Why Compulsory Eating Disorder Treatment Almost Always Backfires

A topic I have visited several times in this blog is forced treatment of adults with eating disorders. I have seen patients taken to treatment against their will improve their medical health many times, but rarely if ever does this approach lead to psychological and emotional wellness and recovery. 

It feels incomprehensible for families to watch a loved one suffer, become ill or even come close to death from any illness, let alone an eating disorder. And watching this process is excruciating. There is a point when severe medical compromise leads a family to take their loved one to the ER for emergency care in order to avoid permanent damage or death, and that step is as valid for an eating disorder patient as for anyone. 

However, compulsory residential treatment for months is another consideration. At this juncture, forcing someone into treatment involves confining them against their will and forcing them to eat and follow rules they never agreed to. The result is such a loss of autonomy and enormous fear of doing things that feel impossible and indeed traumatizing. From the patient's point of view, enforced eating doesn't feel kind or compassionate in any way but instead incomprehensibly cruel. 

This is hard for people with little knowledge of eating disorders to understand. Eating for most people is as simple as breathing and sleeping. It is one of the basic daily tasks we must do to survive. Even for people who ruminate about what to eat, they must eat. For people with eating disorders though, nothing could be more terrifying. 

But forcing people to eat is not the crux of eating disorder recovery. Successful treatment entails regular eating and health to be sure, but love and compassion combined with the growth of the individual outside the pervasive and punitive eating disorder thoughts create true health. 

The circumstances necessary for treatment must be voluntary. A patient needs to realize the need for help while also recognizes the limitations the eating disorder imposes on daily life. From that point of view, there is a purpose to the scary step of starting treatment. There is a reason to seek out extraordinary circumstances and to start down the path to creating a full and healthy life.

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