DSM‐IV criteria

a.Refusal to maintain body weight at or above a minimally normal weight for age and height, (eg. weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% below that expected)

b. Intense fear of gaining weight or becoming fat, even though underweight

c. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self‐evaluation, or denial of the seriousness of the current low body weight

d. In post‐menarcheal females, amenorrhoea, ie. absence of at least three consecutive menstrual cycles (a woman is considered to have amenorrhoea if her periods occur only following hormone, eg. oestrogen, administration).
Anorexia nervosa may be further defined as meeting criteria for either the restrictive type (during the current episode of anorexia nervosa, the person has not regularly engaged in binge‐eating or purging behaviour, ie. self‐induced vomiting or the misuse of laxatives, diuretics, or enemas), or the binge‐eating/purging type (during the current episode of anorexia nervosa, the person has regularly engaged in binge‐eating or purging behaviour, ie. self‐induced vomiting or the misuse of laxatives, diuretics or enemas).

QRS criteria

Quality Rating Scale (QRS) criteria

1. Objectives and specification main outcomes a priori
0=unclear
1=objectives clear but main outcomes not specified a priori
2=objectives clear with a priori specification

2. Sample size per group
0=<50
1=50‐100
2=>100

3. Planned duration of trial including follow‐up
0=<3 months
1=>3 TO <6 months
2=> 6 months

Also recorded are the duration of treatment (weeks) and duration of follow‐up (months)

4. Power calculation
0=not reported
1=mentioned without details
2=details provided

5. Method of allocation
0=not randomised and likely to be biased
1=partial or quasi randomised with some bias possible
2=randomised

6. The concealment of randomization:
2. indicates adequate concealment
1. indicates uncertainty about whether allocation was adequately concealed ‐ partial concealment only
0. indicates the allocation was definitely not adequately concealed

NB. This refers to protecting details on how the allocation code from those involved in patient recruitment. This may be achieved by having allocation done by a central independent body, or protection of code by e.g. sealed opaque envelopes.

7. Clear description of treatment (including drug dosages and adjunctive treatment)
0=main treatments not clearly described
1=inadequate details of main or adjunctive treatments
2=full details

8. Blinding – the quality of blinding would be rated according to the following scale:
3. Done and integrity tested
2. Blinding of outcome assessor and the participant but no test of blinding.
1. Blinding of outcome assessor or participant only (single‐blind).
0. Blinding not done

NB Test of integrity of blind is normally done by asking participants to guess their allocated group. Results can be compared to those which would be expected by chance.

9. Source of subjects described and representative sample recruitment that meets the aims of the trial.
0 = source of subjects not described
1 = source of subjects described but is unrepresentative
2 = source of subjects described plus representative sample taken

10. Use of diagnostic criteria (or clear specification of inclusion criteria)
0 = None
1 = Diagnostic criteria or clear inclusion criteria
2 = Diagnostic criteria + specification of severity

11. Record of exclusion criteria and number of exclusions and refusals reported
0 = Criteria and number not reported
1 = criteria or number of exclusions & refusals not reported
2 = criteria and number of exclusions and refusal reported

12. Description of sample demographics
0 = Little/no info (only age/sex)
1 = Basic details (e.g. marital status/ethnicity)
2 = Full description (e.g. socio‐economic status/clinical history)

13. Assessment of compliance with experimental treatments (including attendance for therapy)
0 = Not assessed
1 = Assessed for some experimental treatments
2 = Assessed for all experimental treatments

14. Details on side‐effects
0 = Inadequate details
1 = Recorded by group but details inadequate
2 = Full side effect profiles by group

15. Record of number and reasons for withdrawal by group
0 = No info on withdrawals by group
1 = Withdrawals by group reported without reason
2 = Withdrawals and reason by group

16. Outcome measures described clearly or use of validated instruments
0 = outcomes not described clearly
1= some outcomes not clearly described
2= outcomes described or valid & reliable instruments used

17. Information on comparability and adjustment for differences in analysis
0= no info on comparability
0.5= some info on comparability without appropriate adjustment
1= some info on comparability with appropriate adjustment
2= sufficient comparability info with appropriate adjustment

18. Inclusion of withdrawals in analysis
0 = Not included or not reported
1 = Withdrawals included in analysis by estimation of outcome
2 = Withdrawals followed up and included in analysis

19. Presentation of results with inclusion of data for re‐analysis of main outcomes
0 = Inadequate presentation
1= Adequate
2 = Comprehensive

20. Appropriate statistical analysis (including correction for multiple tests where applicable)
0 = Inappropriate
1 = Mainly appropriate
2 = Appropriate and comprehensive

21. Conclusions justified
0 = No
1 = Partially
2 = Yes

22. Declaration of interests (e.g. source of funding)
0 = No
1 = Yes