A recent article by Ramasami [1] examines involuntary commitment in the context of anorexia:

While hospital-based treatment can safely refeed and restore weight, the environment is not reproducible and many patients are unable to apply what they learn in hospitals to their home environments. This helps explain why patients often quickly lose weight immediately after discharge and havehigh rates of rapid re-hospitalization. Id.

There are also clinical concerns regarding the humanity of coercive refeeding, the efficacy of involuntary psychotherapy,environmental differences between inpatient units and home resulting in limited generalizability between settings, and the role of the structured inpatient setting in allowing pathological behaviors such as rigid attention to detail and inflexibility to thrive. Id

Outcome data comparing voluntary and involuntary treatment suggest minimal clinical differences between these populations, with the involuntary treatment group's longer average length of stay explained by higher acuity. Id.

Despite these complicating factors,multiple studies assert that involuntary treatment of patients with eating disorders is ethically and legally justifiable when the patient is at imminent risk of deathfrom the medical complications of the disorder. Id.

The hospital remains the only setting in which emergent care can be provided while the patient is monitored for acute medical problemsduring refeeding, and the inpatient psychiatric unit is often the only setting able to manage complex psychiatric comorbidity and offer involuntary treatment, if needed. While involuntary treatment is reserved for patients that do not respond to less restrictive treatment modalities, it remains an option for patients with a significant safety risk.Some providers may be reluctant to utilize civil commitmentto treat anorexia nervosa for a variety of reasons; however, the life-threatening nature of the illness increases the risk of adverse outcomes with an unassertive approach.It is difficult to determine mental capacity for consent to treatment in patients with anorexia nervosa compared with other mental illnesses.Manypatients are intelligent and self-disciplined, present themselves as credible witnesses during court proceedings, and provide rational explanations for their disordered eating behaviors.At the same time, they are often resistant to treatment, have minimal insight into their illness, and demonstrate irrational behavior in the context of significant morbidity and mortality risk. Id. [Citations omitted].

A 2015 study examining the laws pertaining to inpatient and outpatient mental health and substance treatment in the United States reported that only 18 states were consistent in consent requirements across treatment type and modality.Twenty-one states did not allow a parent or legal guardian to psychiatrically hospitalize a minor without the minor's consent.Eleven states granted minors this right before the age of 16, and four states did not specify an age. Although laws may have changed in the past five years, it remains true that the legal requirements for minor consent to mental health treatment vary considerably between states. There is little research investigating the strategy of involving other systems to compel a minor into treatment. Id. [Citations omitted]

Based on this data, how would a court consider a situation where a minor with anorexia wants treatment and the parents object? Conversely, consider the situation where the parents want involuntary commitment and the parent objects - how would the Parham court analyze the issue (Parham v JR, 442 US 584 (1979))? Do you agree with states that require a parent and minor to agree to commitment?