By Peggy O'Farrell
Enquirer staff writer

Researchers at the University of Cincinnati are studying new drug therapies for binge eating disorder and trying new therapies for anorexia nervosa.

But finding drug treatments for anorexia nervosa, a complex and sometimes fatal eating disorder, is much more complex - often because anorexics are so proud of their extreme thinness that they refuse medical treatment.

"I'm working with an anorexic who's one of the most difficult patients I've ever had," said Susan Mendelsohn, a Montgomery psychologist and consultant for eDiets.com, who herself suffered from anorexia and bulimia when she was younger.

"She weighs 94 pounds. She's dying, basically. I asked her, 'What do you want to see on your tombstone?' And she said, 'I want it to say my name and that I died of anorexia.' "

The spotlight is on eating disorders after reports this week that entertainer Mary-Kate Olsen, 18, was seeking treatment for an eating disorder. The brunette half of the Olsen twins is widely rumored to suffer from anorexia.

Dr. Susan McElroy, director of UC's Weight Management Program, is studying two widely used epilepsy drugs - topiramate and zonisamide - to see how effective they are in treating binge eating disorder.

Early results look good, McElroy said.

"Patients report that they are less preoccupied with food. Their urges to binge go away. They feel full sooner and they have significant weight loss as well," she said.

Experts believe topiramate stabilizes a brain chemical that regulates eating behavior. Zonisamide is believed to regulate levels of dopamine and serotonin, two brain chemicals that regulate mood. But those theories are "pure speculation," McElroy says.

In its earlier stages, anorexia can often be treated in part with antidepressants such as Prozac that regulate serotonin levels, experts say.

But Prozac and other antidepressants are ineffective for anorexics in the acute phase - those who've actually entered the starvation phase of the disease.

"The malnutrition complicates the chemistry within the brain," said Dr. Laurie Mitan, an adolescent medicine specialist who treats anorexics at Cincinnati Children's Hospital Medical Center. "Until the patient has been re-fed, the medications that affect the serotonin symptoms don't work."

For details on the UC's Weight Management Program study, call 558-2882.

E-mail pofarrell@enquirer.com