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. 2024 Mar;32(2):179-187.
doi: 10.1002/erv.3033. Epub 2023 Sep 10.

Longitudinal investigation of patients receiving involuntary treatment for extremely severe anorexia nervosa

Florent Abry  1 , Philip Gorwood  1   2 , Mouna Hanachi  3   4 , Laura Di Lodovico  1   5
Affiliations

Longitudinal investigation of patients receiving involuntary treatment for extremely severe anorexia nervosa

Florent Abry et al. Eur Eat Disord Rev. 2024 Mar.

Abstract

Introduction: Involuntary treatment may be a life-saving option for extremely severe anorexia nervosa (AN) in the context of life-threatening conditions and refusal of care. The long-term outcomes of patients undergoing involuntary treatment for AN are poorly understood. This study aims to explore quality of life, long-term outcomes and attitudes towards involuntary treatment in patients involuntarily treated for extremely severe AN.

Methods: 23 patients involuntarily admitted for extremely severe AN (I-AN), and 25 voluntarily admitted patients (V-AN) were compared for body mass index (BMI), residual symptoms, quality of life, and attitudes towards treatment almost four years after discharge. In I-AN, clinical variables were also compared between admission and follow-up.

Results: At follow-up, weight restoration was higher in V-AN (p = 0.01), while differences in quality of life, BMI, and mortality rates were not significant between I-AN and V-AN (p > 0.05). In I-AN, BMI increased and weight-controlling strategies decreased at follow-up (p < 0.05). Despite negative experiences of involuntary treatment, the perception of the necessity of treatment increased from admission to follow-up (p < 0.01) and became comparable to V-AN (p > 0.05).

Discussion: Involuntary treatment for AN does not appear to be a barrier to weight gain and clinical improvement, nor to long-term attitudes towards treatment.

Keywords: anorexia nervosa; feeding and eating disorders; involuntary treatment; malnutrition; psychiatric.

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