In the UK, hospital admissions for eating disorders are increasing, with an 8% annual rise for adolescents according to a recent report (bbc.co.uk/news/health-25960988). It seems more likely that this is due to increasing prevalence and seriousness of the condition rather than changing trends in management. With bed space so limited in both paediatric and adolescent psychiatric units, most of us regard admission as a last resort; in-patients represent only the tip of the iceberg of overall disease burden.

In January 2014 The Lancet published two important trials with editorials relating to anorexia nervosa. One is particularly relevant to …