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startling statistic that only one half of patients with anorexia nervosa recover
and that up to 25% of patients are disabled severely by chronic sequelae of
their disease (Beumont et al, 1993) (p. 184), and the high secondary mortality
and morbidity characterising eating disorders per se, this book provides an
excellent attempt at reconciling the status of thinking about the aetiology of
eating disorders and their assessment and treatment. It is also novel in exploring how body image disturbance relates
to eating disorders and how this can be integrated into the assessment and treatment
The book is divided into three parts, part one
addresses body image disturbance, part two: eating disorders and the final
part: obesity. Whilst particular
coverage is given in the section on eating disorders to anorexia nervosa and bulimia
nervosa, consideration is also given to Binge Eating Disorder, one of the most
recently described and less studied of the eating disorders.
Part one covers theories of body image
disturbance, along with assessment and treatment approaches, assessment prior
to cosmetic plastic surgery, considerations for culturally diverse populations
and the assessment and treatment of Body Dysmorphic Disorder. Parts two and three on eating disorders and
obesity focus especially on assessment and treatment. Particular attention is
given in the eating disorders section to exploring the use of cognitive
behaviour therapy and pharmacologic treatments, and in the section on obesity
the psychological status of the morbidly obese, strategies for improving body
image in this client group and the epidemiology, determinants and treatment of
morbid obesity in African American women are additionally examined. Throughout, useful case examples are given
to expand on detailed approaches to assessment and treatment.
The title of
the book might wrongly lead one to assume its central relevance to clinicians
working in the field of eating disorders. Yet the books exploration of
aspects such as sociocultural factors and their role in body image disturbance
and eating disorders would appeal to a much wider audience.
The book by
steeping itself in a scientist-practitioner approach to the assessment and
treatment of eating disorders and body image disturbance, is particularly
valuable. In so doing, it reviews the
knowledge base and clinical approaches used to date, along with their known
efficacy. In this sense the text is a
crucial accompaniment for researchers working in the field by clearly outlining
gaps in our knowledge base, as highlighted in the chapter on obesity in African
American women, which starkly details how little is known about the mechanisms
of action and effective intervention strategies for this group, and areas
requiring more rigorous research. In
its review of the knowledge and treatment base to date, the book may also be of
interest to service-users.
This Integrative Guide book was published in
1996, and whilst some significant developments have occurred in eating
disorders research since then the work on the biological and genetic bases of
morbid obesity and its pharmacologic treatment particularly springs to mind,
the book is no doubt a valuable handbook for clinicians, researchers, and broader
© 2002 Yvonne Melia
Yvonne Melia writes about herself:
in eating disorders, and particularly the influence of sociocultural factors on
eating disorders, comes partly from my background in psychology, but also from
my personal consciousness of the impact of the contemporary dieting
culture and media representations of body ideals on women and increasingly on
I have a
first degree in Applied Psychology, with a Postgraduate Diploma in Clinical
Neuroscience and am presently employed as Research Associate for the Brain
Injury Rehabilitation Trust.
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