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Hunger and Satiety in Health and Disease exhibits both the advantages and disadvantages of books that are collections of papers by various authors. On the positive side, it brings together a series of experimental studies which reflect a broadening of the approach to weight regulation. The chapters dealing with genetic, hypothalamic, extrahypothalamic, and peripheral factors agree in emphasizing the great complexity of the neural regulation: that practically every part of the brain is involved in food regulation in one way or another; that the exclusive emphasis on the hypothalamus is in need of revision; and that the differentiation between 'metabolic' and 'regulatory' obsesity needs to be modified. They also reflect that the old dichotomy between the innate and the experiential is no longer tenable and that learning experiences have a modifying influence on physiological factors. However, progress has not yet led to an integration of the various findings into an internally consistent hypothesis.
The section on disturbances in food intake provides evidence that the subdivision of obesity into different subgroups, postulated by clinicians,1 has an organic correlate in the morphology of the adipose tissue. For instance, hyperplastic obesity shows an increase of the fat cell number, while hypertrophic obesity is correlated with an increase of the fat cell size. The selection of the clinical papers has confined itself to authors with traditional views of the disorders, with an interesting chapter demonstrating that severe weight loss may be an expression of a variety of conditions, not only of anorexia nervosa. Treatment recommendations range from behavior modification, which is described as the superior method for the treatment of obesity, to traditional psychoanalysis for anorexia nervosa, although J. C. Nemiah states that 'the universal value and appropriateness of psychotherapy aimed at uncovering and resolving conflicts is, I believe, open to question'.