Never Too Skinny
Should women with eating disorders be forced into treatment against their will? At least one study says yes.
By March 1, 2001 - last reviewed on June 9, 2016published
Standing 5'3" and weighing only 95 pounds, Sarah was a magna cum laude Princeton University graduate and a professional ballerina. But despite her elite education, no doctor could convince her that eating was good for her, or that she had anorexia nervosa—an eating disorder that stems from a fear of gaining weight. And no one felt comfortable forcing her into treatment.
"Nothing could prevent my will from controlling my body," Sarah says. Except her body itself. The same year she stopped menstruating, her brittle frame began to crumble beneath her. "My foot broke during a rehearsal. I was on crutches for almost a year. Eventually I had to have a screw inserted into my foot because my body couldn't heal on its own." Years after her body forced her into treatment, Sarah has retired from dancing and is healthy and eating again.
"I'm glad my body fell apart, otherwise I would have refused treatment until I dropped dead," she says. Like Sarah, many people with eating disorders don't recognize that they have a problem and never seek help. But a study in the American Journal of Psychiatry suggests that more sufferers should be checked into hospitals, even against their will. Lead author Arnold E. Anderson, Ph.D., a psychiatry professor at the University of Iowa College of Medicine, examined 397 eating disordered patients, 66 of whom were admitted involuntarily. Surprisingly, his results showed that those patients admitted against their will responded to treatment as well as those admitted voluntarily.
Eating disorders like anorexia have traditionally been attributed to environmental cues: rigid beauty standards, strict homes, rigorous sports and competition. Scientific evidence that they commonly run in families has only reinforced this view. But another report in the American Journal of Psychiatry suggests that a genetic trait may actually be the source of such disorders.
In this study, researchers at the Eating Disorders Program of New York Presbyterian Hospital in New York City examined the relationship between anorexia nervosa and the personality trait of perfectionism. Led by Katherine Halmi, Ph.D., the team examined 322 women with a family history of the eating disorder and found that the extent of the victims' perfectionism was directly associated with the severity of their anorexia nervosa. The researchers believe that anorexia may be linked to the family of genes associated with serotonin, a neurotransmitter connected to mood. They're now planning to analyze the study participants' DNA for patterns that are similar in anorexic family members, but different in those without eating disorders—a goal that may ultimately help to improve treatment for the disorder.
These findings may hit close to home for people like Sarah, whose own sister is also a recovering anorexic. But she warns not to overlook the roles of others who contribute to the illness. "Parties involved should be focusing on how they do contribute to the problem rather than how they don't," Sarah advises.