The role of families in the treatment of mental illness has always been a tenuous one. Often blamed (think refrigerator mothers), but also expected to provide continuous care for the afflicted loved one, families carry a significant burden.

The role of families in the treatment of mental illness has always been a tenuous one. Often blamed (think refrigerator mothers), but also expected to provide continuous care for the afflicted loved one, families carry a significant burden.

Clinical trials of both antidepressants and the antipsychotic olanzapine (Zyprexa) have yielded disappointing results, with no clear benefit of medications over placebo for the core symptoms of anorexia.

Because of the dearth of FDA –approved medications for eating disorders, psychotherapy has gradually become the treatment of choice. Nonetheless, clinical trials of off-label uses of various medications have yielded a few impressive results, particularly for bulimia and binge eating disorder.

A variety of psychotherapy techniques work well for eating disorders, particularly for bulimia nervosa and binge eating disorder. This article gives a brief summary of the evidence from controlled clinical trials.

Dr. Yager, what is your procedure for evaluating patients with eating disorders?

While few psychiatrists specialize in eating disorders, most of us see patients with anorexia or bulimia from time to time. It’s hard to keep up on the latest literature when we see such patients rarely. As you’ll read in this article, eating disorders are still among the most challenging treatment issues in psychiatry.

Dr. Bulik, I first learned about your work when I reviewed your book, Runaway Eating, which I rated as the best book for patients on eating disorders. I know that one of the reasons that you gave the book that title is that many patients don’t quite fit the conventional diagnostic categories of anorexia nervosa and bulimia nervosa.