Eating disorders of all kinds are common and serious in adolescents and young women. Recent government policies have suggested that adolescent mental health strategies should be developed. They have also laid emphasis on early intervention, accessible local provision and have identi ed eating disorders as a priority. It is acknowledged that services at primary care level for adolescents with eating disorders are sporadic or nonexistent. It was considered that a service user perspective would be bene cial in contributing to assessing the needs of adolescents with eating disorders. The research project was established to identify the service provision used, if any, by adolescent sufferers of eating disorders and what, in their opinion, would have been desirable at that time. The research consisted of a semi-structured interview with a sample of recovered adult participants to establish their experiences of services they had received as adolescents. Additionally the participants were asked what further help they felt would have been bene cial and where that help would have been usefully situated. The main ndings suggest that the majority of health professionals are ill informed and not acutely conscious of the needs of eating disordered adolescents. Only counsellors within the voluntary sector agency showed any real understanding and an ability to help constructively. It was concluded that there is a real lack of help at primary care level and that schools should play a wider role in educating adolescents in a positive belief in themselves and in the destructive nature of an eating disorder. RationaleEating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are amongst the most common mental health problems of our time. They affect large numbers of persons and, in particular, target adolescent and young adult women (Hill and Pomeroy, 2001). Although prevalence gures for the full syndrome in that population are thought to be about 1% for anorexia and 3% for bulimia, more recent conceptualisation of terms of diagnosis in the context of a continuum of 'disordered eating' reveals a prevalence as high as 13% (Piran, 1999;Shisslak et al., 1995). In

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The studies reported here explored whether therapeutic groups for women who eat compulsively can demonstrate weight loss as a primary result as well as the improvements in emotional functioning reported by other investigators. In both studies questionnaire data showed little change in self-esteem or attitudes as measured by the Rosenberg Self-Esteem and the Eating Disorders Examination. However, interview data showed considerable changes in attitudes and emotional functioning. The initial study demonstrated no weight loss but marked changes in participants' attitudes to themselves and food, likely to lead to weight loss. A second, longer, uncontrolled study again showed changes in emotional functioning plus weight loss of 5% or more of initial body weight at the end of the intervention in 75% of participants who completed the study (n 0/8) or 50% of those who were initially recruited (n0/12). Weight loss has been maintained in 75% of participants at 18-month follow-up. The data are based on a small sample, which can only be suggestive but supports a further study.

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