PORTLAND – Justice Robert E. Crowley granted a request to force-feed murder suspect Christian Nielsen on Thursday. The action comes a day after Crowley ordered Nielsen to undergo a mental health examination at Riverview Psychiatric Center in Augusta.

The request, which was entered by Cumberland County Sheriff Mark Dion, seeks to stem Nielsen’s self-inflicted weight loss.

Nielsen has dropped from 158 pounds to 105 pounds since his admittance to the Cumberland County Jail last September, according to a motion filed Monday by his defense attorney, Ron E. Hoffman.

“He’s reached a point now where the doctors felt today that his body is cannibalizing himself, and even if he’s taking in calories he’s not getting the nutrients from them,” Hoffman said in a televised interview with WGME News Channel 13 on Wednesday. The station also reported that Hoffman told them his client has been diagnosed with anorexia.

Dion said Wednesday that Nielsen’s weight has dropped to 103 pounds.

Nielsen, accused in the quadruple killings in Newry and Upton last Labor Day weekend, stands 6 feet tall.

Under the order, issued in Cumberland County Superior Court, the sheriff may “carry out all medical procedures deemed necessary to preserve Christian Nielsen’s life and physical well-being.” These procedures may include the use of intravenous injections or feeding tubes.

Dion said Correctional Medical Services, the jail’s health services provider, will bring in a doctor who specializes in the digestive system to treat Nielsen. Dion was unable to say the specific method of feeding tube that would be allowed, but said that a nasal tube was one of the more common methods.

“They recognize that they’re being compelled by the law to do this,” Dion said. Crowley reached his decision after a private meeting with the sheriff’s attorneys, he said.

“I support taking whatever effort we can to keep Mr. Nielsen alive so he can have a fair trial,” said state prosecutor Andrew Benson.

Nielsen has been boarded at the Cumberland County Jail since attacking an inmate at the Oxford County Jail in September.

Dion said the Portland jail staff only noticed the weight loss within the past month, after Nielsen had become more selective about his food intake and increased his physical activity.

Dion said the medical center tried unsuccessfully to supplement the weight loss with intravenous injections, and that Nielsen’s blood work shows that his muscle tissue is being consumed for energy.

“Mr. Nielsen was engaged in self-destructive behavior which we thought could lead to his own death,” Dion said. He equated the actions to a drawn-out suicide attempt, which the sheriff is required by law to inhibit.

Nielsen was placed on suicide watch in December after slashing his forehead with a disposable razor.

Hunger strikers should not be artificially fed if the inmate is of sound mind and refuses treatment, according to a declaration made by the World Medical Association, an international organization representing physicians. That position is supported by the American Medical Association, though neither organization has the authority to make laws or policy.

Nielsen’s life-threatening condition influenced the belief that he is mentally unfit to make decisions regarding his own health, Dion said.

“I think you can infer that from the court’s decision,” he said.

In addition, Dion said weight loss can affect one’s cognitive abilities, further decreasing their ability to make informed decisions regarding their own health.

Benson said an examination of Nielsen to determine criminal responsibility, competence, and any abnormal condition of the mind has been completed. However, the results are impounded until the defense determines whether they will use it to enter a plea or go to trial.

Crowley ordered Nielsen to undergo another mental examination on Wednesday. It will be conducted at Riverview Psychiatric Center and places Nielsen under the custody of Brenda Harvey, commissioner of the Maine Department of Health and Human Services.

The jail will focus on recovering Nielsen’s health so he can clear the medical admission requirements for entrance to the Riverview facility, Dion said.

His actions were part of his responsibility regarding the care of inmates, he said.

“I know people are upset that I’m trying to ‘save him,'” Dion said. “But that’s my duty.”

Nielsen, 32, is a former short order cook who was arrested Sept. 4, 2006, at the Black Bear Bed and Breakfast in Newry, where he was renting a room. He is accused of murdering four people over Labor Day weekend: James Whitehurst, 50, of Batesville, Ark., a guest of the inn who was shot in nearby Upton; Julie Bullard, 65, the inn’s owner, who was shot in her bed; and Selby Bullard, 30, Julie’s daughter, and Cindy Beatson, 43, Selby’s friend, who were shot after coming to the inn to check on Julie Bullard. All four bodies were mutilated.

Nielsen’s trial is tentatively scheduled for October.