I feel that heter for a roev harbeh is because he is a choleh see mechaber end of 3, and m'b there. the fact that he is eating lerefuah negates the issur.
The m'b seems to be saying that the lack of kavana today is a reason not to be mechayev one to eat.
Im not so sure myself, one thing I do know is that the established minhag is not to eat even if hungry. This is why I said that a rov should decide these things, and no, sorry, even yungerlite who learn three sedorim are not necessarily rabbonim. (I dont know you though)