Recently I've been asked to speak about the Maudsley approach to healing anorexia on several radio shows. In every interview there is a question or comment about "force-feeding" anorexics, and it's always offered in a tone of mingled horror and contempt, as if there could be nothing worse than coercing someone into eating.
To which I usually respond something like, "Actually, there's nothing worse than watching someone compulsively starve herself to death."
Now an interesting paper published in the American Journal of Psychiatry takes on both the moral and legal issues around the idea of what the authors call coerced care for eating disorders. I love the analogy its author, Dr. Arnold Andersen, uses for how dieting can lead into anorexia: "The situation resembles that of a person boarding a canoe headed for Niagara Falls on a journey that begins voluntarily but ineluctably transforms into a nonvoluntary propulsion toward the Falls, with the person at times not recognizing that the upcoming Falls even exist."
That describes it so very well. Someone who is deep in anorexia cannot see the falls or even know they exist. They need the strong hand extended from the shore to pull them out of the current.
Far worse to watch the boat go merrily over the falls.