I have been asked quite a few questions on sectioning for Eating Disorders under the UK Mental Health Act. Having an eating disorder especially Anorexia Nervosa and a BMI  of 13 and under puts you at a higher risk of getting sectioned . I escaped sectioning very narrowly and went into hospital voluntarily. I still remember those days of bad anorexia when  my reasoning skills had become very impaired, and my delusion of being fat had spiraled out of control. In order to correct such thinking and to repair the brain and body, enforced feeding is bought in.  Enforced refeeding can work for patients, providing it is done correctly and with sensitivity taking into account patient’s history, background, culture and religion: it gets your brain to the point where you have a half-chance of thinking coherently again. Fear of feeding tube encouraged me to gain weight. It is a shame that after all that time the battle is far from over. Going inpatient is often a right choice to make as it puts you at a much higher advantage and gives you a much higher chance of successfully recovering.

A reader is sharing her experience of getting sectioned with us. We have omitted lots of details from her story. The world of Eating Disorder is a very dark and turbulent world, some of the behaviours and thoughts can be triggering for people who are suffering from Eating Disorders and are desperately seeking recovery. To safeguard all, we have decided to use the censor board method (many apologies for that). Also name and some of the locations have been changed to safeguard the privacy of our contributor.

What is Sectioning?

According to Royal College of Psychiatrists “being sectioned means being admitted to hospital whether or not you agree to it. The legal authority for your admission to hospital comes from the Mental Health Act rather than from your consent. This is usually because you are unable or unwilling to consent. The term ‘sectioned’ just means using a ‘section’ or paragraph from the Mental Health Act as the authority for your detention. A better word is ‘detained’. You are detained under the Mental Health Act. The paragraph or ‘section’ number is often used so a patient may told they are on a section 2 or section 3.”

Sectioned for Anorexia

Sectioned for Anorexia

I was sectioned and held forcibly against my will for three months. They simply pinned me to ground, tied my arms and legs with my mother’s scarf and threw me in the back of my father’s Mercedes, two of my brothers sat with me in the back, while my father drove at record-breaking speed to the local hospital. To drown my screams, a Bollywood music was playing at full blast on the car stereo.

 

I was 19 years old then. I will be 22 in December. I am maintaining my weight at the BMI of 18.5. In order to be considered recovered, this is the minimum weight you have to maintain.

Families love getting people with anorexia or bulimia nervosa sectioned. Anorexics have a good chance of getting sectioned due to very low body weight. Bulimics are cleverer and will avoid getting sectioned, even if it means playing along with treatment team and manipulating them to suit their choice of bulimic lifestyle.

Once you’re sectioned, anorexics also play the same game. Gaining weight just to fulfil a minimal requirement to get out of the hospital and willingly going through all the therapy programs.

I hated that unit. There was no freedom. All control was taken away from me. I was told that I couldn’t leave the hospital.   I was fed through the feeding tube for the first two weeks of that period. According to some, I was very close to the point of death. 

I was forced to remain in-patient till my weight reached a certain point which was deemed healthy for my age and height. If I wasn’t sectioned and If I didn’t experience what I experienced in that in-patient unit, I would still be anorexic today. 

My Anorexia

My anorexia was triggered by many factors. I come from a large South Asian family. I have 9 siblings and I’m unlucky the number 7 one.  My father is very skilful in making money.  We always did and still have money.

As a child, I wasn’t abused but I was often neglected. My five brothers had a spoilt and arrogant upbringing. My two sisters were always too busy deceiving and lying to my parents. My younger sister was just quiet and withdrawn. In other words, brothers got away with the drugs and alcohol and sisters got away with the deception. We only had one rule to follow, and that was that every summer holidays we had to go back to our parent’s village to spend time with their relatives. We also knew that one day we will be getting married in that village to so and so relative’s offspring.

I first met Ana (anorexia) at the age of 12 after witnessing a beating my father gave my mother over something she had over cooked. I remember going to bed hungry, and that’s when the whole cycle of not eating started.  While my father exercised control over his off springs and wife, I exercised rigid control over my diet. It went undiagnosed because my parents were too busy bickering and trying to get my brothers out of one trouble after another. Due to yearly trips abroad, we missed months and months of school. We would come back to UK after a long absence from school with fake certificates that would show the authorities that we had been in full-time education abroad.

Anorexia ruled my life for eight years, and it took two force feedings and one sectioning under Section 3 of Mental Health Act 1983 to overcome this disorder.

I was 19 when I was first hospitalised for this disorder. I collapsed at home from sudden cardiac arrest. I was lucky that it happened in front of everyone. I have no memory of that incident, but I was told that I was given CPR in our driveway while my family and neighbours watched.  I arrived at the hospital with slow heartbeat, low pulse rate, chest pains, and a very low blood pressure. I was put in intensive care. I almost died hooked up to a life-support machine caused by the strain that the anorexia had put on my heart. After days in coma, my family made a decision to switch off the machine, and an Imam was called to make a final prayer.  But I did not die; that night, my heart kicked back in, and I came back to life. I was then force fed through a tube, and once my weight stabilised, I was discharged. Three months later, I was sectioned against my will. To be sectioned, you have to have five people who agree you are a danger unto yourself or others. And I was a danger to myself.

 

Life under Section and Inpatient Treatment

The first time I was inpatient I had no choice but to eat. I was put on a feeding tube and through petrified eyes, I read the labels on feeding tube… Fat… grams, Cals…grams. I tried to pull the tube out, but couldn’t. I was being monitored 24/7.

The second time I was inpatient was when my family and treatment team got me sectioned. I refused to eat anything and wanted to stick to a starvation diet. I was under a lot of mental and physical stress. With the stress of staying in the hospital, gaining weight and losing all control over my life, I felt my mind was giving up. My anxiety worsened, and  I just ended up lashing out at anyone who came near me. I was restrained, forced to take medication and injected.

Feeding Under Sectioning

If you refuse meals and supplements for 3 days, you will be given a feeding tube. After skipping meals for several days, I was forced into tube feeding. This was my second time on tube feeding. The difference was that I have no memory of first tube feeding. All I remember is waking up and being on a feeding tube. This time ,it was more real, and I pulled out feeding drips time and time again. I was put on one to one observation for several days.

 Once my weight was restored to a certain BMI, I was taken off the feeding tube. After coming off the feeding tube, I had to eat solid foods and stick to meal plans. I was supervised during and after meals, and if you don’t want to go back on feeding tube, then you would never ever dream of refusing meals, (another alternative they will offer you is a supplement drink). I was not allowed to move around. By that time, I had learnt my lesson a very hard way. Those 14 days on feeding tube were the most horrible days of my life. It took me about 12-14 weeks to get back down to my healthy safe weight. I was given a weight band and told to gain between 1.5 kilos to 2 kilos a week.  I had an eating plan, and  I had to finish everything on my plate and stick to my meal plan. I was given 2-3 choices to choose between every day and I was also provided with halal meals.

 What I hated about in-patient was that basic things were taken away from me like my iPod, mirror, makeup, diary, toiletries, perfume, shoes, scale, tape measure and tweezers. Your luggage is searched on arrival which is completely humiliating.

My family was only allowed to visit me once a week, and those visits were often filled by arguments and negotiations. I hated inpatient with sheer vengeance. I hated my family. I knew if I wanted to get out, I had to sacrifice everything and do what everyone wanted me to do.

 

Leaving Inpatient

I was discharged within three months because of the increased pressure from my family and relatives that I would make a full recovery if my family was close by and more intimately involved with my treatment—helping to administer feeding, working with the medication and so on.  Of course, my family had their own agenda, and I agreed with them on home treatment simply because who wouldn’t want to go home from the eating disorder unit? Forced into leaving home was very disruptive and depressing. But I was out of control. I simply wasn’t capable, at that time, of being sane or rational. The depression that I was experiencing was severe.  I didn’t sleep, I couldn’t concentrate, I could only see one thing, and that was fat and layers of fat on my body. And yet I didn’t want to be in the hospital. I wanted to be discharged, or to discharge myself, so that I could go quietly on my way and live my life without rigid rules of the hospital.  So I reached a compromise with my parents that I gain weight, attend day unit, behave myself and get married. I went to Day unit and left the program after four weeks. What happened after the Day unit is irrelevant. Am I recovered? Yes, I am. Food is a very small struggle, but I’m never ever giving that control to anyone ever again. I maintain my weight because yes that experience has scared me for life.  That act of taking away my iPod, my toiletries, and my tape measure is something I never want to experience again. It has made me tough. At times, I dance to my family’s tune and at times they dance to my tune.

The day I was discharged with restored weight  was the most disturbed day of my life. My mind felt numb.  After losing your liberty, autonomy and freedom of choice, home feels like heaven. That freedom to make small choices is the greatest thing you can ever experience.

I don’t know how to explain this, but if I compare anorexia and my family, then anorexia is my worst enemy. My family did not send me to the hospital and to my grave, but my anorexia did. The voice telling me to starve myself to death did not belong to my family but to my anorexia. Underweight, malnourished and erratic behaviour was not dictated by my family but my anorexia.

The issues I have with my family are my personal issues and if I were anorexic, underweight, brain dead, low in self-esteem, then today I wouldn’t be fighting the battle I am fighting for myself. Over the years I have gotten used to my history of eating disorder, and I’m aware it will always be a part of my life. My mum still gets emotional about it sometimes and looks for signs of a new episode. I used to get really down about it and not want to talk about it. I still don’t talk about it. But now I want to share my experience and try to help other people in the same position, why because many people don’t fully understand the condition, and there is still a huge amount of ignorance about it.