In the state of Virginia, there are many barriers to the involuntary hospitalization of adults. You may recall the highly publicized story of state senator Creigh Deeds, who brought his paranoid, delusional, and violent son to hospital under emergency custody order only to see him released without treatment when the order expired. His son nearly stabbed his father to death before killing himself.
Following this highly publicized tragedy, Virginia's emergency custody laws have been updated, making it easier for people in the throes of a mental health crisis to receive emergency treatment. In turn, this has caused hospital overcrowding. In a system where there aren't enough beds to treat people who are actively trying to harm themselves and others, Anna's slow, stubborn suicide via poop bag is just not a priority.
Anna is an adult, she does not want inpatient treatment for her eating disorder, and in Virginia, there are extremely strict requirements that must be met before a person can be involuntarily hospitalized for observation, let alone treatment.
These are set by the legislature. Anna does not meet these requirements.
Mama Ginger -
ahem - can't do shit.
We know Mama Ginger does not just let Anna do whatever she wants in the home, because Anna complains about living in Caesar's household and following Caesar's laws. Otherwise, we know very little about this situation, and everything we do know is filtered through Anna, who isan unreliable narrator at the best of times, and an outright liar at worst.
Opinions are divided over whether Anna's mother should kick her out, let her deteriorate, and then pursue guardianship status. This is something very few parents can bring themselves to do. There are not many resources available to Mama Ginger.