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Eating disorders such as anorexia and bulimia continue to be of concern and interest to medical and mental health practitioners. A wealth of literature and media productions are available for both professional and lay audiences. Some of this information is enlightening; some is confounding. James E. Mitchell's new book,
Bulimia Nervosa, seeks to expand our knowledge of that disorder, until recently the lesser known of the two major eating disorders. The incidence of bulimia nervosa has been found to be greater than that of anorexia, thus compelling our attention.
By narrowing his focus to a particular segment of the eating-disordered population—namely, adult, normal-weight women with bulimia nervosa—Mitchell provides the practitioner who has little or no information an excellent base from which to understand the complex phenomena of eating disorders. Mitchell works within a descriptive and behavioral theoretical framework, because, as he states, psychodynamic models are not well developed. Given the wealth of literature available from a dynamic, psychoanalytic perspective, one can argue this point. The reader seeking this kind of information will have no trouble finding sufficient material. Mitchell's book is a clear, concise, and thorough discussion of a behavioral approach in the context of a medical model of treatment. As such, it is extremely useful. It is not, however, a comprehensive overview of theoretical perspectives, dynamics, and treatment strategies of eating disorders.
Mitchell begins his book with a definition of bulimia nervosa as a behavioral disorder. He notes the relationship between bulimia and such other phenomena as affective disorders, alcohol and drug abuse, and personality disorders. He describes cultural variables, such as women's conflicts about their roles and our society's current preoccupation with thinness. He thus sets the stage for subsequent chapters dealing with assessment and treatment.
The outline that Mitchell provides covers ever