Anorexia Nervosa and Bulimia
Diagnosis and Treatment
Anorexia Nervosa and Bulimia was first published in 1985.
Anorexia nervosa - deliberate self-starvation - has been estimated to afflict one in 200 white females between the ages of 12 and 18. Bulimia - binge-eating followed by self-induced vomiting, laxative abuse, or fasting - can occur as a symptom of anorexia nervosa or as a separate syndrome. Its prevalence in the population is harder to measure since sufferers do not necessarily lose noticeable amounts of weight and their behavior can be kept secret. Recent research indicates that the incidence of these disorders is increasing and that they are associated with serious medical and psychological risks. Because the causes and symptoms of anorexia nervosa and bulimia overlap, they are best looked at together, as part of a spectrum of eating disorders. Few books, however, provide an integrated approach.
The book is organized in three parts. Part one, on diagnosis and assessment, includes a discussion of the medical complications and the complex psychodynamics of anorexia nervosa and bulimia. Part two outlines the treatment plans developed at the University of Minnesota and at other medical centers. Mitchell and his colleagues describe the application of behavioral principles to the treatment of eating disorders, explaining specific techniques such as cognitive therapy and adaptive skills training; they also evaluate the results of drug therapy and offer practical suggestions for clinicians on its use. This part closes with a comprehensive plan for each disorder.
Many observers believe that eating disorders are related - at least in part - to a paradox in American culture: that in a society with an overabundance of food, the ideal of beauty is an unnaturally thin body. The book ends with an exploration of adolescent attitudes toward weight and eating, based on previous studies and the findings of an extensive survey of adolescent males and females. In its assessment of personal, cultural, and gender-related attitudes toward weight, the survey helps us understand the factors that may predispose some adolescents to eating disorders.
In addition to Mitchell, the contributors are: Elke D. Eckert, Richard L. Pyle, Allan M. Josephson, Dorothy Hatsukami, Craig Johnson, Marilyn Stuckey, Leah Lebeck, Gretchen M. Goff, John T. Kelly, and Sonia E. Patten.