Can Someone With Anorexia Refuse Treatment?

Anorexia nervosa is a severe mental health condition that can lead to life-threatening consequences.

In the UK, the legal question of whether individuals with anorexia can refuse treatment has been addressed in several recent cases, highlighting the complex interplay between autonomy and protection. The Mental Capacity Act 2005 provides the legal framework for determining whether a person has the capacity to make decisions about their treatment. According to the Act, a person lacks capacity if they are unable to make a decision due to an impairment or disturbance in the functioning of their mind or brain. This determination must be made on the balance of probabilities and cannot be based solely on the person’s condition or behaviour.

The Case of Patricia

The case of Patricia and others is a notable example. Patricia, a 25-year-old woman suffering from severe anorexia nervosa, autism, and pathological demand avoidance, was deemed by the Court of Protection in 2023 to lack the mental capacity to make decisions about her treatment. Despite her refusal of life-saving treatment, the court initially ruled that it was not in her best interests to be forcibly fed, as this would cause her significant distress.

This, however, was reversed by the Court of Protection in 2025, allowing doctors to treat her without her consent if necessary to save her life. Expert testimony in the case highlighted that while some individuals with anorexia may regain capacity if they manage to overcome their condition, Patricia’s anorexia prevented her from using and weighing information to make rational decisions about her treatment.

Best Interest Decisions

The concept of best interests is central to cases involving individuals who lack capacity. Under the Mental Capacity Act 2005, determining a person’s best interests requires considering all relevant circumstances, including their past and present wishes, beliefs and values. For life-sustaining treatment, the decision-maker must not be motivated by a desire to bring about the person’s death. In cases like Northamptonshire Healthcare NHS Foundation Trust v AB, courts have granted declarations that it was in the patient’s best interests not to receive further active treatment for anorexia nervosa, recognising the distress and harm that forced treatment could cause.

These cases underscore the delicate balance between respecting a person’s autonomy and ensuring their protection when their mental illness impairs their ability to make rational decisions. Courts must carefully assess each case, considering the individual’s capacity, the impact of their illness, and their best interests, particularly when life-sustaining treatment is involved. The legal framework provided by the Mental Capacity Act 2005 ensures that these decisions are made with thorough consideration of the person’s circumstances and rights.

Our specialist Care Funding and Court of Protection team can answer any of your queries relating to mental capacity, best interest decisions and the next steps once an assessment of incapacity has been received.

Contact the team today, or call 0800 088 6004.