This nine chapter “reference guide to eating disorders” looks at a range of conditions from anorexia and bulimia nervosa to obesity. The book's self‐avowed purpose is to provide practical information about eating disorders and disturbances. Topics include obesity; medical care and physical health issues associated with eating disorders; psycho‐education; socio‐cultural influences; prevention and special populations and treatment.
Following a brief introductory overview of the images of Tinkerbell and Barbie as they relate (or rather do not relate) to real women, each chapter begins with a quotation from a survivor of an eating disorder, and proceeds to look at a different aspect of this social problem. The chapters are generally well referenced, citing mainly recent material – at most, ten years old, with the majority taken from publications within the previous four years.
A whole chapter is devoted to each of anorexia nervosa and bulimia nervosa. The chapter on anorexia includes case studies, examples of some famous people with the condition, and some historical cases already outlined. There is also a brief literature review, covering 1860 to 2001, and an examination of the condition in fiction and autobiographies. The anorexia chapter also looks at the prevalence of the conditions, and some cultural issues – particularly the fact that anorexia is often found in societies that associate attractiveness with thinness, societies which tend to be highly industrialised and technologically advanced. The bulimia chapter, which mirrors the anorexia section, includes a word‐for‐word transcript of how a client describes weight control, binge‐eating and purging.
Chapter 5 looks briefly at medical care and physical health issues. Topics covered include mortality, oral complications, the GI tract, cardiovascular effects, brief paragraphs on neurological issues, kidney dysfunction, dermatological complications, and slightly more detailed outlines of osteoporosis and osteopenia, reproductive system difficulties, and diabetes. Chapter 6 concentrates on psycho‐education – information about eating disorders and disturbances. The chapter looks at important factors in the development of eating disorders, which appear to be related to age and gender (over 90 per cent of cases occur in women). This chapter also covers other factors such as family factors, the cultural context for eating disorders, and socio‐economic status – as the class goes up, so does the prevalence of eating disorder. Other aspects are also covered – such as the set point theory, where the body tries to defend a particular weight. This chapter also outlines a 1940s starvation research study that would undoubtedly not be approved on ethical grounds in the twenty‐first century. Other issues are covered, such as restoring regular eating patterns, vomiting, laxatives and diuretics in controlling weight; health weight; physical complications; and relapse prevention. This chapter also includes a short selection of internet resources – mainly US based, as would be expected.
Chapter 7 examines socio‐cultural influences, particularly the impact of Western culture on eating and body image disturbances. The chapter uses Fiji as an example of a society where obesity is regarded as the desirable image, rather than the emaciated body ideal of the overfed West. This chapter also examines the power of the media, including the reproduction of a small number of powerful images used on posters and billboards in the USA. Chapter 8 suggests that prevention is the only real way to combat the problem. There are other issues, however; quite apart from the cloak of secrecy and anxiety that often surrounds eating disorders, there are not enough mental health professionals to meet the challenge. Childhood through late adolescence is a particularly important time. Examples are given of prevention programmes, including National Eating Disorder Awareness Week and internet based prevention programmes. Special groups are also mentioned – such as athletes and sexual abuse survivors. Chapter 9 concentrates on treatment, and the need for collaboration between mental health professionals and doctors. Suggested interventions include stepped care treatment; self‐help; psycho education; and cognitive behavioural therapy. Types of psychotherapy are also discussed briefly: interpersonal and other kinds of psychotherapy; family therapy; group therapy; medication; hospitalisation; the costs of treatment; what kind of treatment is preferred.
Although this work does not have an overall conclusion, each chapter does have its own summary as well as, in some cases, suggestions for additional resources, and the treatment chapter does have a conclusion. There is also a straightforward appendix which reviews the current American Psychiatric Association recommendations for treatment for anorexia nervosa, bulimia nervosa, binge‐eating disorder and for eating disorders not otherwise specified. In general, this is a well‐referenced, no‐nonsense work, although its emphasis, as might be expected in what is a reprint, is firmly North American. A range of evidence‐based sources are used to inform the chapters, including health reports, books and journal articles. The index is accurate and easy to follow. This book offers a straightforward overview of eating disorders, strengthened by the use of quotations from real survivors as well as evidence from the medical literature.
