Yesterday we thought about whether or not it’s right to refeed someone against their will. Current guidelines suggest this should be allowed if the person is classed as disturbed or unstable.
The trouble is, the world isn’t divided into crazy people and sane people. There’s just different degrees of crazy. All sin is insanity.
And here’s what complicates things even further. The closer you get towards an anorexic weight the more you feel compelled to starve yourself. The dynamics of starvation mean that as your body wastes away, so does your capacity to think and make judgements. This is known as “the whirlpool effect.”
Consider this. According to the Mail, eight out of ten women and seven out of ten men have started New Year on a diet. What’s the issue with this? Well, potentially nothing. The problem is that for some people, as they lose more weight, they find it increasingly difficult to stop. According to one theory, such people have a neurobiological predisposition to eating disorders, which is triggered by a lack of nutrition. For people with this brain chemistry, calorie restriction has a calming effect and produces a kind of ‘high’. Thus they may restrict their food intake (either consciously or unconsciously) as a way of coping with uncomfortable feelings or stressful events. Even without going on a diet, if someone becomes malnourished through for example, sickness, the same factors can come into play.
Even if we don’t buy this theory, it is undeniable that starvation in any person causes huge physiological and psychological problems, many of which can’t be addressed until the body is properly nourished. When your weight falls below a certain threshold, you become unable to think properly. You are more vulnerable to depression, social isolation, mood swings, irritability, paranoia. Your thinking becomes polarised and you may feel anxious and confused.
This was proved during a clinical study known as the Minnesota Starvation Experiment, between November 19, 1944 and December 20, 1945. The study was designed to determine the effects of severe and prolonged starvation, using 36 volunteers from a pool of 100 volunteers. Results showed that semi-starvation produces significant increases in depression, hysteria and hypochondriasis. Most of the subjects experienced periods of severe emotional distress and depression, including self-mutilation (one subject amputated three fingers of his hand with an axe, though the subject was unsure if he had done so intentionally or accidentally). Participants showed a preoccupation with food, both during the starvation period and the rehabilitation phase. Sexual interest was drastically reduced and the volunteers showed signs of social withdrawal and isolation. The participants also reported a decline in concentration, comprehension and judgment capabilities.
This suggests that the profound social and psychological effects of eating disorders may result from symptoms of undernutrition and that recovery depends critically upon physical renourishment as well as psychological treatment.
With this in mind it is worth asking how many people actually set out starve themselves to death? In my view, very few eating disordered patients want to die or even consider this as a possibility.
For this reason it would seem that while eating disorders are about much more than food, they are never about anything less.