Fame has nothing to do with it.
Eating disorders may have something to do with fame and fashion, Princess Diana, Princess Victoria of Sweden, the heiress to the throne.
Eating disorders should be portrayed as lethal, and not being Kate Moss and scoring Johnny Depp.
My first interesting case comes from summer of 2011. On the ward where I worked, there was this patient who had been there for more than two years. And she would have rather stayed there for longer, than gain 7 kg. Up to 47 kg, which is not much given that she was kinda tall.
So, the chief of the ward went on a summer leave, and I had the entire ward on my own. This particular patient had signed a four-page agreement, and she had her own nurse for 24/7. But she did not gain weight.
So I called a meeting with her nurses, I tore apart the document, and granted her unsupervised outdoor permission. And quit the 24/7 nurse system. Then I said, "This isn't working. Help me help you." And she agreed to some extra calories per day. She would exercise a lot, pace quick in and around the hospital grounds, and I told her, "Good, muscle tissue weighs more than fat. So exercise. But you will gain weight."
Her weight rose, then stopped. One morning when she was on a scale, I was there, and tried her bladder. Hard as stone. She collected urine so she would weigh more. I poked it, "Like a football." Then I ordered that she will be given the strongest anti-diuretic at 5 AM, 6 AM, 7 AM and at 8 AM, when the patients were woken up. Let's see how she does. Wake her up three times before the wake up call. Hold that urine.
She got it, in three days I called it off.
Then she got her first period in years. I congratulated her.
But the weight gain stopped. Another meeting. Prior to that I had a tube brought to the room, as well as a text from the ICU, regarding the fluid which contains calories they give their patients who can't get the energy otherwise.
Again, I first congratulated her for what she has achieved. Then I, again, asked her to help me. And I said, "here's a tube. I'll put it to your stomach via your nose. Failing that, I put an i.v. for you, and here's a leaflet about it. And, if you puke or your weight does not reach 47, I'll have you tied up so that you can't puke or remove the i.v. But you will score weight. So, "help me help you." She realized I was not kidding, and agreed to more calories.
By the time, in just a month, the chief of the ward came back from his vacation, and she weighed 47,3 kg. I had already referred her to the outpatient psychiatry once the 47 kg was reached. But when she first went there, her weight was 36,6 kg. I know the people there, dorks. So, she stayed at the ward, and then the chief established a new program for her, and she started to lose weight again. He didn't get it.
Another case from an outpatient clinic. There was a patient, and he came to my appointment with his parents. I allowed him to tell me about his situation, and the thing with the people who have anorexia is that they suffer from anxiety if they eat. So once the patient had talked for about 10 minutes, then I just told him that "what's so cool about your anxiety? You have everything going well. What's making you anxiety so fucking special? That's your mother there! Your father! How about their anxiety? They are scared to death because of you, and you whine as a pussy. So, what makes the quality of your anxiety so special it supercedes everybody else's anxiety?"
He could not answer, but within a month he had gained 4 kg, and was happy about it.
And only later did I realize her mother in the room was shrink as well... I would never have done what I did, had I known that.
What this boils down to is anxiety. You have to outsource the caloric intake so that they don't feel the anxiety. That's the point of it. Chances are, deep within, they hope for it. My approach has served me well, but my other colleagues do not see the beauty of it.
Nothing I can do about their stupidity.
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