[Compulsory treatment in anorexia nervosa].

Anorexia nervosa is a psychiatric disorder with a very high mortality rate. If the eating disorder reaches life-threatening severity, for example through a body mass index lower than 13 kg/m (2), the possibility of compulsory treatment has to be considered. However, civil commitment of patients and forced feeding against their will may reduce self confidence and self esteem. This impedes the important goal of motivating patients to undergo psychotherapy. Furthermore, compulsory treatment is regarded as a contravention of the patient's physical inviolability as enshrined in the German Constitution. Up to now only a few studies about the use of guardianship legislation for anorexia nervosa have been published. The present paper reviews psychiatric literature and significant judgements of German courts on this topic. It finishes by examining clinical issues on forced feeding and possible consequences for psychotherapy.