It’s an article by Professor Christopher Fairbairn submitted in September 2004 (and thus possibly out of date) to the International Journal of Eating Disorders published by Wiley Interscience on 25th April 2005. The title is Evidence Based treatment of Anorexia Nervosa. I found it here http://www3.interscience.wiley.com/aboutus/topics/eating_disorders_evidence_base.html - hope that link works better

The abstract reads “This paper addresses the question Is evidence-based treatment of anorexia nervosa possible? Barely is the conclusion drawn. New forms of treatment are needed for adults with anorexia nervosa, and the true value of family-based treatment for adolescents has yet to be established. © 2005 by Wiley Periodicals, Inc.” and the article appears (at least to me as a simple bean counter without a clinical qualification to her name) to be arguing that there isn’t yet any overwhelming evidence for the so called evidence based treatments for Anorexia Nervosa cited in the NICE guidelines

The authors feel that we as doctors should be more forthright ambassadors for conventional medicine. They blame doctors for colluding with alternative medicine out of ignorance and also expedience - we wish to use the ‘harmless placebo’.

Your position on acupuncture appears to be quite close to this harmless placebo argument, whereby alternative therapies are provided for a difficult to treat conditions as a way of keeping our customers satisfied. (The authors consider acupuncture to be ineffective in all but analgesia and nausea and even then to be no better than conventional treatments and with weak evidence). Singh and Edzard consider the harmless placebo approach to be ‘paternalistic and inevitably involves deception’. It is discussed on page 244 onwards (hardback).

Equally I’m not so grandiose as to presume that nothing ‘cept what I learnt at medical school is useful in promoting, improving or maintaining health.

But, although fairly open minded, I am cautious about the explicit intervention. Look it in the eye and tell me what it is. We know from aromatherapy studies that the type of oil is irrelevant. Maybe the studies were wrong, but the take home message to me was it’s the process not the active agents that give benefit.

Crystal therapy, colour therapy, there’s all sorts of presentations of stuff that I’ve sat through which really has bemused me.

Acupuncture, as you say, scores points. It can work. It has little in the way of treatment emergent adverse events. It is fairly cost efficient (locally there are over 600 folk having acupuncture on the NHS regularly, i.e. at fixed regular intervals forever) and this investment in indefinite longditudinal care has contained them (with no other input from other services now necessary). Prior to this, frequent ‘phone calls to GP surgeries and trips to A&E and repeat Consultant referrals were the norm. None of these are mental health patients, so in mainstream health provision I would see acupuncture as having some utility in affording both better patient care (with helpful symptom reduction) and meaningful impact.