'Terminal anorexia': a lived experience perspective on the proposed criteria

Abstract

In an article (Asaria in J Eat Disord 11:107, 2023) recently published by the Journal of Eating Disorders, I expressed my lived experience views on the concept of 'terminal anorexia nervosa' (AN), and why I believe that this is a harmful new term. The article was not a response to the original paper in which Gaudiani et al. (J Eat Disord 10:23, 2022) proposed criteria for the label. However, as a result of feedback that my article did not appreciate their criteria, I have written this follow-up paper to build on and reinforce what I previously wrote. This article outlines problems with each criterion in turn, again from my lived experience perspective. It then addresses dangerous ambiguities around how the criteria can be applied safely, and their confusing purpose in the real world. Finally, I discuss the impact of labelling AN sufferers with terms that may suggest their wholehearted allegiance to the illness, in both life and death (or 'till death do us part').

Keywords: Anorexia nervosa; Cognitive behavioural therapy; Compassion; Criteria; Eating disorder; Ego-syntonic; End-of-life; Hope; Identity; Label; Lived experience; Palliative; Terminal; Therapeutic alliance; Therapeutic relationship; Treatment-resistant.