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Geraldine Shipton sums up the basis of this book in the opening chapter, writing that it aims to consider the different ways in which eating and not eating compensate for an absence of an emotional and relational kind, and the conflicts that might ensue. It goes on to give a very full coverage of the spectrum of eating disorders: anorexia nervosa, bulimia nervosa, obesity and eating disorders not otherwise specified (EDNOS), their links to the external world, the internal emotional world, as well as the psychopathology of the individual, cultural perspectives, and giving up-to-date statistics regarding the provision for treatment of these life-threatening illnesses.
It is both interesting and startling to note that the high mortality rate of those suffering from eating disorders falls behind only the rates for drug abuse (both prescription and illegal) and suicide by self-poisoning, as a cause of death in young adults.
The breadth and depth of this book is vast, with Shipton exploring the earliest history of eating disorders from the Fasting Girls at the time of Catherine of Sienna through to present day culture and perspectives, and she reviews the work of some of the authors who have written about the subject through the ages. Much commitment is given to thinking about eating disorders in the current social and cultural context, the seriousness of the nature of the problems and the complexity of engaging with people who are mostly very frightened and isolated. Differences are carefully teased out between anorexia and bulimia, citing the comments of many authors in the field, and mentioning how an eating disorder may be an expression of varying degrees of psychopathology from an underlying potential psychosis through to a borderline personality disorder, through to a neurotic disposition to a more fleeting transitional problem in adolescence.
The chapter on culture is interesting and diverse, with references made to the pioneering work and perspectives of several femi