I'm so sorry - what a difficult situation. I watched my two brothers die a slow painful death from alcoholism and like you say, this is probably quite similar. What I appreciated from my close friends in my situation was having a kind and genuinely interested and caring listener who wasn't afraid to talk about the situation with me. It's a special kind of person and friend who is comfortable doing that. Someone who just cares and listens and doesn't try to fix the unfixable.

Very difficult and sad.

She needs a residential facility.

Has she been living this way for decades without therapy of any kind?

I know someone who was in this situation and it was the therapist who made sure she got into a facility.

Thank you both, it is very sad and the family has tried to help but she is still the same. There's been some therapy but she has not gone to a facility, I doubt she would. I have dealt with alcoholics and you can't help them unless they want help.

I guess I thought there was a course of action that is routine but not everything is fixable.

https://www.eatingdisorderhope.com/treatment-centers Has her husband tried contacting a facility specifically for eating disorders?

You are a wonderful friend for being so caring.

ETA wrote too quickly- friend, not sister.

I deleted my comment, since the family has chosen to do nothing (which I can't comprehend, but that's just me, I'm pugnacious to the core), my friend's story is irrelevant.

You can commit people who are that mentally ill. Maybe long enough for them to break their cycle and realize they need help and be willing to accept it.

I don’t have any words that can actually help, it’s such a sad situation I just wanted to send my support. I hope you’re able to find the answers you’re looking for.

Thank you all. I have mentioned getting medical power of attorney, that sort of thing and it was considered. I'm not sure how much it helps in the long run though,

Thank you for sharing your story, roarah. So interesting that addressing obsessive compulsiveness may be a key part of treatments for some people. I was also surprised to see that anorexia and eating disorders carry the highest mortality rate of any psychiatric illness save substance abuse. So scary.

What a terrible sickness for anyone to go through. I don't understand it except to relate it to alcoholism and the power that has. Incomprehensible.

Anorexia is a very complex disorder, involving a psychology of wanting to feel in control and accepted. This form of distorted eating is often seen as a healthy endeavor by them. Because they justify and rationalize their restricted (no fats, no sugar, no gluten etc) eating as a form of "self-care" they do not seek treatment for something they don't view as an illness or disorder. An societal views reinforce the positive aspects of a super thin body. Intervention challenges the sense of control and the need to maintain perfect discipline that drives the disease. Roarah, congratulations that you did the hard work involved in recovery. And as you described, a relapse prevention plan is mandatory for continued success.

The husband can talk to a psychiatrist about alternatives, including possible involuntary psych hospital admission - depending on the specific circumstances.

My dad was an alcoholic. My mother somehow got him to consent to get evaluated by a counselor. My dad agreed, based on the evaluation, that he was an alcoholic, but refused treatment. A year later (I was in 8th grade) we had an intervention. If memory serves, I think we tricked him into thinking it was going to be a fun day and instead we confronted him. For the next year, I was really angry at him, and said I knew the next dress I’d buy would be for his funeral. And I was right, as he died from a heart issue my freshman year.

I wish we hadn’t done any of that. At the end of the day, my dad was going to to get help or not get help. It was never up to me or anyone else. And maybe it wasn’t even a choice for him at a certain point. Maybe he was so depressed that the thought of climbing this mountain was too great, and he gave up.

Instead, I wish we’d spent our time telling him how much we loved him. Period. Not that we loved him, “but.” He was going to die. His time came sooner than most. I missed out on the time we had left by being angry and worried.

My advice to you is to surround this family in love. To let go and acknowledge that, yes, she is dying, and yes, she is loved. There is nothing more precious than this gift of true and unconditional love.

I suggest that the husband talk to his wife's doctor and see whether they can formulate a clear plan for hospitalization and treatment. I also suggest everyone around her stop talking about her weight, and stop talking about eating/food, and try to overcome any anger they might have (for some reason the illness does give rise to anger in concerned family members and friends, perhaps due to the helplessness that they feel). Instead, tell her how much she is loved, how she is worthy and needed, and how everyone wants her to be healthy (again, don't talk about her weight or food--focus on her happiness and health).

I think that chronic eating disorders are much harder to treat than acute disorders, from my experience. My daughter nearly died from an acute onset of anorexia (at the age of 12). My sister had anorexia as young woman (lost her hair, her periods stopped) and still struggles. And my sister-in-law has battled chronic anorexia as an adult for years, recently seeking out therapy. My daughter finally turned a corner after being treated with medication to battle the obsessive-compulsive aspect of the disorder, but it took hospitalizations, several years of constant care, all kinds of treatments and therapies, and some backsliding, before she could regain her health.

Often anorexics have a harsh inner voice that tells them they are fat, ugly, should die, etc. and combating that harsh voice is important (another reason to flood the individual with affection--they are already dealing with a conviction that they are not worthy or are flawed).

It is a dangerous and terrible illness. My heart goes out to this family, and to your friend, and I do hope that she can be treated.

It hurts to read this thread. I hope your friend can be helped, but it doesn't sound like there is much chance of her wanting help unless it is forced initially and she improves enough to come around. Even if her family tries, there are no guarantees. If it were me, I would have to at least try.

The husband is beyond trying, facilities have been mentioned, everything tried. She is resistant to all. I didn't realize until recently how much had already been done to help but the husband just cries knowing he is going to lose her. She lost all her teeth years ago but now the dentures don't fit and she is a wisp.

Sending you and this family so many hugs, Bumblebeez. Whenever anyone suffers or dies from an illness, we tend to live in the Land of Guilt, guided there by the Illusion of Control. "What ifs" echo and echo and echo... and when the illness in question seems to have an element of "choice" behind it, then it becomes that much harder to even accept that it is, indeed, an illness.

I would recommend the family reach out for hospice care. If there is a music thanatologist in their area, it might be worth looking into, too.

I am profoundly sorry.

I don't want to derail this thread in any way... but I wanted to say to Anele that your first post really touched something in me, made me cry. My dad was an alcoholic too, and our situations sound maybe a bit similar, but probably also very different. My dad died in 2010 when I was 38. I think what you've said is very wise and benevolent.

Bumblebeez, I'm very, very sorry for your friend. What an incredibly sad and painful situation.

I am so very sorry for this tragic illness. Holding you and your friend and her family in my heart.

Lakeaffect, Forcing treatment will not change outcomes. Change will only happen if she wants to get better. Anorexia is often the physical need to disappear permanently. It,like any addiction, is a chronic illness which is often terminal, to no fault of anyone's. Friends, spouses, family and even the sufferer are not to blame. Remember also lakeaffect, if you think you are pugnacious image how pugnacious a person who can go most of her life abstaining from food will be. You can not make her better but fighting will ruin what time is left.

I wish your friend and her loved ones peace, understanding and love during this difficult time.