For the second time in five days, Mohave County Jail officials are force-feeding polygamous sect leader Warren S. Jeffs because of a self-imposed fast.

The medical staff at the Kingman, Ariz., jail resumed force-feeding Jeffs on Tuesday after he stopped eating Monday evening, according to a Mohave County Sheriff's Office spokeswoman.

Medical director Kirsten Mortenson first placed Jeffs, 53, on a feeding tube Friday morning after he became weak and debilitated because of a prolonged fast.

He was able to resume eating on his own but stopped again, said spokeswoman Trish Carter. She said Jeffs is being closely watched around the clock because of his behavior and condition.

"This has been a continuing problem with his on-and-off eating habits," Carter said. "We've had to force-feed him in the past."

Jeffs' bouts of fasting are often tied to significant court hearings involving the Fundamentalist Church of Jesus Christ of Latter Day Saints. Last week, hundreds of FLDS members turned out in Salt Lake City for a court hearing on sale of property in a trust once controlled by the sect.

In a letter dated July 31 and filed as a court document Monday, Mortenson said Jeffs' condition was deteriorating and "death could be imminent without immediate medical intervention."

The letter, written to Superior Court Judge Steven F. Conn, said Jeffs would be evaluated daily and force-feeding discontinued when he improved.

Carter said medical staff are treating Jeffs at the jail.

Jeffs, head of the FLDS, has been jailed at the Mohave County facility since February 2008. He is awaiting trial on charges related to two underage marriages he conducted.

Jeffs is already serving two consecutive five-to-life sentences in Utah related to his performance of a marriage between an underage girl and an adult member of his sect, which is based in the Utah-Arizona border communities of Hildale and Colorado City, Ariz.

Jeffs has required medical treatment several times since being apprehended in 2006 because of self-imposed fasts or engaging in harmful behavior.

He attempted to hang himself in his cell at the Purgatory Correctional Facility in Hurricane in January 2007 while awaiting trial in Utah. After being convicted and sentenced on charges of being an accomplice to rape, Jeffs was moved to the Utah State Prison.

He was moved from a maximum security unit to the prison's infirmary in February 2008 after fasting left him malnourished and dehydrated. At that time, his knees also were ulcerated because of extended periods of praying. That same month he was relocated to the Mohave County Jail. Four months later, Jeffs again engaged in a fast that left him debilitated.

He was treated at a local hospital and then flown to Las Vegas for treatment of fast-related health problems.

In September 2008, a fast again left Jeffs with health problems that required treatment at the Kingman Regional Medical Center. At that time, the jail imposed a 15-minute, thrice daily limit on time Jeffs could spend on his knees praying. Jail Commander Bruce Brown said then that Jeffs occasionally had to be restrained in his bed because he would not comply with the rule.

Mortenson said in her letter to Conn that Jeffs was unable to urinate, had weakened over several days and his "vital signs are worse."

"He has peripheral edema due to protein/calorie malnutrition," Mortenson wrote. "This deterioration will continue to accelerate and become harder to reverse the longer it persists."

In a minute order, Conn said he "would not feel comfortable or even qualified to enter orders purporting to address the specific medical needs of an inmate."

The judge said the jail is responsible for addressing Jeffs' medical issues, "whether brought on by himself or some independent agency."

Jeffs is housed in a solitary cell at the Mohave County Jail; when able, he is allowed an hour outside his cell daily to exercise.

He also is allowed to make telephone calls and receive visitors. His mother, wives and children have visited him there, according to jail logs, as have FLDS leaders Wendell Nielsen and Frederick Merril Jessop.