I was so hoping no one would ask me about that reference.  It was mentioned
in an English-language television documentary about the treatment program
for anorexia nervosa at Karolinska Institut in Sweden which I saw on
Norwegian TV last year.
This treatment program does not consider anorexia nervosa to be a
psychiatric, but a metabolic disorder.  They do treat it behaviorally, by
doing whatever it takes to get the patient eating, and find that when their
body weight gets over a certain threshhold, they improve further and faster.
According to the TV film they have better long-term success than psychiatric
approaches.  
The producer of the documentary was the father of a young woman who was
under treatment there, after nearly dying of anorexia which psychiatric
treatment failed to improve.  I seem to remember she came from Down Under -
it was a long way from Sweden, anyway, could have been the US too.  
This thing of appetite center being turned off by weight loss below a
critical level, was the reason they decided to stop viewing anorexia as a
mental illness, and start treating it as a somatic one.  They cited studies
done on normal weight adults who voluntarily participated in a starvation
experiment.  These adults developed the mental features of anorexia nervosa
when they were starved enough.

It's a bit of a stretch to assume that the exact same thing is happening in
a newborn, but who of us hasn't seen the baby who appears content to starve?
And, when they are actively fed for some time so that they catch up to where
they should be, they suddenly start to take the initiative themselves like
any other baby.  A baby who passively accepts being underfed is a lot
scarier to me than the one who hasn't given up trying yet and is crying a
lot.  When I see pacifiers being offered to babies who are not getting
enough food, it makes me crazy.  I can't get those pacifiers out of the way
fast enough.  Once a baby is gaining like wild, I try not to get too
invested in whether parents choose to offer pacifiers or not.  But when the
health (or even life) of the baby is at stake, I don't have any trouble
being very direct.  Anything else constitutes negligence, in my book.

Rachel Myr
Kristiansand, Norway

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