A patient with anorexia nervosa who has been hospitalized for refeeding may actively try to sabotage any attempts to provide adequate nutrition.

Patient selection: anorexia nervosa


A sabotaging behavior should be suspected if:

(1) the weight gain is less than expected

(2) the patient is not being strictly observed


Types of behavior that are intended to sabotage treatment:

(1) resisting feeding attempts

(2) purging

(3) food diversion, including nasogastric feeds

(4) turning off drips

(5) drinking water or wearing weights to suggest weight gain

(6) compulsive exercise

(7) attempting to leave against medical advice

(8) recruiting friends and family

(9) inducing illness to prevent transfer to a psychiatric ward

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