This review provides an overview of some neurobiological factors that may c
ontribute to the development and maintenance of eating disorders, and the p
sychopharmacological treatment of anorexia and bulimia nervosa; Various met
abolic, physiologic, and neuroendocrine disturbances are associated with bu
limia and anorexia nervosa, but it is often not clear whether they represen
t state or trait markers of the disorders. While most patients with bulimia
nervosa who receive appropriate pharmacotherapy will experience significan
t short-term improvement, there is a substantial rate of relapse during lon
g-term continuation treatment with medication. Strategies that appear to im
prove long-term outcome in bulimia nervosa include combination treatment wi
th cognitive-behavioral therapy (CBT) and changing to an alternative antide
pressant medication. The role for medication treatment in anorexia nervosa
remains very limited, although the SSRI antidepressant fluoxetine may have
a limited role in longterm treatment of anorexia.