Bill W., one of the co-founders of Alcoholics Anonymous, wrote the Big Book of Alcoholics Anonymous and also the companion volume, Twelve Steps and Twelve Traditions. He also published a whole series of articles under the title, As Bill Sees It.

Dr Bob, the other co-founder, is remembered for just one saying: "Let's not louse the whole thing up. Let's keep it simple."

There are those who believe that Dr Bob's one statement was the most profound of all. Addicts tend to be compulsive complicators. Never is this truer than in the guidelines that tend to be written for sufferers from eating disorders.

In the PROMIS Recovery Centre in the last seventeen years we have treated over a thousand inpatients suffering from eating disorders. We should by now know something about the subject but it is remarkable how many people, sometimes with no clinical experience whatever, have absolute firm convictions on precisely what should or should not be done for patients with eating disorders.

The most vociferous of these are, of course, the potential new patients. The failure of their own ideas may be manifestly obvious in their compulsive behaviour but still they cling desperately to the very ideas that have resulted in so much destruction. Frequently patients from the anorexic end of the eating disorder spectrum will arrive at PROMIS with a long list of food substances that they simply cannot eat, often because "they cause allergic reactions". Correspondingly, patients from the compulsive overeating end of the eating disorder spectrum or those who are bulimic will arrive with a long list of substances that are "binge foods". Each is terrified of the food itself as if it had some magical property of its own. In the case of sugar and white (refined) flour, this is true: they have similar stimulant effects to those of cocaine for recreational drug addicts. They set up a craving for more.

At PROMIS we believe that these are virtually the only food substances that should be of concern to patients with eating disorders. It is the craving for mare that causes the damage and therefore sufferers from eating disorders should focus primarily upon giving up those substances that cause cravings. There are people who binge on fats or fruit or almost anything but the subject of "binge foods" is really a different issue. Eating disorder sufferers will binge, once the initial craving has been stimulated, on whatever food substance they choose. This choice is a habit that can be broken, whereas the craving that is stimulated by sugar and white flour is a compulsion. It is sometimes thought to be paradoxical that at PROMIS we take anorexic patients off sugar and white flour, which are potentially fattening. Our hope in doing so is to demonstrate to the patient that it is only these substances that set up the frightening craving to eat more and more. If they avoid them they will not get the cravings and will hopefully begin to see that other foods can be eaten perfectly safely without that risk.

Similarly we tend to challenge patients on their concepts of food allergies, mineral and trace element deficiencies and intestinal candidiasis. These clinical conditions