The Ethics of Force Feeding in Anorexia Nervosa

I’m cheating. This is not a real blog post.
I’m going to plug a piece I just wrote for another publication/blog (see below) called:

Anorexia Nervosa: The Ethical Dilemma of Force Feeding. Check it out, leave a comment.

I’m “cheating” in part because I’ve been busy  (mostly writing my thesis, but also writing and editing other articles, editing essays, tutoring, and all sorts of fun things that leave me with less time for the blog), and in part because it is relevant and I think it will be of interest to SEDs readers.

Here is the story:
A friend of mine asked me to write an article for Inquire UofT. Inquire is an interuniversity publication and the University of Toronto chapter is at its infancy–as is their blog. My friend told me I could write about anything I wanted but the topic had to be current and controversial. She said to aim for 250-500 words. I wrote 1600, but managed to cut it down to about 1450.

The piece is considerably more opinionated than anything I’d write for Science of Eating Disorders . And keep in mind that, as I often do in situations where I want to provoke a discussion, I end up writing statements that can seem more “one-sided” or “extreme” than what I actually think or believe. (Isn’t that what being controversial is about, anyway?) The issue is very complicated and each case is unique, so don’t expect me to resolve the dilemma in 1500 words.



Tetyana is the creator and manager of the Science of Eating Disorders blog. She has a BSc in Neuroscience and an MSc in Medical Science, both from the University of Toronto. Lately, Tetyana is particularly interested the effects of a biogenetic framing of eating disorders on stigma, health care policy, and public understanding of eating disorders. To get in touch, email at tetyana[at]scienceofeds[dot]org.


  1. I agree with Laura, at least more than I do with the ‘it’s their lives let them do as they please’ POV.

  2. Really good article and i like your take on things. Thanks for writing it. Not everybody can be saved and that’s a sad thing. In the future though hopefully this will be less of a reality. Pallative care/hospice care where we are though needs to be accepted as being the right form of treatment for some people. To not recognise this can do damage not just to the sufferer but to their families also.

  3. Awesome article! I did a video on this subject in response to an Oxford Ethics case report entitled “To Kill Or To Violate?” The question of whether to force a very sick patient into yet another round of traumatic refeeding when she has endured said treatment with no benefit multiple times in the past. I find it positively unconscionable! That case still haunts me.
    The crux of this issue, for me, is very astutely written in your statement, “Is this letting anorexia win or is it acknowledging that this deadly illness is often intractable?

    For many of these cases, perhaps it is too late.

    But, one thing is clear: in all of these cases, those in charge of treatment (or financing treatment) have failed; even just by letting their patient’s disorder get this far. To deny someone treatment – as many insurance companies do – is to fail patients; to discharge when they are not ready because treating them is too hard, is to fail patients. To belittle, dismiss and minimize the grave nature of this illness is to fail these patients.”
    We need to cut the bullshit hypocrisy found so often in treatment and the denial thereof; to provide EARLY awareness and intervention before the ED is so far insinuated into one’s psyche that recovery becomes extremely unlikely.
    Thank you for exploring this issue!

    • Thank you AnaGirl for your comment! I’m really glad you enjoyed the article! :)
      I completely agree: early intervention, and sufficient, long-term intervention is important. Not the re-feed and release type-of-intervention which just predisposes people to relapse.

  4. This is a very difficult issue, however I agree that we cannot abandon the majority of patients with AN. That being said, it is arguable that at a certain point it may be too late to ‘save’ someone. If every type of treatment option continues to fail, and if the patient is being forced to stay alive over the course of years, is it really ethical to continue ‘forcing’ them to live? They must feel absolutely terrible, each and everyday with just barely enough nourishment to keep going.

  5. This is such an interesting, albeit heartbreaking subject. There are certainly no easy answers.

    I wonder if a similar question can’t be asked about other mental illnesses. For example, what about someone with unabating depression, who has experienced intense suicidal ideation for years on end, gone through every treatment under the sun, and still continues to live in misery? Should we try to stop such a person if they attempt suicide? What are our ethical obligations to them? AN is rather unique among mental illnesses, though, in that it does cause physical harm that can lead to death; for many mental illnesses, severe sufferers can suffer for years on end, but their illness will never itself lead them to death.

    • As you point out, I think the added complication with AN is that the illness itself entails behaviours that will eventually lead to death, but what happens if the individual doesn’t express suicidal ideation but behaves in a way that will lead to death? Food refusal in someone with depression as a means to achieve death is very different, in my opinion, than food refusal in an AN patient.

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