Attempts by a team of US clinicians to introduce the concept of “terminal anorexia” has drawn harsh admonishment from the National Association of Anorexia Nervosa & Associated Disorders (ANAD). The non-profit group dedicated to treating eating disorders has issued an urgent call to action to counter the proposal, which it warns could see those with eating disorders offered Medical Assistance in Dying (MAiD).
The proposal was the subject of a critique published by Cambridge University in October 2023. It suggested that a diagnosis of “terminal anorexia” could apply to patients over the age of 30, who have suffered from the illness for an “extended period.”
But, once labeled as “terminal” -- generally meaning that further treatment is futile and death is the most likely outcome -- patients could be able to pursue physician assisted suicide.
ANAD contends that those labeled with "severe and enduring anorexia nervosa" are too often denied care due to an inability to meet target weights, or because they continue to struggle with eating disorder behaviors. On its website, the group challenged professionals to look beyond the standards of published treatments, which tend to overlook the individual and their cultural experiences.
These factors are important to the treatment of anorexia, ANAD argues, and their lack of consideration can lead to goals that are unattainable. This in turn can make treatment all the more difficult, as patients who miss their goals can feel disheartened by their perceived failures.
Accompany
Instead, ANAD pointed to their own model: helping to build nonjudgmental environments that “meet folks where they are.” The non-profit argues that allowing patients to set the pace of their progress could be a boon to treatment and would be more humane than offering assisted suicide.
ANAD went on to clarify that there is a difference between a “chronic” illness and a “terminal” illness, writing:
“Being labeled with a terminal illness has the potential to become a self-fulfilling prophecy. Regardless of the duration or severity of the illness, everyone deserves access to quality care.”
The group concluded by calling for increased flexibility and opportunity for treatment, patient autonomy in goal-setting, as well as provider respect for said goals. ANAD further pled to medical professionals to continue “to believe in the possibility of future recovery, even where their patients cannot.”
Visit ANAD’s webpage to read their full arguments against the concept of “terminal anorexia.”
