On exactly this same basis, there is no indication whatever for sufferers from eating disorders to be prescribed anti-depressants or other mood-altering prescription medications. Of course Prozac and other selective serotonin re-uptake inhibitors (the wonder drugs of the moment) "work" for bulimia, for which they are commonly prescribed, but so would heroin. On the same basis, heroin would work for toothache, in so far as it took away the pain, but it would do nothing for the underlying disorder of the tooth. Anti-depressants and other mood-altering prescription drugs therefore have nothing whatever to offer in the treatment of patients with eating disorders. They should be totally avoided. Patients need to be helped towards feeling the full range of their emotions and learning to react appropriately so that they have a full and stimulating life. The alternative of suppressing their feelings with sugar and white flour or with the mood-altering effects of bingeing, starving, vomiting or purging, leads to a drab and colourless existence. Great claims are often made for what is achieved through taking antidepressants. The real tragedy of their widespread use is in observing what is taken away: the spontaneity, creativity and enthusiasm that are the essence of life itself.

The one pharmaceutical drug for which there might be a proper place in the treatment of eating disorders is Naltrexone. This is an anti-euphoriant, commonly used in the treatment of recreational drug addicts in order to take away any "buzz" that they might get from taking heroin. The drug is used as an aid to prevent relapse. The idea is that Naltrexone blocks the opiate receptors in the brain and patients will not take heroin if they find that it achieves nothing in the way of mood alteration. On the same principle Naltrexone is sometimes used to help patients suffering from alcoholism maintain their abstinence. At PROMIS we do not use Naltrexone either for recreational drug addicts or for alcoholics because we believe that the best way of maintaining recovery comes through attendance at regular meetings of the Anonymous Fellowships and through working the Twelve Step programme. This mood-altering process is quite sufficient on a continuing basis to counter the suicidal depression of neurotransmission disease. Anything else is superfluous. The use of pharmaceutical substances is dangerous for any patients suffering from any form of addictive behaviour. They may come to believe that the solution to all their problems can, after all, be found in a bottle or a tablet.

For this reason at PROMIS we use pharmaceutical drugs only for a short period of detoxification at the beginning of treatment. It is precisely for this process that I believe one should use Naltrexone, one tablet daily for the first month of treatment, in patients suffering from anorexia. It takes away the mood-altering effects - in particular the sense of total control - of starvation. The great challenge in anorexia is in the double negative: how does one help someone not to not do something? By taking Naltrexone for the first month of treatment, the anorexic patients lose that sense of total control through starvation because it no longer produces a moodaltering effect. Even so, these patients should not be prescribed Naltrexone for longer than one month because otherwise they would risk becoming dependent upon using a substance. This psychological - even if not physiological - dependency upon