Someone in our community is engaged in a long-term treatment program for eating disorders. She lives with a group of other women who are patients at the hospital in an apartment down the street from the center where she will spend most of her days. She will be discharged back to her own apartment on Shabbat afternoon, but with no capacity to prepare food. She could eat sandwiches etc., but she raised the possibility of ordering something hot and fresh on GrubHub or a similar app.
I’m thinking that within the parameters of the general pesak that is given for eating disorders that “food is medicine,” and that eating disorders have a 5 year survival rate, comparable to many forms of cancer, it could be considered a tzorekh of a cholah with some sakanah for her to have food she is interested in eating each and every day. With GrubHub she’d be get something hot and fresh.
Any other considerations? Is this flawed analysis?
This is not a flawed analysis at all. If eating the hot food is important for her health, then she can definitely do it. It is minimally a case of חולה שאין בו סכנה, but much more likely a חולה שיש בו סכנה. Even giving it the אין בו category, the halakha is that אמירה לגוי is permitted, see Shulchan Arukh OC 328:17. If she can do this before Shabbat for delivery on Shabbat, even the better. I assume that she will be eating kosher.
If she needs to order on Shabbat itself, and use her phone to do so, then there is a machloket if she can do a derabanan beyadayim for a case of חולה שאין בו סכנה, see again Shulchan Arukh OC 328:17 and Mishnah Berurah 328:57, who rules, like the Shulchan Arukh, that in such a case she needs to do a שינוי, which would be pretty hard when it came to using a smart phone. However, see Nishmat Avraham OC 328:3a, who rules, based on Mishnah Berurah 328:102 (quoting Chayei Adam) that if the דרבנן cannot be done with a שינוי it can be done directly, and he quotes Shemirat Shabbat KeHilkhatah Chapter 33 footnote 23, who says the same in the name of רש”ז אוירבך.
All of this is if we consider this case to only be חולה שאין בו סכנה. However, one should consult with the doctor (with her permission), or with her herself, and it is likely that on the basis of that, this case should be considered one of ספק פיקוח נפש, and all the rules of פיקוח נפש would apply.
When we are dealing with an issue that could really exacerbate someone’s eating disorder, then it should be considered סכנת נפשות. In our case, the person reported that they could eat cold sandwiches, but felt that hot would be better. This was not, in my estimation, a case of פיקוח נפש. If she expressed a real need for it and there was a concern for exacerbating the condition, that would be a different matter.