Amazon prime called 'Emma wants to live'. It's a documentary about a young girl with anorexia that sadly dies. She films parts herself and states that she knows the documentary will end in one of two ways - her recovery or her death.

I am watching it a little bit gobsmacked - one picture shown of her really, really shocked me.

So I may be being ignorant here but I have to ask why wouldn’t they put a tube down her throat and hold her in a psychiatric treatment unit undergoing intense psychological treatment. I still don’t get why they can’t do that? Like if I went to the hospital and claimed I was going to kill myself I would be held until I was deemed safe to leave. So these poor people with anorexia are just committing suicide slowly. Don’t understand why more can’t be done.

In this documentary it seems to me as if they had explored all avenues of treatment and she could not be saved, however, surely she could have been saved had she been tube fed? I imagine that would be a horrible experience for anyone suffering from anorexia but if the alternative is death then surely it is necessary?

I hope I don't cause offence but I genuinely just wanted to know why this is the case as I am sure there is more to it.

I don't know the answer but I'd be interested to see what others say. I'd probably equate anorexia more with killing yourself by abusing drugs rather than outright committing suicide and I suppose we don't force people abusing drugs to detox.

Tube feeding wouldn't fix the underlying issues. It would likely be experienced as a violation and impede recovery. It would impact on the relationship between HCPs and the person suffering.

Also human rights are a thing.

If it were as simple as just feeding someone, we wouldn't still be losing people to anorexia.

I think more funding for mental health would be a good start.

tube feeding would only make her gain weight - you can't legally imprison someone for not eating and at some point she would be released - with all the issues that make her anorexic still untreated.

It's a very very complex disease - in my case I just enjoyed feeling hungry and felt like I had no will power if I gave in to the pain - utterly idiotic but there you go

When my weight was low 6,10 I was told if I didn't go voluntarily to a psychiatric hospital I would be sectioned in the 80s.
Perhaps this had been tried before to no avail.It is a complex illness that takes a real hold.Ive been there twice.

also we live in a society that values thin look at all the threads here about obese people being a drain on society, unhealthy, fat kids, fat husbands and the oh so wide eyed threads with people moaning about being 'so fat' at 5ft 7" and a size 8

I was a size 4 and under 6,5 stone, I chain smoked and didn;t eat - but lots of people would judge me as healthy based on my size

@ghostyslovesheets not idiotic at all - it's a mental illness, there is no rationale behind the thinking.

You overestimate the mental health care in this country. I knew a young person who was suicidal and was admitted into hospital. He absconded due to severe anxiety issues and withdrawal from drugs. He was returned then assessed by a psychiatrist and not found to be a danger to himself. Less than 6 months later he was dead.

All the same points were made on the thread about Nikki Grahame's sad death. Strapping down a traumatised person and force feeding them does absolutely nothing for their mental health nor the underlying cause of the disorder in the first place.

My sister died of eating disorder. She was 21. Realistically the services for eating disorder recovery are abysmal unfortunately-that's not a dig at staff at all but at the actual services available. ED isn't about weight but they are complex disorders and realistically early and rigorous intervention with CBT is generally regarded as the best possible road to recovery from ED. That's not it alone but that is the best possible starting point if that makes sense.
One of the main obsticles (not sure if I've spelled that right) is the length of the wait to be seen. Very often this is a very long wait so the illness is more progressed. I'm in NI and my sister was diagnosed as a teen and CAMHS were woefully unprepared for dealing with ED. The physical aspect is really only one side, so although technically speaking you could put a tube down someone's throat, it's sort of like putting a sticking plaster on a gaping open wound. We need to address the psychological aspects of the illness in tandem with dealing with the physical aspects. It puts massive strain on internal organs.
Now I'm no expert at all and I'm sure this could be much better explained by a medical professional but that's to give you a bit of an idea. It's a horrific illness and as it stood three years ago there was a 20 per cent morality rate with the illness which is massive.

The problem with tubes is they can be pulled out. Unless you restrain or sedate the person almost constantly (which has ethical issues) then it can only be done with the person's consent.

Honestly, it's because there aren't enough beds available in ED units - they're incredibly expensive. You can be close to death and still not get a bed as there's a finite number, and unless their heart stops you can't really call 999 and get them admitted to A&E.

It's an absolute disgrace that this country won't fund more beds.

Is it set in the US? There are different protocols in different states and countries. Here treatment is generally very poor and often treatment providers require patients to ‘buy into’ treatment when they’re far too sick. A state called Anogsognosia exxists which means people can’t recognise how ill they are.

Patients can be sectioned and tubed, sadly it’s often far too late and treatment also ends too quickly- as soon as a certain amount of weight is gained it’s stopped. Treatment relies too heavily on scale weight, only full and prolonged nutritional rehabilitation will reverse the effects of starvation and this is years not weeks or months. Full nutrition, possibly anxiety medication and therapy if needed (it’s not always)

A complicated illness, a brain based biological disease. The U.K. has a lot of catching up to do in terms of knowledge and the NHS is stretched.

Often people are extremely sick before they can access treatment and physical and mental decline can be rapid.

Because even when you are being fed with an NG tube, you can throw it up.
If a person is determined not to take on calories, they will always find a way. Sadly, anorexia has one of the highest rates of death, of the mental health areas, and can reoccur years later, if triggered.
You don't just outgrow it with age, it happens with senior citizens a lot too.
It is a strange struggle of self control, between what you know, and what you feel and think.
No one else can make you better, and that is a lot of pressure.

Vegcheeseand crackers I am sorry about your sister.

Eating disorders are a psychological condition with physiological outcomes, in a similar way to depression and self injury. You can stick a plaster on the wound but it doesn't solve the problem why it is there in the first place.

Tube feeding is sometimes used when it is an immediate life or death situation but without the patient's consent, it will impede recovery greatly. Many people suffering from AN suffer delusions and control over what they eat is a huge component of the disorder. Taking this away by tube feeding is deeply traumatic and will make the therapeutic relationship between the staff and patient much more tough to develop.

@WitchisDead that's awful! Poor guy . Yes you're right I am overestimating the help and I also agree that pinning someone down and feeding is not getting to the core of the problem.

I feel like I will be heavily flamed for saying this but I will. I have a 7 year old daughter and I feel like if she had anorexia, I would literally sit on top of her and force feed her and stop her from exercising. I really wouldn't care how much emotional stress that caused her as I would rather that than her dead. That may sound awful and totally ignorant but I just can't imagine allowing my daughter to waste away before my eyes, I just don't think I'd physically be able to allow it to happen.

I'm not for one second blaming the parents either, I'm just saying from a personal point of view, how do the parents actually restrain themselves from taking total control and making them eat.

When I read Nikki Grahame's story (the big brother star who very sadly died of anorexia last week) she said they tried tube feeding her as a child and she kept ripping it out. Eventually they sowed the tube into her stomach but she still kept trying to get it out and she was left with an awful scar. I guess it isn't feasible to keep doing that repeatedly. It really is the most frightening devastating illness.

@VegCheeseandCrackers thank you with sharing your experience. I'm sorry about your sister. I agree it is a horrible horrible illness and I truly didn't understand the extent until watching this documentary.

Some people will remove a feeding tube. Unless you sedate them/ keep them restrained there is no way of stopping them removing it (I don't think there are any courts that would let you keep a person restrained/sedated for this)time

It's a complex mental health issue a lot more than just wanting to eat/not eat/control/fear/loss of control. Sometimes dying actually seems better/less painful.

I understand people saying that tube feeding isn't getting to the root but surely it buys some time? How is it any different from offering antidepressants to depressed people? That's not getting to the root but buying some time until they can see a therapist.

@theteachesofpeaches ahhhh that makes so much sense and explains a lot of what I was wondering.

@Grumpyoldblonde it's in Holland

Force feeding someone who will not and cannot eat does not solve the underlying issue, anorexia is a illness that isn't just cured overnight with feeding, there can be terrible damage done to the body and internal organs which eating cannot reverse. It comes on gradually, people hide there food, drink water, do all sorts of things to appear the same weight so you dont always know straightaway.

@weetus

I understand people saying that tube feeding isn't getting to the root but surely it buys some time? How is it any different from offering antidepressants to depressed people? That's not getting to the root but buying some time until they can see a therapist.

Well, you can 'offer' tube feeding to ED patients, you can't force them though.

I think your assumptions about what you would or could do with your own daughter are naïve.

Also the idea that forcing treatment on someone presents "issues". It is not just "issues". It is in most circumstances illegal and a fundamental breach of a person's human rights. It may seem strange that in the face of certain death we cannot compel treatment but we can't.

Thanks @weetus I'm more than happy to share and it always hits me when I hear someone else has passed from it.