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

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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.

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

That simply wouldn't happen most of the time, you have the freedom to kill yourself unless they deemed you so mentally ill you are unable to make a rational choice. Even with people who are severely unwell there is often no treatment.

When I watched this documentary in 2016 it really upset me.

Going to this clinic in Portugal was meant as an extreme last attempt to cure her. There were a lot of discussions at various panel shows in the Dutch media about why force feeding etc wasn't an option anymore.

I think there is a lot that triggers this illness.The first time for me I was at school I forgot I suffered 3 times.
My friend who was larger stopped going into the hall for lunch as she wanted to lose weight.So I lost weight too.Then lost my appetite it got so bad that a teacher told my dm who took me to the gp.
It is the most awful feeling being watched and checked on that you have eaten.I used to hide food and throw it away.
In my early 20s I think all the thin images saw played a part I equated thin with beautiful.I thought I was clever and could stop when I wanted,anorexia had other ideas,!
My parents being strict and controlling,dm being overweight,society,lack of self esteem and for me stress and life changing events all caused mine.
I saw one psychologist who had a go at me for not eating and said our appointments were pointless if I didn't do as asked.
I thought it was odd at the time however I didn't want to lose the one person who could help.Families are at a loss in these situations professional help is needed to overcome the anorexia voice in your head.
When I went into hospital my parents were told I could die of organ failure in the next couple of weeks as I had completely stopped eating.I was 22.

You certainly can be detained under the mental health act for anorexia and tube fed and it does happen although clearly a last resort because it is very traumatic

I haven't seen the documentary but I expect the answer would be that it had been tried and failed. How many times should a person be held down and force fed before it's agreed that it's futile? Tube feeding would restore weight but not change the persons underlying thinking so as soon as the tube feeding stops they might go back to previous behaviours and lose weight again. If that happens many times over then sometimes an agreement is made (often court sanctioned in the UK) not to try again.

The idea of the tube feeding is to get someone well enough to engage with psychological therapy which certainly would be provided in inpatient units but it isn't a certain cure. In the end the person has to change their behaviour and if it is very longstanding and deeply ingrained that is very hard.

Please could someone who knows clarify something to me? Are images of very slim/thin models or, for example pop stars likely to trigger anorexia? I've always felt that seemed a bit simplistic, but happy to be corrected.

It definitely has some impact eg the increase in eating disorders in developing countries is often linked to more exposure to western media.

What doesn't help is the demonisation of "fat" people & the admiration of someone who is very thin/their willpower. I used to work in a fashion boutique on Bond st & one of my colleagues had anorexia (had been hospitalised a few times), she was clearly very underweight but looked glamorous eg clothes, hair. The customers loved her & she had the highest sales figures by far.

It’s a neurobiological illness with associated psychiatric symptoms. The pathophysiology is biological. The gene is triggered by an energy deficit which can occur via several different mechanisms. Intentional weight loss with good or less good intentions, unintentional weight loss, significant energy deficit through exercising and not eating enough etc.

The two main problems are 1, physicians are slow to begin treatment and wait until BMI is at a catastrophic level, and 2, weight targets for weight restoration are pretty much always too low which gives the patient virtually zero chance of a meaningful recovery.

@PyongyangKipperbang how old are you? Please seek help. Malnutrition will kill you. If it doesn’t kill you, you will end up with osteoporosis and be senile before you’re old. I knew a 40 year old woman who looked 70. She was senile, couldn’t talk, couldn’t walk and had osteoporosis. I also know someone who died in her 20s after years of battling with anorexia.

Anorexia isnt about being thin, it really isnt. “The starvation to be thin (or bingeing/purging or overeating or whatever) is a symptom of other MH struggles. As soon as more people realise this then there will be less body shaming and more successful treatments.“

This, 100%

DaisyDreaming

@DaisyDreaming I don’t have anorexia but have the anorexia gene. I wonder if one day they will be able to target that gene in people who do get anorexia and have the gene

How do you know have the gene? Where did you get the test done?

DD1 has been seeing a psychiatrist weekly. She gets weighed, but then we just say 'good restoration' or 'doing ok'. The far more important things are her blood pressures, heart rate, and her mental state.

It's such a horrible, complcated illness....i had it and i recovered by a miracle of escaping from my abusive ex.My poor damily...they were so scared.

I do think the thin is in culture makes things worse but i didn't develop my problem because I felt fat...it's because I wanted control.

I wonder if treatment is postcode dependant?
Certainly my cousin's teenage daughter was hospitalised for 6 months in an ED unit at a Priory hospital a couple of years ago, all NHS funded.
She was getting the same of care as self-funders - it was not two-tier levelled treatment between NHS & self-funders.

My cousin's daughter has improved - the mental health care that she received helped enormously. I'm not sure that she was force fed though. It might be necessary to get the patient to a certain weight that their body & more importantly the brain has the nourishment to begin to function again.
There is hope for my cousin's daughter - she will always have anorexia but it is being controlled by careful treatment.
She lives with her parents & they watch her like a hawk and they fund weekly counselling/therapy. However any sign of stress & it all worsens. They have been told that if it gets as bad as it was before the inpatient treatment, she will go into multiple organ failure & there is nothing that they can do.
She now has a job that she loves & it gives her a real sense of purpose. Fortunately she has worked all the way through lockdown so her life has been normal than most of ours! She's a lovely girl & we are all hoping that her situation is being managed as much as is possible.
It is a truly brutal disease.

I resonate with the control comments. I wouldn't say I've ever had anorexia, or been anorexic as such but as a teen and early twenties I would under eat, especially during times of stress.

About 5 years ago I lost control of my life in a big way. Someone in my family did something which meant I had social services involved and police and basically had no control of anything. (Not my fault I might add!!)
Anyway, I stopped eating. I felt so utterly desperate and helpless and I didn't know what to do so I stopped eating. I focussed on that completely and started visiting pro ana websites and that just became my focus. I can't even say why I did it. I was a mum with a 1 year old, and I would go running having not eaten a thing for 24 hours and I felt exhausted but I felt like I was achieving something.
Anyway it never developed into full blown anorexia and I did return to a normal weight without intervention, but I often wonder if had my genetic make up been different, had I been younger or other circumstances been different, could that have triggered a full blown eating disorder.
I think control and lack of control seems to be a huge instigator for many anorexics.

[quote weetus]@Griefmonster yes it probably is very naive and of course unless I am in that situation, can't say how I would react. It's just mind boggling to me. There are people dying with cancer that are not allowed to die at a clinic due to protocol. Yet young people are dying due to anorexia also due to protocol. It's very hard for me to wrap my head around and I suppose I must count myself lucky that I have never went through it myself. [/quote]
An adult with cancer can refuse treatment, even if they know it will lead to their death, and even if they would have a high chance of recovery with treatment.

That situation is more akin to an anorexic refusing treatment than the topic of assisted suicide.

I wish I could understand it myself. It’s not a desire to be thin that I have, I just stop eating. I weighed 5.4 stone at my lowest at 15 and was hospitalised. I’ve had pneumonia twice and I know I’ve done irreparable damage to myself. I know it’s never going to leave me either.
Force feeding isn’t going to solve the problem unfortunately.

It's an illness that is based on not feeling in control. Food intake becomes the thing that will fix that feeling, because it can be controlled. And the feeling of being that hungry is weirdly addictive, because it's "proof" you're somehow winning against your own body's ugly desire.
So If your child showed signs of controlling behaviour around food, quite possibly the worst thing you could do is force him or her. I've struggled with emotional issues around food for years, but the other thing worth pointing out is that there is a very broad spectrum of illness. That is also why it's very difficult to get the right treatment, as the mild cases like me will be fine if carefully handled by parents, but it can be hard to spot who will progress to the life threatening side.

@Drunkenmonkey yep that was me. I'm wary of feeling hungry these days. It tempts me.

@vannyy

Please could someone who knows clarify something to me? Are images of very slim/thin models or, for example pop stars likely to trigger anorexia? I've always felt that seemed a bit simplistic, but happy to be corrected.

It definitely has some impact eg the increase in eating disorders in developing countries is often linked to more exposure to western media.

What doesn't help is the demonisation of "fat" people & the admiration of someone who is very thin/their willpower. I used to work in a fashion boutique on Bond st & one of my colleagues had anorexia (had been hospitalised a few times), she was clearly very underweight but looked glamorous eg clothes, hair. The customers loved her & she had the highest sales figures by far.

There was a period where I was only eating a single slice of toast a day, I lost weight rapidly (unsurprisingly) and all I heard was praise. Hard not to experience that and not feel like weight loss is the ultimate achievement.

In recent years I've heard grown women tall about how suffering with severe D&V is worth it because it results in weight loss.

It's a bit difficult to argue that those with eating disorders are doing something wrong when they are just taking what is quite a normal societal view up a few notches.

@DogsSausages

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.

Yes. Karen Carpenter had apparently recovered from her anorexia but it still killed her because her heart was damaged.

I worked on a psychiatric ward where they had 2 patients (under 16) tube fed. They were on 2 to 1 observations by staff 24/7 and care planned to be restrained if they showed attempts of removing their tube or purging. So it can happen.

@WitchisDead

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.

This is correct. I know people who have attempted suicide in the AM, been taken to to hospital, let back out and been back trying to kill themselves by the PM.

Mental health patients are rarely detained.

you can't section people forever there are time limits

@tearsandtiaras I agree and there’s not enough beds for everyone who would need one at the best of times.