Book Review March 15, 2010

Integrated Treatment of Eating Disorders: Beyond the Body Betrayed

Merry N. Miller, MD

J Clin Psychiatry 2010;71(3):364

Article Abstract

From our regular book review column.

J Clin Psychiatry 2010;71(3):338-347

Submitted: July 23, 2008; accepted May 1, 2009.

Corresponding author: Chadi A. Calarge, MD, Department of Psychiatry, University of Iowa Carver College of Medicine, Psychiatry Research, 2-209 MEB, 500 Newton Rd, Iowa City, IA 52242 ([email protected]).

Integrated Treatment of Eating Disorders: Beyond the Body Betrayed

by Kathryn J. Zerbe, MD. Norton, New York, NY, 2008, 370 pages, $35.00.

Integrated Treatment of Eating Disorders by Kathryn J. Zerbe is an outstanding addition to the current literature on eating disorders. Zerbe shares nearly 30 years’ worth of clinical and academic experience treating and teaching about eating disorders, providing thorough discussions of every aspect of these complex illnesses. At the same time, she conveys humility about the many difficulties of working with this population, including her own fears and frustrations. This volume is such a gift to those who work with eating disordered patients: it normalizes the challenges that all clinicians face and provides in-depth discussions about how best to help these patients.

In her preface, Zerbe describes this as a "pragmatic text" (p 1), and indeed her text provides wide-ranging discussions that are anchored in the reality of many years of clinical experience. There are many clinical vignettes from her years in practice that bring the text to life. Zerbe has organized her material into 3 sections: an overview about how to approach treatment, a discussion of developmental issues at each stage of life, and a final section on special issues including sexuality and transference/countertransference issues. This structure results in a text that is dense with information.

Zerbe reviews the current literature in a wide variety of areas, creating a resource that is very up-to-date and comprehensive. She includes discussions about the neurobiology of eating disorders, psychological concepts, and cultural influences. She also describes psychotherapeutic approaches for these patients in much depth. Theoretical discussions about therapeutic concepts are followed by well-chosen vignettes.

The organization allows for discussions about aspects of these disorders that are not commonly addressed. Developmental variations in clinical presentation and therapeutic approaches are described, including the more familiar onset during adolescence and lesser-known presentations during adulthood. Sexuality in the context of eating disorders—a topic that is frequently ignored—is addressed well. Transference and countertransference issues are also discussed skillfully, important topics to understand for those working with this very challenging and sometimes provocative population. The book concludes with a thoughtful discussion of resiliency and of the meanings of good outcome.

In summary, this text provides an opportunity to learn from a true sage in the field of eating disorders. It is highly recommended for clinicians from all backgrounds and can also serve as a valuable source of information for patients and family members. If a clinician or trainee wanted to find a single source for eating disorder education at multiple levels, this would be the text to recommend.

Merry N. Miller, MD

[email protected]

Author affiliation: James H. Quillen College of Medicine, East Tennessee State University, Johnson City. Potential conflicts of interest: None reported.