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The Stockholm solution

Transcript: part 1
ROSS COULTHART: From all over the world, the tourists come to Sweden, drawn to Stockholm by the easy charm of one of Europe's most relaxed and beautiful cities. Among the visitors - three Australians. But these young women aren't here for a holiday. As healthy as they look now, when they arrived here, each was terribly ill, suffering from a disease that all too often kills its victims and destroys their families.

JEMMA BOND: I was literally re-fed by a naso-gastric tube and then I joined a psychiatric ward, and realistically, I think, my mental state got worse.

NAYNA PURCHASE: I could feel my heart stopping. My ears were ringing. I couldn't see and I went to bed because there was nothing else I could do. And I didn't know if I'd wake up in the morning.

ROSS COULTHART: Jemma Bond, Nayna Purchase and Tess Stanway have struggled with their eating disorders for years, although that description doesn't really convey the severity of their illness. Jemma and Nayna have Anorexia Nervosa. A few months back they were starving to death. Tess has bulimia, which compelled her to binge uncontrollably on food and then make herself sick.

Their parents realised conventional treatment just wasn't working, so they flew their daughters 16,000 kilometres to find help.

What if the way the world's been treating eating disorders is wrong? What if over a century of dealing with Anorexia and Bulimia as conditions caused by a psychiatric illness just isn't right?

Well, here in Stockholm, in Sweden, they've been asking those questions. And they've developed a new treatment based on a ground-breaking idea on what they think causes these eating disorders. And the results they're getting are startling.

DR MICHAEL CARR-GREGG, PSYCHOLOGIST: This is on a par with the invention of penicillin, the treatment of scurvy and the treatment for infections with antibiotics. I'd put it right up there.

GERALD PURCHASE, FATHER: If science proves it to be true it is an enormous - it's a momentous discovery. It turns things absolutely upside down.

ROSS COULTHART: This is the Karolinska Institute, the internationally renowned medical research centre that awards the annual Nobel Prizes for physiology and medicine. It's here, 11 years ago, that Professor Per Sodersten and Dr Cecilia Bergh began to develop their eating disorder treatment. It's based around a revolutionary theory that this disease is not caused by a psychiatric illness at all. They argue it's often just a consequence of too little food and too much exercise. Their studies show that even a simple diet can develop into an eating disorder. The denial of proper nourishment means the body can respond in alarming ways, trapping a sufferer with the classic psychiatric symptoms we see in anorexics and bulimics. Sufferers quite literally forget how to eat properly.

PROFFESSOR PER SODERSTEN, KAROLINSKA INSTITUTE, SWEDEN: It's intuitively difficult for many people to understand that something as natural as eating can go wrong, but it can. And there are very many examples of what can happen in the brain when eating goes wrong.

ROSS COULTHART: Professor Per Sodersten and Cecilia Bergh have ditched the antidepressant drugs commonly prescribed in other treatments, using a combination of therapies to teach patients how to eat all over again. And, in most of their patients, the psychological problems the girls have then usually begin to disappear.

Do you think that what they're doing here is potentially a cure for eating disorders?

NAYNA PURCHASE: Yes. It may not be an instant cure, but it is a cure.

ROSS COULTHART: What is it they're are doing wrong in conventional treatment in Australia that you think - possibly - they are doing right here in Sweden?

NAYNA PURCHASE: The difference is that in Australia they just got me medically stable and kicked me out, basically. Here, as well as getting me to a level that I can survive, they are teaching me how to eat, when to feel full, when to stop eating, how to manage when I'm out of here.

ROSS COULTHART: There's a long waiting list for this clinic, which can only take 100 patients, including children, at any one time. Swedish nationals are treated here for free. The government has made Karolinska the emergency centre for all of Stockholm's eating disorder patients and more than 200 people have come out of here in remission. After a rigorous scientific trial, Sodersten and Bergh are claiming hitherto unheard of results.

DR CECILIA BERGH, KAROLINSKA INSTITUTE: Seventy-five per cent of these patients would go in remission within about a year and about 90 per cent of those going in remission will stay healthy. We follow all patients for five years after remission.

ROSS COULTHART: Now these are extraordinary claims, but the experience of four Australian families, including three still here in Sweden, does seem to back it up. It's been a huge personal and financial toll for each family to bring their child here - $1,000 a day for outpatients Nayna and Tess, $2,000 for Jemma, who is an in-patient at the clinic.

JEMMA BOND: In Australia I couldn't even imagine getting better. There wasn't even the thought of being normal again.

ROSS COULTHART: Fifteen-year-old Jemma has only been here in Sweden for eight weeks, so it's still very early days yet, but it's clear already to her mother, Caroline, that bringing Jemma to the other side of the world may have saved her daughter's life.

CAROLINE BOND, JEMMA'S MOTHER: Believe me, my daughter, looking back on it, has been ill probably for three years, and she came close to death at least twice. There's nothing indulgent about any of this. I believe that if I took her home tomorrow, she would go back - and she said this to me herself - she would go back down the same track and perhaps die, and the figures are that 20 per cent of them will die without adequate care. And I find that very frightening.

ROSS COULTHART: Hard to believe now, but when Nayna Purchase came to Stockholm four months ago she was the weight of a child half her age.

GERALD PURCHASE: The worst moment was the very first evening at the Royal Children's Hospital. What was gut-wrenching was this little child sitting next to me saying, "I'll do anything. Please don't leave me here." And it was hard, just having this little soul just crying and saying, "I'll go down downstairs to McDonalds, I'll eat anything, But don't leave me here." It kept her alive medically, and for that I'm grateful. But that's the limit to what it did.

ROSS COULTHART: During the last five years, she's had lengthy stays in Australian hospitals, often admitted as an emergency patient because her weight was so dangerously low.

NAYNA PURCHASE: I know that they wasted my time, my parents' time, my parents' money, doing something that they assured us would help me. So in a way I am angry, but at the same time I'd be dead if it weren't for them.

GERALD PURCHASE: I'm grateful that she was kept alive. The treatments were not doing anything.

ROSS COULTHART: How close to death did she get?

GERALD PURCHASE: Very. There were one or two incidents where we thought she was going to die. At one particular time she simply refused to eat or drink and I remember having the conversation with her, saying to her, "For how long can you survive without drinking?" And she said to me, "Maybe five or six days." And I said, "Yep. That means you will be dead next weekend." And she just kept quiet.

ROSS COULTHART: Nayna's father, Gerald Purchase, is a psychologist based in Mildura, in country Victoria. From the medical literature, he understood that eating disorders are supposedly a psychiatric or mental illness, and that the way to treat them is to look for an underlying cause. It's a notion developed last century by a pioneer of modern psychoanalysis, Sigmund Freud.

GERALD PURCHASE: If you had come to me with your child with an eating disorder five years ago I would have treated you in essentially a Freudian manner because I would have looked for the underlying cause and I would not have helped you at all.

ROSS COULTHART: Nayna's Australian doctors went looking for what they thought would be the cause of her eating disorder. That meant often probing and confronting questions for her family.

GERALD PURCHASE: Essentially somebody was always blamed. It was usually my wife. 'Blamed' is perhaps too strong a word, but the reason that triggered it was often given my wife's illness.

ROSS COULTHART: She was suffering from a brain tumour?

GERALD PURCHASE: My wife had had a brain tumour. But there were plenty of other reasons - my wife was too exotic, we were too strict, we were too undisciplined.

ROSS COULTHART: At Karolinska, they believe such psychiatric probing can make eating disorders worse.

DR CECILIA BERGH: The more you ask the patients about why they became anorexic and what was the family situation at that time and keep asking and questioning the patient and the parents about it, the more you maintain the illness. So we don't do that.

DR JOHN COURT, PHYSICIAN, ADOLESCENT MEDICINE: Over and over again I see where parents and families are deeply depressed and distressed by their young person's illness. And of course part of that is - "What did we do wrong? It must have been our fault." Every parent asks themselves. That's not true, or it's not appropriate to explore it.

ROSS COULTHART: Melbourne doctor Dr John Court is one of Australia's most senior physicians specialising in adolescent medicine. He helped set up the conventional eating disorders treatment program at Melbourne's Royal Children's Hospital, but he's so impressed by the Swedish results that he's prepared to acknowledge that decades of psychiatric treatment of eating disorders, while well-meaning, may indeed be useless.

Is there any evidence that any of the conventional treatments for eating disorders have any effect at all?

DR JOHN COURT: Well, the short answer to that is no. I have to say that I have become increasingly disillusioned by the role of formal - what one might regard as conventional psychiatric treatment.

ROSS COULTHART: Why?

DR JOHN COURT: Because they don't seem to work in the way in which we would regard conventional treatment for any other disease to work. They don't seem to help.

ROSS COULTHART: Eating disorders in Australia are on the rise for both sexes. Our culture is more sports- and body-obsessed than ever before. Up to three in every 100 women has Anorexia or Bulimia, up to 20 per cent of anorexics will eventually die because of complications caused by their illness.

But the current treatment to fight this epidemic is clearly failing. There is no scientific proof that it is actually a mental illness which causes young women like these to develop eating disorders, and there's no explanation yet for why women particularly seem more susceptible to the disease.

Per Sodersten and Cecilia Bergh believe that the often bizarre psychiatric symptoms of Anorexia and Bulimia are, in fact, caused by the starvation, and that they're not the cause of the disorder in the first place.

DR CECILIA BERGH: We say that the psychiatric symptoms that all patients have, such as anxiety, depression and obsessional acts and thoughts, are consequences to the distorted eating behaviour, to the starvation, or to the binge eating.

ROSS COULTHART: Trapped in the obsessions of her illness, this young patient has to be encouraged to accept that there's not more in this glass than she's already agreed to drink. The tension here lies just below the surface, never more so than at meal times, under the watchful eye of the their case managers, these patients are measuring out their meals to the nearest tenth of a gram - they don't want to have to eat any more than they've agreed to. It underlines how something so natural for most of us is for these young women utterly confronting.

Jemma Bond is still very early in her treatment and every meal is an ordeal. Patients here are taught how to eat again using a computer known as a "mandometer". This tracks the rate that they consume food against that of normal eaters. It helps them avoid eating either too slowly or quickly.

Jemma eats using the "mandometer" under the supervision of her case manager, Rebecca.

JEMMA BOND: Oh, it's so useful. It's my safety zone now, really.

ROSS COULTHART: Why?

JEMMA BOND: Because I know it won't lie, as such.

ROSS COULTHART: In the next eating room the stress of meal time is too much for another girl. But Jemma has learned just to ignore it.

DR CECILIA BERGH: For about three months, they eat with their case manager and they keep on training and training. It's very much like if you break a leg and you need a crutch and you have a cast, and you keep on training and training with the help of the cast and the crutch, and then eventually you lose the crutch and you don't need it any longer, and that's the same with the "mandometer" - you don't need it for more than maybe three or four months, and then your eating behaviour has normalised.

ROSS COULTHART: After every meal, patients must rest in these warming rooms for an hour. Experience has shown that heat dramatically helps calm the anxiety patients feel about eating. It's also part of their resocialisation, to teach them the skills many have forgotten.

Per Sodersten and Cecilia Bergh's theory has its origins in research done soon after World War II. The allies knew little about how to help starving refugees, so the US military asked a noted scientist, Dr Ancel Keys, to study the effects of starvation on the human body. In that research, which began at the University of Minnesota 60 years ago, 36 fit, healthy and sane young men agreed to starve themselves for six months. They halved their calorie intake. All soon started to develop obsessions with food, doing excessive exercise and binge eating.

DR CECILIA BERGH: They displayed all the symptoms that you see with our patients, with our Anorexia and Bulimia Nervosa patients.

ROSS COULTHART: Per Sodersten and Cecilia Bergh believe that Minnesota study is the crucial element to understanding eating disorders and the best way to treat them. It proved that fit, sane people could develop eating disorders, with all those psychiatric symptoms, just by starving themselves.

PER SODERSTEN: There are two risk factors for Anorexia and eating disorders in general, and that's too little to eat and too much physical activity, and then all sorts of things emerge as the phenomenon develops, and we say that everything, all the symptoms you see in an eating disordered patient, have emerged from these two factors.

ROSS COULTHART: Anorexics have a compulsion to exercise, anything to burn off the calories they may have consumed. Jemma now realises she slid into Anorexia while dieting, studying hard at school and constantly going for long runs. She always refused to believe the psychiatrists in Australia, who she says blamed her eating disorder on her mother's strong character.

JEMMA BOND: I knew Mum had nothing to do with it, but when it's being drilled into your head every day in hospital, you can't help but believe some of it.

ROSS COULTHART: What do you know now?

JEMMA BOND: None of it's correct in that respect. I think my mum was in tears more than I was at some stages in Australia because she felt so guilty, or at least the hospital made her feel so guilty.

ROSS COULTHART: So has it helped your relationship coming here?

JEMMA BOND: Oh, 100 per cent, 100 per cent. I'm now just my mum's daughter again. I'm not her patient, as such, because she had to look after me because she felt she had to because of what she had been told she did.

ROSS COULTHART: Jemma Bond's mother, Caroline, is a Brisbane surgeon, used to treating patients of her own. But nothing prepared her for having to help her own daughter fight Anorexia and the impact it had on her family.

CAROLINE BOND: It feels as if the whole family has Anorexia. We've just been smashed to bits. Someone else used the word 'disemboweling' of the family and I would agree with that completely. We're all asking ourselves, 'did we do something?'. We're all wanting to do something. We all feel totally powerless.

ROSS COULTHART: It's a gradual treatment, taking just over a year to put at least three-quarters of patients into remission. But Jemma Bond has no doubt, even after a couple of months, that it's working.

JEMMA BOND: Nothing's been forced here. I'm never scared, and realistically I'm taking the steps towards recovery myself.

ROSS COULTHART: And that's changing the way that you feel about eating food?

JEMMA BOND: Yes. I feel safe with the meals I have here. Never did I feel safe in Australia.

ROSS COULTHART: Per Sodersten and Cecilia Bergh want their research to be trialed elsewhere in the world to confirm it really is the breakthrough they think it is. But, as you'll see in part two, efforts to get such a trial up and running in Australia are meeting resistance.

DR MICHAEL CARR-GREGG: Well, it seems extraordinary to me that there is such a reticence to even consider this.



Transcript: part 2
ROSS COULTHART: Helen Prim's struggle with Anorexia began when she was 16. Like so many of those with the disease, she couldn't rid herself of the awful obsessions that made her want to starve herself.

HELEN PRIM: It got really serious. I couldn't think of anything else - food, and to get thinner, and everything else in my life was put aside, so I think it was really bad.

ROSS COULTHART: Four years ago, Helen started treatment at the Karolinska Institute clinic, and barring any relapse, by the end of next year she'll be deemed cured.

So you're not technically a cure yet?

HELEN PRIM: No.

ROSS COULTHART: Do you feel cured?

HELEN PRIM: I feel cured. Sometimes I can think that life would be better if I was thinner, or sometimes when everything else is, or something else is bad, I can start to think, "OK, if I don't eat, everything will get better." But every time I think that, something else in my head tells me, "OK. This is stupid. You tried it and it doesn't work."

ROSS COULTHART: Few conventional treatments for eating disorders monitor their patients for any more than a year after treatment. About 40 per cent of those patients relapse. What makes Karolinska's treatment results extraordinary is that not only do three-quarters of its patients get better in a year, 90 per cent of them are still well five years later.

HELEN PRIM: Now it feels really good. I have a life and I don't have to control it with food.

ROSS COULTHART: You're getting married?

HELEN PRIM: Yeah, I'm getting married next year.

ROSS COULTHART: Did that ever seem possible to you three years ago, four years ago?

HELEN PRIM: No. I didn't think that way. I was focused on food and getting thin.

ROSS COULTHART: Were you ever frightened of dying from your eating disorder?

HELEN PRIM: Well, dying sometimes seemed like a way out, because when you're in that thing you can't see a way where you're fully recovered, or a way out. So, yeah.

ROSS COULTHART: It makes where you are now all the more miraculous, doesn't it?

HELEN PRIM: Yeah. Yeah, it does.

ROSS COULTHART: Helen Prim sees herself as living proof that the Karolinska treatment's focus on eating behaviour is the key to beating this disease.

HELEN PRIM: They didn't treat you like a very sick person, a very ill person. They just focused on eating. They didn't focus on the psych ... the problem in your head. They focused on - you know, because, I think when you eat right the problems in your head slowly disappears.

ROSS COULTHART: Because those psychiatric symptoms diminish as patients learn how to eat again is what suggests to Cecilia Bergh that eating disorders are not a mental illness at all.

CECILIA BERGH: We are measuring carefully psychiatric symptoms every six weeks during treatment and we see that the obsessional compulsive symptoms as well as depression and anxiety decreases when the eating behaviour normalises and as an effect of that, the BMI, or the weight, goes up.

ROSS COULTHART: So as they learn how to eat again the psychiatric illness goes away?

CECILIA BERGH: Correct.

ROSS COULTHART: But if you're right, then 100 years of modern psychiatry is wrong, isn't it?

CECILIA BERGH: Yes.

ROSS COULTHART: That must be very confronting for many psychiatrists who are still using psychiatric treatments to try to fix eating disorders.

CECILIA BERGH: I'm saying that the psychiatric community could very well be right. It could be a psychiatric illness, but no-one has shown that psychiatric illness causes Anorexia Nervosa, and as long as no-one has shown that Anorexia Nervosa is a psychiatric illness, then I think we should use the results we have today.

ROSS COULTHART: Eleven weeks into her stay, Tess Stanway is also getting better.

MARIE STANWAY: I can see her love of life coming back. The psychiatric symptoms of anxiety and, you know, obsessions relating to behaviour, and depression, I see them going. I see my daughter coming back as the person that she was.

ROSS COULTHART: Tess's mother, Marie, is getting ready to head home to Australia. But Tess will stay in Sweden. Her father, John, and brother, Jack, have flown in to take over the support role.

MARIE STANWAY: I'm looking forward to going back home, getting on with my life, looking forward to our family being together and just being normal.

ROSS COULTHART: Did you ever think you'd get there?

MARIE STANWAY: I always hoped I would and I never gave up hope. I needed to have the hope to keep going.

ROSS COULTHART: John Stanway knows all too well the high personal and economic cost of eating disorders on Australian families. For as well as being Tess's dad, he's chief executive of one of Melbourne's top teaching hospitals, Monash Medical Centre, which is considering a trial of the treatment in Australia.

MARIE STANWAY: What I would love to see is that this opportunity, that I think we're very fortunate to have had, is available to people that want it.

DR JOHN COURT: I do believe that we would be serving the public well if we were able to introduce this into Australia, and I do believe that we need to have such a trial if we're going to convince the people in the field.

CAROLINE BOND: And I think we really have to now give it a try. What do we have to lose? We're losing girls and wasting an enormous amount of public money.

ROSS COULTHART: What would it have cost the Australian taxpayer to have paid for Nayna's last five years of conventional treatment in Australian hospitals, not to mention the next 10, 15, 20 years of care?

GERALD PURCHASE: Oh, if we were talking about ongoing hospitalisations for the next 10 or 20 years, if we're talking about two or three months a year in hospital...

ROSS COULTHART: We're talking about millions?

GERALD PURCHASE: We're talking about huge amounts.

ROSS COULTHART: Dr Michael Carr-Gregg is one of Australia's top psychologists specialising in adolescent health. He travelled to Sweden last year to see the Karolinska treatment after an Australian girl he was unable to help with conventional treatment got better there. He tried and failed to get a report of her dramatic improvement accepted by the prestigious Australian Medical Journal.

DR MICHAEL CARR-GREG: I think it is shameful that psychiatry, and particularly those elements of psychiatry dealing with eating disorders, have rejected this notion out of hand and have stopped us from publishing the articles that we wanted to publish in the Australian medical journals.

ROSS COULTHART: Are there impediments being put to your being able it to run a trial in Australia?

DR CARR-GREG: When I asked the Centre for Excellence in Eating Disorders whether or not they would run a trial, the answer was no, so that's a pretty big impediment - 'no'.

ROSS COULTHART: There are people in the psychiatric profession who claim that conventional treatment IS working.

DR CARR-GREGG: So put your treatment up against the Karolinska Institute model in a trial. That's all I ask.

ROSS COULTHART: If Karolinska is getting the results it's claiming in its study, they are extraordinary results, aren't they?

DR LOUISE NEWMAN: Look, they're certainly very positive and compared to some standard treatments they are definitely worth doing further research and replicating.

ROSS COULTHART: Dr Louise Newman is chair of the Royal College of Psychiatrists Faculty of Child and Adolescent Psychiatry. She says local resistance to a trial has more to do with a broader problem of inadequate government funding for research into eating disorders.

DR LOUISE NEWMAN: The treatment system here does not even have the basics in terms of infrastructure to allow us to adequately treat the number of people with eating disorders in the community at the stage we would like to treat them. We don't have enough expertise in terms of the work force. We don't have designated facilities that allow to us build up a centre of expertise. We don't have adequate research funding.

I think this is very much a matter for government to think much more broadly about in terms of a research agenda.

ROSS COULTHART: Dr Newman's criticism of the Karolinska's treatment - that it's still experimental - has also been used by the Federal Health Department to decline paying for Australians receiving treatment in Sweden. Do you think that's fair?

DR LOUISE NEWMAN: I think it's a very harsh criteria. It certainly makes it difficult for people in Australia to access programs that are being developed.

TONY ABBOTT, FEDERAL MINISTER FOR HEALTH: I think that the criteria under which the program operates are reasonable criteria. I think my department has conscientiously administered the program.

ROSS COULTHART: Health Minister Tony Abbott says he wants to see a trial of the Karolinska treatment in Australia despite any local opposition.

The reality is that the gatekeepers to the accepting of any treatment into Australia are primarily psychiatrists - the very people who are in charge of the current, let's say not very well-performing conventional treatment. Is that not a conflict of interest?

TONY ABBOTT: If I thought that the profession was unreasonably setting its mind against a prospective new treatment, one option that would be available to me as the minister would to ask the National Health and Medical Research Council to conduct a formal evaluation, and that's certainly something I would look at if I believed on the basis of reasonable evidence that the profession was being unreasonable.

ROSS COULTHART: What is your position on a trial?

TONY ABBOTT: I would certainly like to see one happen. It does seem that this treatment in Sweden is getting very interesting and encouraging results, so let's see if we can have a trial here in Australia.

ROSS COULTHART: Per Sodersten is enthusiastic about the prospect of a trial of his Karolinska treatment in Australia.

PER SODERSTEN: And I think that the first evidence we have produced so far is that the treatment we have here is effective. I think the most important step is to compare this treatment with other types of treatment.

ROSS COULTHART: So you'd like to see a replication of your results in Australia?

PER SODERSTAN: Of course, and all over the world. And that's nothing new - as soon as someone has a good result, in whatever field of endeavour, it needs to be replicated, and this is no exception.

ROSS COULTHART: Today's weigh day for Jemma Bond. Jemma accepts she has to put on weight to get better. But as she's still in the grip of the disease, knowing she's putting on weight is unbearable. To stop patients dwelling on it they aren't told how much they weigh.

Jemma's gained the right amount.

REBECCA JOHANSSON, KAROLINSKA INSTITUTE: She was happy that it's going after the plan. Of course she's terrified of gaining weight. I mean, it's the worst thing in the world. Once you've put on a little bit more weight it's a lot easier to think, and you're a little bit clearer and it's easier to reason about the goal weight.

COUNSELLOR: How many minutes do you spend looking at yourself in the mirror?

JEMMA BOND: Probably in a day, all up, an hour.

ROSS COULTHART: A counselling session later that day. Cecilia is suggesting Jemma may obsess less about her weight if she stops using a mirror.

COUNSELLOR: And you accepted that we took the scale away from you, right?

JEMMA BOND: Yes.

COUNSELLOR: And you accepted not having the very, very tight jeans?

JEMMA BOND: Yes.

COUNSELLOR: And now we have the mirror left. And we need to do something about the mirror, because the mirror actually reminds you about Anorexia.

ROSS COULTHART: Ever so gently, she's being encouraged to change her own behaviour.

COUNSELLOR: And then this is over.

CAROLINE BOND: Jemma's strength to combat this disease - that is what I see as improving at the moment. They are giving her that control, that facility, to say, "This is what I can do to push this disease out of the way." We are not there yet because we haven't discussed exercise, but certainly in her feeding, from a meal point of view, she's in control of her meals.

ROSS COULTHART: Nayna Purchase is well enough now to live in the apartments next to the hospital. All up, coming here for treatment will cost her parents at least $150,000. But five previous stays in Australian hospitals, months at a time, costing taxpayers hundreds of thousands of dollars, had failed to help Nayna overcome this illness. Did any of that work?

NANYA PURCHASE: It made me medically stable. At least my blood count, my weight, my pulse had improved. But I didn't feel any better inside.

ROSS COULTHART: Next week, Nayna's back home to Australia, where she'll be monitored by Karolinska for another four years.

GERALD PURCHASE: I am delighted with what I see. I'm delighted to have my daughter back. But I'm also aware of reality and there is a part of me which still needs to just stand back slightly.

ROSS COULTHART: Do you fear a relapse?

GERALD PURCHASE: Oh, surely. I don't see any evidence, but I certainly fear it.

CECILIA BERGH: I feel very good, and you're so happy for her and for her parents and her friends that she will now go back to school and she will start to face a life of being healthy.

ROSS COULTHART: For these young women, it will take years before any of them can feel confident they're cured of their eating disorders.

JEMMA BOND: Since being in the hospital in Australia, I've made so many friends who have been in a similar situation to me and I'd really like them to be able to have the same opportunity as I have been given.

ROSS COULTHART: Because you think this place works, don't you?

JEMMA BOND: Yes, I do. And I'm only halfway through treatment, but I'm certain this place works.

ROSS COULTHART: The reason they want their story told is because they believe there may finally be a solution to a disease that destroys so many young lives.

CECILIA BERGH: They themselves want to unstigmatise Anorexia and Bulimia Nervosa. They themselves think that there's nothing wrong with them. They happen to have this problem with eating behaviour, but otherwise there is nothing wrong with them. And they know they can be fixed.

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