Doctors have been issued with controversial new guidelines which spell out for the first time when they are legally allowed to force-feed anorexic patients close to death.

The rules state that if two doctors believe an anorexic patient is mentally ill and in danger of dying, the patient can be sedated and tube-fed against their will.

The new Scottish guidelines, issued by the Mental Welfare Commission, also allow dangerously underweight children to be force-fed against the wishes of their parents.

Anorexia affects a growing number of Scots and there has been severe criticism of the lack of specialist services. Scotland on Sunday can reveal that each year around 30 patients are already tube-fed without consent north of the Border.

The practice is allowed under existing mental health laws, but until now there has been no specific guidance on when and how anorexic patients should be force-fed, leaving medics vulnerable to compensation claims.

Patients’ groups last night expressed concern about the guidelines because they fear doctors will be more likely to resort to force-feeding rather than trying to persuade patients to consent to treatment.

But Dr Flora Sinclair, medical officer for the Mental Welfare Commission, said they wanted to ensure the practice was only carried out as a last resort and under strict criteria.

Patients who become extremely ill as a result of their eating disorder need to be kept alive by artificial means, such as a tube inserted into the nose or stomach which gives the body vital nutrients.
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The struggle for food has long been a drama for millions of impoverished Brazilians.

But these days the nation is transfixed by another sort of starvation: anorexia among the successful and well off.

The deaths of four young women in the last two months from anorexia – a disorder characterised by an abnormal fear of becoming obese, an aversion to food and severe weight loss – have been splashed across the front pages of newspapers. The subject has become a morbid fascination for Brazilians and a theme of a popular soap opera. It’s also touched off a debate within the fashion industry that has long presented the rail-thin model as the paragon of female beauty.

The most recent victim was Beatriz Cristina Ferraz Lopes Bastos, 23, whose death on Sunday at a hospital in Jau, 300kms northeast of Sao Paulo, was reported by national television news programmes.

Local media reports said she was 1.57 metres tall and weighed just 35kgs.

“Another victim of anorexia,” the Globo newspaper said on its website, alongside a glamorous photo of the blonde-coiffed Bastos. An English teacher and a skilled piano player, Bastos was an amateur historian and wrote a literature column for a hometown website.

Folha de S. Paulo newspaper reported that she described herself as “thin” on an internet discussion group and friends said they had to “fight with her to eat”. A former boyfriend, Leandro Murgo, told reporters Bastos was a chubby teenager and became fixated on losing weight.

Brazilians were shocked at the November 14 death of 21-year-old model Ana Carolina Reston, who died of generalised infection caused by anorexia nervosa. She was reportedly 1.72 metres tall and weighed about 40kgs.

Two days later, college student Carla Sobrado Casalle, 21, died in the southeastern city of Araraquara, also with symptoms linked to anorexia.

She was 1.74 metres tall and weighed 45kgs. A third anorexia victim died later in the month.

Vía: Gulfnews.

Pandeblog shows us the faces of the dead skinny girls

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Cameron Diaz has become the latest star to say she is worried about the influence of ultra-skinny celebrities.

Her comments echo those of Billie Piper and Kate Winslet, who both criticised the phenomenon last week.

The Hollywood actress, 34, tells ITV1 show Parkinson: “I think it’s terrifying. It’s tragic and sad.

“I think that it’s a sickness, something that’s going on in someone’s head where their perspective is off.

“We get ideals from images that we see and there certainly should be more responsibility put on those people who are putting those images out into the world.

“Let’s be a little bit more responsible to what’s realistic.”

She adds: “I’m a skinny girl, so all my life all I have ever wanted to be is curvaceous and voluptuous, have everything falling out everywhere.

“Some people…their perception and their perspective is completely askew.”

Last week, former Doctor Who star Piper said Victoria Beckham should not be a teenage role model because of her tiny frame.

The star, who suffered from anorexia, said she worried that younger people were looking up to skinny stars.

Former singer Piper, 24, said: “I think the whole size-zero debate is disgusting.

“Some models you see are tiny because that’s the way they were born, but then they’ll get the attention and that will start feeding a fire.
“My sister, who is 13, looks amazing but she’s already worried about her figure.
“She loves Posh and I say: ‘Come on Ellie. She’s tiny. What’s wrong with Shakira? She’s sexy, curvy,’ but she has no interest.”

Winslet also joined the debate, describing the trend as “unbelievably disturbing“.

The 31-year-old said she refused to have any magazines showing skinny stars in her house because of the damaging effect it could have on her six-year-old daughter, Mia.

“It’s only a matter of time before she becomes aware of it and it frightens the life out of me,” she said.

Nicole Richie and Kate Bosworth are among the celebrities whose shrinking figures have been the subject of debate.

The controversy over underweight models has been raging since the death last month of Ana Carolina Reston, 21, a Brazilian model who suffered from anorexia (some pics here).

In August, Uruguayan model Luisel Ramos, 22, died of heart failure after not eating for several days.

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Dec. 18, 2006 (Newsweek)
If a food craving strikes, try a manicure to “keep your hands occupied.”
This kind of tip is common fare on pro-”ana” (anorexia) and pro-”mia” (bulimia) Web sites. Well intended or not, they’re not “benign,” says Dr. Rebecka Peebles of Stanford University, coauthor of “Surfing for Thinness,” published in Pediatrics last week. Stanford researchers surveyed patients treated for eating disorders, ages 10 to 22, and found that users of pro-eating-disorder sites were sick longer. And 96 percent of them reported learning new tips for weight loss or purging; 69 percent said they used them.

The sites tend to gloss over bad news: people with anorexia are 56 times more likely than their peers to commit suicide. (And they’re not broadcasting the November anorexia-related death of Brazilian model Ana Carolina Reston.)

Sites deny being harmful, saying they provide a community for those with eating disorders. The term “pro-ana” is broadly used, and sites vary greatly. “We offer them support, saying, ‘It will be. Continue going to your doctor’,” says five-foot, 89-pound proana.us owner Anna Robbins.

In November, the Academy for Eating Disorders suggested a mandatory warning statement: “Warning: anorexia nervosa is a potentially deadly illness. The site you are about to enter provides material that may be detrimental to your health.”

—Karen Springen

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