Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment
Weiss, Fran, American Journal of Psychotherapy
J. KEVIN THOMPSON AND LINDA SMOLAK: Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. American Psychological Association, Washington, DC, 2001, 403 pp., $39.00, ISBN 1-55798-758-0.
Body Image, Eating Disorders, and Obesity in Youth is one of the first edited books on children and adolescents that deals with body image, obesity, and eating disorders. It is a welcome groundbreaker. The editors distill and summarize the findings of examination of risk factors, prevention programs, assessment strategies, and treatment options for 6- to 17-year-olds into a manageable review for beginning clinicians, graduate students, and seasoned researchers.
The impetus for the text is that obesity, eating disorders, and body-image disturbances affect a significant number of children today. The volume consists of 14 chapters and an introduction by the editors. The chapters are divided into four sections: Foundations; Risk Factors; Assessment and Prevention; and Treatment.
Section I lays the groundwork for the discussion of eating-related problems among children and adolescents. Authors Jennifer O. Fisher and Leann L. Birch lead the section by exploring in utero possibilities of developing a dietary taste. They also discuss formula versus breastfeeding. The view of the etiology of eating problems originating from children's earliest experiences with food and eating is in tune with the more psychodynamic literature. This vantage point marks the scope of the problem.
Linda Smolak and Michael P. Levine address the important DSM differential diagnostic question: "Are there body image disturbances among children, or body image problems?" They examine genetic influences to body-image disturbances. Their studies concede that there are no conclusions, just suppositions.
Jennifer Zoler Dounchis, Helen A. Hayden, and Denise E. Wilfrey give an excellent appendix of the summary of body-image and eating-disorder studies within ethnically diverse child and adolescent populations.
Section II is a strong section, which reviews the research of risk factors thought to connect to eating disorders. Catherine M. Shisslak and Marjorie Crago gives us a thoughtful and provoking chapter that tries to separate eating disorders from a generalized psychiatric diagnosis.
Ari B. Steinberg and Vicky Phares examine parental influences on body image and weight concerns. They cite a number of studies that conclude that family therapy is an "effective treatment strategy" since the relationship between parents' attitudes and beliefs concerning weight, eating, and body shape and the development of body image concerns and eating disturbances has been well established.
Mary E. Connors tries to bring light on the connection of the relationship of childhood sexual abuse (CSA) to body image and eating disorders. There is an helpful review of the literature. She also raises an interesting question: Does CSA increase psychic distress, which gives rise to tension reducing activities so that survivors of CSA may use self-mutilation, as well as binge eating, as temporary relief?
Section III is the best section. Kelley Hill and Claire Pomeroy present a new view of body-image disturbances, different from the other chapters. They clearly state that "many adolescents are preoccupied with and critical of their appearance, however, only a small percentage of adolescents go on to develop a true eating disorder." The typical adolescent struggles with control and body image are magnified. They address obesity and offer a warning about total liquid protein diets, medications, and surgery for children and adolescents. …