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Book Review

The Treatment of Eating Disorders: A Clinical Handbook

Joel Yager, MD

Published: May 15, 2011

The Treatment of Eating Disorders: A Clinical Handbook

edited by Carlos M. Grilo, PhD, and James E. Mitchell, MD. Guilford Publications, New York, NY, 2009, 606 pages, $75.00 (trade cloth).

For those interested in the treatment of eating disorders, this substantive new clinical handbook by Drs Grilo and Mitchell provides a superb resource, presenting the best perspectives of an internationally renowned group of the field’s leading authorities. The handbook accomplishes several feats. First, its clearly written chapters review the tried and true; next, it updates the growing evidence base on which clinical practices have increasingly relied; and finally, it describes some of the newer and still-evolving theoretical paradigms and treatment strategies for eating disorders, several of which have not previously appeared in major texts. This collection represents as clear a status report as I’ ve seen regarding how the field is thinking about what current and emerging treatments can offer.

Interested readers might wish to Google the detailed table of contents to see what’s covered in these 35 chapters. Suffice it to say that the field is well covered—anorexia nervosa, bulimia nervosa, binge-eating disorder/eating disorder not otherwise specified, and night-eating syndrome. Obesity per se is not addressed separately, although chapters consider obesity in relation to eating disorders and psychiatric aspects of gastric surgery for obesity. Treatment paradigms include nutrition; pharmacology; multiple types of individual psychotherapies; family-based treatments; inpatient, partial hospital, and outpatient settings; self-help approaches; and the application of newer technologies to these disorders. The text is divided into 5 parts: an overview of eating disorders, treatment of anorexia nervosa, treatment of bulimia nervosa and binge-eating disorder, special topics in treatment, and research issues. The editors introduce each of the 5 parts with a brief synopsis of contents. Chapters describing cognitive-behavioral therapy, interpersonal therapy, psychodynamic psychotherapy, medication management, and other key approaches provide scholarly reviews, updates, treatment principles, and a few "mini-manuals." Since a blow-by-blow review of each chapter is not possible here, I’ ll simply share a few observations and highlight several novel offerings.

Although the discussion of diagnosis in the overview section may have to be tweaked after the updated DSM-5 appears in 2013, the basic concepts concerning diagnosis and assessment are likely to remain substantially similar to those comprehensively covered in Part I.

Among overall excellent chapters on the treatment of anorexia nervosa in Part II are 3 new or infrequently covered topics, addressing specialist-supportive clinical management, cognitive remediation therapy, and compulsory (involuntary) treatment for anorexia nervosa. In Part III, also containing excellent chapters devoted to the treatment of bulimia nervosa and binge-eating disorder, are 3 chapters focusing on dialectical behavior therapy, integrative cognitive-affective therapy, and self-help approaches. And among the special topics addressed in Part IV are chapters on the treatment of childhood eating difficulties and disorders, obesity treatment for binge-eating disorder in the obese, treatment of night-eating syndrome, and new technologies in the treatment of eating disorders (including Internet-based treatments, e-mail, texting, telehealth, and PDA-assisted approaches). This section also includes a notable chapter focusing on those who care for individuals with eating disorders, dealing with carer distress and burden. To my knowledge, these topics have not previously been covered in such detail in published clinical handbooks.

Part V, addressing the assessment of eating disorder treatment efficacy and needs for future research, goes beyond the usual job description of a clinical handbook and points to knowledge gaps and future needs for empirical investigation. The material included here will be useful to investigators and funding agencies developing policies and research agendas, but is of less concern to the average clinician.

The bottom line: Clinicians and students interested in the assessment and treatment of patients with eating disorders will definitely want to own this book. It’s a keeper.

Joel Yager, MD

Author affiliation: University of Colorado School of Medicine, Aurora, Colorado. Potential conflicts of interest: None reported.

Volume: 72

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