Why is it that people seem to be forced in a mental hospital for being too skinny, but not too fat?

mattwilson wrote:Too many of them

You're probably right. I guess it's not about being dangerous, it's about being unusual.

If you're referring to people with eating disorders, there's a little more involved than being too skinny.

I'd imagine it's because being dangerously underweight can kill you very quickly. Anorexia nervosa has one of the highest death rates of any psychological disorder.

On the other hand being overweight, even to "morbidly obese" levels, typically takes decades for the symptoms to become severe enough to present an immediate health risk. Obviously, you're better off doing something about it sooner rather than later, but the pressure isn't nearly so immediate.

You may get a life or death problem quicker with anorexia, but you will still inevitably reach that same kind of point by being morbidly obese.

Besides, you're supposed to be committed to treatment for being dangerous to yourself or others. Even cutting yourself can get you put in a mental hospital. I'm willing to bet most doctors would agree, cutting yourself isn't as dangerous as eating ice cream all day with diabetes and weighing 400lbs.

This must be a UK thing. In the US you can eat or starve yourself to death if you like. You can walk around with a tinfoil cap too. One only is committed when a crime is involved.

Median wrote:You may get a life or death problem quicker with anorexia, but you will still inevitably reach that same kind of point by being morbidly obese.

Besides, you're supposed to be committed to treatment for being dangerous to yourself or others. Even cutting yourself can get you put in a mental hospital. I'm willing to bet most doctors would agree, cutting yourself isn't as dangerous as eating ice cream all day with diabetes and weighing 400lbs.

Sure, but like I said it'll take time. It's the equivalent of smoking 20 cigarettes a day versus being a crack junkie.

CdesignProponentsist wrote:This must be a UK thing. In the US you can eat or starve yourself to death if you like. You can walk around with a tinfoil cap too. One only is committed when a crime is involved.

You might be subjected to treatment in some cases if you had anorexia nervosa or similar. Anorexia isn't just being skinny, it involves altered self-perception and fear of weight gain.

Matt_B wrote:

Median wrote:You may get a life or death problem quicker with anorexia, but you will still inevitably reach that same kind of point by being morbidly obese.

Besides, you're supposed to be committed to treatment for being dangerous to yourself or others. Even cutting yourself can get you put in a mental hospital. I'm willing to bet most doctors would agree, cutting yourself isn't as dangerous as eating ice cream all day with diabetes and weighing 400lbs.

Sure, but like I said it'll take time. It's the equivalent of smoking 20 cigarettes a day versus being a crack junkie.

When someone who is morbidly obese gets to a point where their life is on the line, are they committed to psychiatric treatment like those who are too skinny? If people who cut themselves are forced in mental hospitals for treatment, clearly it's not about immediate life threatening problems, but simply harming yourself; which those who are moribdly obese clearly do.

Median wrote:When someone who is morbidly obese gets to a point where their life is on the line, are they committed to psychiatric treatment like those who are too skinny? If people who cut themselves are forced in mental hospitals for treatment, clearly it's not about immediate life threatening problems, but simply harming yourself; which those who are moribdly obese clearly do.

People who self-harm are, again, not a valid comparison. They're at an elevated risk of suicide, and it's fairly common for self-inflicted injuries to become more severe over time if they're left untreated. They're probably not at quite as high a risk as anorexia nervosa sufferers, but I'd imagine they're still at considerable risk.

Anyway, where would you draw the line with the morbidly obese as to when they need treatment? As I've said, the symptoms are unlikely to be severe until they're into their forties or fifties and many will last well into old age. Perhaps you could target those who suffer from diabetes, cancer or cardiovascular problems, but It's also the case that psychological treatment is unlikely to be effective for people who have had a lifetime of being obese; the only widely effective solution is surgery which is very expensive and even that won't work unless the patient is prepared to adapt to a new diet and lifestyle.

Matt_B wrote:

People who self-harm are, again, not a valid comparison. They're at an elevated risk of suicide, and it's fairly common for self-inflicted injuries to become more severe over time if they're left untreated. They're probably not at quite as high a risk as anorexia nervosa sufferers, but I'd imagine they're still at considerable risk.

Anyway, where would you draw the line with the morbidly obese as to when they need treatment? As I've said, the symptoms are unlikely to be severe until they're into their forties or fifties and many will last well into old age. Perhaps you could target those who suffer from diabetes, cancer or cardiovascular problems, but It's also the case that psychological treatment is unlikely to be effective for people who have had a lifetime of being obese; the only widely effective solution is surgery which is very expensive and even that won't work unless the patient is prepared to adapt to a new diet and lifestyle.

So people who self-harm should be committed to treatment because it's likely to "become more severe over time if they're left untreated," but not those who are morbidly obese? If I started to self harm today, I'd probably be put in a mental hospital so it's certainly a valid comparison.

The least people in psychology could do is to if the problem from eating too much is as severe as the problem from eating to little, to put them both in a mental hospital. Whether they should or shouldn't put someone in a mental hospital can be debatable, but it should be no debate that they should be consistent... The majority would be outraged if they started putting them in mental hospitals for eating too much. It's apparently okay to do it to the minority though.

Median wrote:So people who self-harm should be committed to treatment because it's likely to "become more severe over time if they're left untreated," but not those who are morbidly obese? If I started to self harm today, I'd probably be put in a mental hospital so it's certainly a valid comparison.

In case it's not immediately obvious, we're talking a much shorter timescale here, of months/years versus decades.

The least people in psychology could do is to if the problem from eating too much is as severe as the problem from eating to little, to put them both in a mental hospital. Whether they should or shouldn't put someone in a mental hospital can be debatable, but it should be no debate that they should be consistent... The majority would be outraged if they started putting them in mental hospitals for eating too much. It's apparently okay to do it to the minority though.

I've already outlined the differences in the level of risk, timescale and effectiveness of treatment. If you still wish to suggest that they're in some way equivalent, I think we'll have to leave the discussion here.

Matt_B wrote:

Median wrote:So people who self-harm should be committed to treatment because it's likely to "become more severe over time if they're left untreated," but not those who are morbidly obese? If I started to self harm today, I'd probably be put in a mental hospital so it's certainly a valid comparison.

In case it's not immediately obvious, we're talking a much shorter timescale here, of months/years versus decades.

The least people in psychology could do is to if the problem from eating too much is as severe as the problem from eating to little, to put them both in a mental hospital. Whether they should or shouldn't put someone in a mental hospital can be debatable, but it should be no debate that they should be consistent... The majority would be outraged if they started putting them in mental hospitals for eating too much. It's apparently okay to do it to the minority though.

I've already outlined the differences in the level of risk, timescale and effectiveness of treatment. If you still wish to suggest that they're in some way equivalent, I think we'll have to leave the discussion here.

"The least people in psychology could do is to if the problem from eating too much is as severe as the problem from eating to little, to put them both in a mental hospital." Even if the time scale is the same, the morbidly obese still aren't forced in mental hospitals. If someone is due for a heart transplant or to lose a leg, they aren't forced into a mental hospital for psychiatric treatment are they?

Besides, the law is about being an imminent danger to yourself, right? Months or years as you say is not imminent, and just because something isn't deadly doesn't mean it's not dangerous, yet they still put someone who starts harming themselves in a mental hospital and do nothing about those who eat themselves to death.

Median wrote:Why is it that people seem to be forced in a mental hospital for being too skinny, but not too fat?

Who's forced in for being too skinny? My understanding would be that they are having medical problems associated with being so thin. On the flip side, an obese person also experiencing medical problems will also be told to receive medical attention and will also be informed there that they are at an unhealthy weight.

I don't quite get your point.

HughMcB wrote:

Median wrote:Why is it that people seem to be forced in a mental hospital for being too skinny, but not too fat?

Who's forced in for being too skinny? My understanding would be that they are having medical problems associated with being so thin. On the flip side, an obese person also experiencing medical problems will also be told to receive medical attention and will also be informed there that they are at an unhealthy weight.

I don't quite get your point.

The morbidly obese person isn't forced in a mental hospital for psychiatric treatment like those who are too skinny. Eating too little harms yourself, as well as eating too much, yet only the skinny people seem to be forced in a mental hospital.

logical bob wrote:

CdesignProponentsist wrote:This must be a UK thing. In the US you can eat or starve yourself to death if you like. You can walk around with a tinfoil cap too. One only is committed when a crime is involved.

You might be subjected to treatment in some cases if you had anorexia nervosa or similar. Anorexia isn't just being skinny, it involves altered self-perception and fear of weight gain.

Yeah, I'm familiar with anorexia. But it wouldn't happen in the US. Best that could happen is hospitalization if they lost consciousness, but as soon as they were conscious again there is no legal grounds for keeping them.

CdesignProponentsist wrote:

logical bob wrote:

CdesignProponentsist wrote:This must be a UK thing. In the US you can eat or starve yourself to death if you like. You can walk around with a tinfoil cap too. One only is committed when a crime is involved.

You might be subjected to treatment in some cases if you had anorexia nervosa or similar. Anorexia isn't just being skinny, it involves altered self-perception and fear of weight gain.

Yeah, I'm familiar with anorexia. But it wouldn't happen in the US. Best that could happen is hospitalization if they lost consciousness, but as soon as they were conscious again there is no legal grounds for keeping them.

Why do you say that? I've heard of a US psychiatric nurse who said he had to commit someone who was starving herself. So it does happen.

I have very mixed feeling about this. On one hand, I look at it like substance abuse: If they don't want to live, and aren't hurting anyone else by poisoning themselves, so be it. Not my problem. Eating disorders are much the same, but just as with substance abuse, they become everyone else's problem when they show up in the ER in extremis with their family shouting "Save them!" Then it costs $250,000 to put Humpty Dumpty back together just so they can get out of the hospital to drink, smoke, shoot up, eat/don't eat again.