A High Court judge has ruled that it is in the best interests of a woman who suffers from "extremely severe" anorexia to be fed against her wishes.
Mr Justice Peter Jackson found that the 32-year-old, who has other chronic health conditions, "lacked capacity" to make a decision about life-sustaining treatment.
Sitting at the Court of Protection in London, the judge said it was a "very difficult decision" to make in a situation requiring "a balance to be struck between the weight objectively to be given to life on one hand and to personal independence on the other".
Her case had "raised for the first time in my experience the real possibility of life-sustaining treatment not being in the best interests of a person who, while lacking capacity, is fully aware of her situation".
Giving his conclusion in a judgment made public, he said: "The competing factors are, in my judgment, almost exactly in equilibrium, but having considered them as carefully as I am able, I find that the balance tips slowly but unmistakably in the direction of life-preserving treatment.
"In the end, the presumption in favour of the preservation of life is not displaced."
He declared that "it is lawful and in her best interests for her to be fed, forcibly if necessary".
The "resulting interference" with the rights of the woman, who lives in Wales and cannot be named for legal reasons, but is referred to as E, was "proportionate and necessary in order to protect her right to life".
The judge said of her: "Albeit gravely unwell, she is not incurable. She does not seek death, but above all she does not want to eat or to be fed.
"She sees her life as pointless and wants to be allowed to make her own choices, realising that refusal to eat must lead to her death."