When Does the “Duty to Protect” Apply with a Client Who has Anorexia Nervosa?

Individuals with eating disorders, especially those with anorexia nervosa, have the potential to experience significant harm and even death as a result of behaviors related to their condition. Because of this risk, the authors argue that there is a duty to protect (i.e., an obligation to take some action when a person is engaging or considering engaging in a behavior that may lead to self-harm) when a client's anorexia-related behavior has progressed to the point of medical jeopardy—that is, her or his life is in danger. This article reviews information on anorexia, including mortality data; ethical and legal issues when a client is believed to be a harm-to-self; and the literature related to involuntary hospitalization and compulsory treatment of clients with anorexia. The article concludes with a set of guidelines for when the duty to protect when a client has anorexia nervosa begins and with suggestions for interventions.

Mediators of the association between abuse and disordered eating in undergraduate men

The vast majority of ED research has focused on women. However, recent studies have suggested that ED symptomatology in men may be underestimated. Additional investigations are needed to better understand EDs and their correlates among men. This study examined the relationships between childhood abuse experiences and disordered eating in male undergraduates. In addition, potential mediators and moderators of the association between abuse and disordered eating were evaluated. Results indicated that physical abuse and physical neglect were the only adverse childhood experiences associated with disordered eating. In addition, depression mediated the associations between these forms of abuse and ED symptomatology. However, neither anxiety nor alexithymia were significant mediators of the association between abuse and EDs. Social support moderated the association between physical neglect and depression, such that individuals with high social support were less depressed than those with low social support, regardless of their level of physical neglect. These results are somewhat different than those found in exclusively female samples, highlighting the importance of specifically examining EDs and their correlates among men.