If an adult with an eating disorder refuses admission, what should be done?

The refusal to admit an adult with an eating disorder usually stems from two assumptions:

The first is a lack of awareness of the illness and its severity. In this regard, it is crucial to assess the risks of the illness and the possibilities for outpatient treatment if there is no immediate risk to the person's life. At this stage, they can continue to receive support until they establish a bond with the healthcare provider, accept the problem, and develop treatment strategies for their recovery. If there is a risk to their life, involuntary hospitalization will be considered by the specialists treating them, either through the emergency department or from the specialized outpatient services. This decision will be ratified by the forensic doctor and judge, who will monitor the case in coordination with the therapists at the hospital where the person is admitted.

The second scenario is when suicidal ideation exists because the person has lost all hope of recovery. These cases are usually accompanied by comorbidity with a depressive disorder , which must be treated concurrently with the eating disorder for recovery. In any case, we will proceed as in the first scenario and arrange for involuntary hospitalization to save the person's life.

In both cases, it is very important to listen with understanding and empathy, not to judge or blame the person with moralizing speeches about what is right and wrong.