Exacting Beauty: Theory, Assessment and Treatment of Body Image Disturbance

By Weiss, Fran | American Journal of Psychotherapy, Winter 2000 | Go to article overview

Exacting Beauty: Theory, Assessment and Treatment of Body Image Disturbance


Weiss, Fran, American Journal of Psychotherapy


J. KEVIN THOMPSON, LESLIE J. HEINBERG, MADELINE ALTABE, AND STACEY TANTELEFF-DUNN: Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. American Psychological Association, Washington, D.C., 1998, 396 pp., $39.95, ISBN 1-55798-541-3.

The goal of this book-the third on body image that was either authored or edited by J. Kevin Thompson-is "to attempt to integrate theory, assessment, and treatment for the field of body image; to provide a guide for researchers and clinicians interested in the field of body image disturbance and to bridge research and practice." After reading this text, the clinician would hope to come away with a clear sense of the etiology of body-image disturbances and then to be able to identify the best clinical treatment that would match patient diagnostic presentation. Although the research material is well handled, the treatment aspect is somewhat incomplete.

The authors present a good overall view of the origin of body image and body-image disturbance, and an excellent historical review of research in the field of eating disorders, i.e., anorexia nervosa and bulimia nervosa, as well as bingeeating disorder and obesity. The book also addresses the complexity of defining, measuring, and creating theoretical models while exploring the social and cultural aspects of body image and the public media emphasis on thinness. And it outlines the current thinking about making a differential diagnosis of body-dysmorphic disorder, often a difficult matter. Some important work in body-dysmorphic disorder is missing, however, such as that of Eric Hollander, M.D.

The book's forte is presenting the reader with a strong array of models for measurements and assessment and different testing methodologies, as well as including helpful tables, appendices, and references.

The 11 chapters are divided into five parts: 1. An Overview: Prevalence, Diversity, Assessment, and Treatment; 2. Societal and Social Approaches; 3. Interpersonal Approaches; 4. Feminist Approaches; and 5. Behavioral, Cognitive, and Integrative Approaches. The term "approaches" is somewhat misleading because it infers presentation of several different treatment methodologies that the book only partially delivers.

The authors conclude that the cognitive-behavioral modality of treatment, supported by "empirical findings," has been the most successful in the treatment of body image thus far, and they are not nearly as exhaustive in covering other treatment modalities, such as the feminist perspective.

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