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June 14, 2006

Fluoxetine Treatment of Anorexia Nervosa: Important but Disappointing Results

Author Affiliations

Author Affiliation: University of Minnesota, Minneapolis.

JAMA. 2006;295(22):2659-2660. doi:10.1001/jama.295.22.2659

Anorexia nervosa is a severe, treatment-resistant illness primarily affecting women. It has one of the highest all-cause mortalities, and the highest suicide rate of any psychiatric illness.1,2 Restriction of food intake, refusal to maintain adequate body weight, and disturbed thinking about food, weight, and body image are hallmarks of this illness. A prominent associated feature is profound ambivalence about therapeutic efforts (whether nutritional, psychological, or pharmacological) aimed at weight restoration. In addition to the classic pattern of extreme food restriction, a subset of patients also report binge eating and purging behaviors (the “binge-purge subtype”). Co-occurring psychopathology is common, especially depression, obsessive-compulsive disorder, and other anxiety disorders.3