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This double-blind controlled study examines the impact of clomipramine when taken by an anorexia nervosa population, refeeding in hospital, over and above that generated by the established treatment programme. Of the 16 patients studied, all reached their target weights including three who asked to leave the study. Clomipramine was significantly associated with increased hunger, appetite and energy intake. It tended, though, to be associated with a reduced rate of weight gain, possibly because activity was increased. Patients receiving clomipramine were more stable in their eating habits and maintained body weight better than those on placebo after leaving the trial. These findings indicate the sensitivity of the hypothalamus to changes in body weight. Clomipramine, which is known to act at a hypothalamic level, seems to influence hunger, appetite and dietary intake according to the body weight of the patient. The threshold weights which have been shown to trigger hypothalamic sexual responses, may also influence hunger, appetite, motility and voluntary energy intake.
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