Body Image, Eating Disorders, and Obesity

With the 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 process.

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 book’s 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 audiences alike.

© 2002 Yvonne Melia

Yvonne Melia writes about herself:

My interest 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 men.

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.