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Can Anorexia Be Treated with Medication?

BySCOTT TERRANELLA, M.D., ABC News Medical Unit
June 13, 2006, 5:29 PM

June 13, 2006 — -- Michelle Cruz was 14 years old when she read a story in a teen magazine about girls vomiting to lose weight.

"I took it the wrong way," she said. "I don't think it was meant as a how-to, but it gave me the idea. I tried it right away. I lost weight, my body felt better, I thought I was faster, quicker and better at sports."

It wasn't until she collapsed at age 15 while playing high school volleyball that it was revealed she had an eating disorder. She was hospitalized for anorexia nervosa and treated with the antidepressant Prozac.

While she says the drug helped her recover, medical research is less clear about its benefits for people with eating disorders. Specifically, a new study now shows that Prozac, also known as fluoxetine, may not be the magic bullet doctors and patients hoped it would be, although it does appear to help some women, like Cruz.

In a study published in the Journal of the American Medical Association, researchers compared Prozac to a placebo to try to prevent relapse of anorexia nervosa in women who had successfully regained weight.

"The results were disappointing, and surprising," said Dr. Timothy Walsh, the study's lead researcher and a professor of psychiatry at the New York State Psychiatric Institute at Columbia University Medical Center. "Fluoxetine was no better than the placebo in preventing illness."

Less than one third of the women were able to maintain the weight they'd regained (27 percent of the fluoxetine group and 32 percent of the placebo group). Experts had hoped a combination of psychotherapy and medication would lead to treatment success.

Since many anorexics also suffer from depression and anxiety, there has been keen interest in antidepressants, and many patients are currently treated with them. Many case studies have been positive, such as Cruz's story.

"I was on Prozac for a long time and felt good," she said. "I stopped taking it on my own when I went to college. I got worse after stopping and felt worse when I wasn't on something."

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