Q & A: A Patient Who Resists Treatment

Reprinted from Eating Disorders Review
March/April 2001 Volume 12, Number 2
©2001 Gürze Books

Q: I’ve been treating a young patient with anorexia nervosa who needs an inpatient program. But, she refuses to accept this recommendation. Her family has asked me about having her hospitalized against her will. What are the odds that she’d gain any benefits from hospitalization if she’s so resistant? (L. Reynolds, Houston)

A: Without knowing the specifics of this patient’s case, it’s impossible to even speculate on what the impact of involuntary treatment might be. Decisions to hospitalize patients involuntarily can never be undertaken lightly, and legal jurisdictions vary widely from place to place. The problem you’re confronting certainly isn’t rare. A substantial minority of patients with severe eating disorders receive care only when involuntarily committed. Coincidentally, the study described in this month’s lead article (see page 1) sheds some light on what may happen to involuntary patients, but the report addresses only what may happen during the period of acute hospitalization.

Of course, this study should be followed up to see if and how the weight gains achieved during hospitalization endure. Nevertheless, the results suggest that even patients who are involuntarily hospitalized can make substantial initial progress. The caveat is that such successes may require treatment units in which well-developed and well-tested eating disorder programs exist, and where staff are trained and experienced to conduct these treatments.

— J.Y.

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