AbstractIntroductionInvoluntary treatment may be a life‐saving option for extremely severe anorexia nervosa (AN) in the context of life‐threatening conditions and refusal of care. The long‐term outcomes of patients undergoing involuntary treatment for AN are poorly understood. This study aims to explore quality of life, long‐term outcomes and attitudes towards involuntary treatment in patients involuntarily treated for extremely severe AN.Methods23 patients involuntarily admitted for extremely severe AN (I‐AN), and 25 voluntarily admitted patients (V‐AN) were compared for body mass index (BMI), residual symptoms, quality of life, and attitudes towards treatment almost four years after discharge. In I‐AN, clinical variables were also compared between admission and follow‐up.ResultsAt follow‐up, weight restoration was higher in V‐AN (p = 0.01), while differences in quality of life, BMI, and mortality rates were not significant between I‐AN and V‐AN (p > 0.05). In I‐AN, BMI increased and weight‐controlling strategies decreased at follow‐up (p < 0.05). Despite negative experiences of involuntary treatment, the perception of the necessity of treatment increased from admission to follow‐up (p < 0.01) and became comparable to V‐AN (p > 0.05).DiscussionInvoluntary treatment for AN does not appear to be a barrier to weight gain and clinical improvement, nor to long‐term attitudes towards treatment.