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Anorexia Nervosa
Bulimia Nervosa
Atypical Anorexia Nervosa
Avoidant Restrictive Food Intake Disorder

Tipping the scales: ethical and legal dilemmas in managing severe eating disorders

American Psychiatric Association Publishing
By Philip S. Mehler, MD, FACP, FAED, CEDS Dennis Gibson, MD, FACP, CEDS

Gibson, D. & Mehler, PS (2021). Role of medical guardianship. In Westmoreland, P. (Ed.) Tipping the scales: ethical and legal dilemmas in managing severe eating disorders. American Psychiatric Association Publishing.

Tipping the Scales: Ethical and Legal Dilemmas in Managing Severe Eating Disorders centers on the complex and at times wrenching medicolegal and ethical challenges encountered in treating patients with severe and enduring eating disorders (SEEDs). Unlike other mental health disorders, for which the care of a medical physician is typically unnecessary, patients with eating disorders have many significant medical complications that demand careful oversight by a physician knowledgeable in treating these disorders. The tragic dearth of such expertise is made more alarming by the fact that anorexia nervosa has the highest mortality rate of any mental disorder aside from opioid abuse. Accordingly, the book addresses the medical consequences of SEEDs and explores that subgroup of patients whose illness appears intractable—people who are no longer seeking a “cure” but, rather, enough improvement to afford them a reasonable quality of life. For such patients, depending on their age, treatment history, and support system, treatment teams may either commit to achieving a full recovery or engage in a harm reduction model.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…
Written by

Dennis Gibson, MD, FACP, CEDS

Dennis Gibson, MD, FACP, CEDS serves as the Clinical Operations Director at ACUTE. Dr. Gibson joined ACUTE in 2017 and has since dedicated his clinical efforts to the life-saving medical care of…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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