Evidence for the effectiveness of existing treatments of patients with eating disorders is weak. Here we describe and evaluate a method of treatment in a randomized controlled trial. Sixteen patients, randomly selected out of a group composed of 19 patients with anorexia nervosa and 13 with bulimia nervosa, were trained to eat and recognize satiety by using computer support. They rested in a warm room after eating, and their physical activity was restricted. The patients in the control group (n ‫؍‬ 16) received no treatment. Remission was defined by normal body weight (anorexia), cessation of binge eating and purging (bulimia), a normal psychiatric profile, normal laboratory test values, normal eating behavior, and resumption of social activities. Fourteen patients went into remission after a median of 14.4 months (range 4.9 -26.5) of treatment, but only one patient went into remission while waiting for treatment (P ‫؍‬ 0.0057). Relapse is considered a major problem in patients who have been treated to remission. We therefore report results on a total of 168 patients who have entered our treatment program. The estimated rate of remission was 75%, and estimated time to remission was 14.7 months (quartile range 9.6 > 32). Six patients (7%) of 83 who were treated to remission relapsed, but the others (93%) have remained in remission for 12 months (quartile range 6 -36). Because the risk of relapse is maximal in the first year after remission, we suggest that most patients treated with this method recover. E ating disorders, i.e., anorexia and bulimia nervosa, are serious health problems in young women (less than 5% of patients are men), characterized by a disordered intake of food. Thus, anorexics eat only small amounts of food and lose body weight; bulimics eat large quantities of food and vomit or use other methods to maintain normal body weight. About 1% of all women develop anorexia at the age of 14-19 years, and 1-3% develop bulimia when 20-23 years old (1). Anorexics have less than a 50% chance of recovery within 10 years after the onset of the disorder, 25% develop into chronicity, and mortality can be as high as 25% (2). Bulimics have a better prognosis, but fewer than 50% recover, and 30% continue to binge eat and purge (2, 3).There is a considerable amount of data on the time course and outcome of anorexia and bulimia nervosa (2-4), but the effect of treatment interventions has not been extensively evaluated. Hence, there is little scientific evidence for the selection of one kind of treatment rather than another. In fact, it was recently pointed out that the effects of most treatments are unknown (5). Evaluation of medical interventions should be done in randomized controlled trials (RCT) (6). Three RCTs have compared treatment effects in young anorexic patients. In the first, family therapy was effective in comparison with individual therapy in 10 patients who had been ill for about 1 year and who had been treated on average once before (7). The treatment had no effect in 70 other patients who participa...

We report the results of a study based on 1,428 patients with eating disorders treated at 6 clinics. These patients were consecutively referred over 18 years and used inpatient and outpatient treatment. The subjects were diagnosed with anorexia nervosa, bulimia nervosa, or an eating disorder not otherwise specified. Patients practiced a normal eating pattern with computerized feedback technology, they were supplied with external heat, their physical activity was reduced, and their social habits restored to allow them to return to their normal life. The estimated rate of remission for this therapy was 75% after a median of 12.5 months of treatment. A competing event such as the termination of insurance coverage, or failure of the treatment, interfered with outcomes in 16% of the patients, and the other patients remained in treatment. Of those who went in remission, the estimated rate of relapse was 10% over 5 years of follow-up and there was no mortality. These data replicate the outcomes reported in our previous studies and they compare favorably with the poor long-term remission rates, the high rate of relapse, and the high mortality rate reported with standard treatments for eating disorders.

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Both treatment regimens are effective; mesalazine suppositories seem to be the preferred alternative.