A Review of:Evidence Based Treatment for Eating Disorders: Children, Adolescents, and Adults (Eating Disorders in the 21st Century),2nd ed., edited by Ida Dancyger and Victor FornariandThe Oxford Handbook of Child and Adolescent Eating Disorders: Developmental Perspectives, edited by James Lock

Abstract

[Author Affiliation]Heather Goff. The Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland.*ISBN: 1631174002. New York: Nova, 2014. 582 pages.[dagger]ISBN: 0199744459. New York: Oxford University Press, 2012. 324 pages.Address correspondence to: Heather Goff, MD, The Center for Eating Disorders at Sheppard Pratt, 6535 N. Charles Street, Suite 300, Baltimore, MD 21204, E-mail: hgoff@sheppardpratt.orgA mother sits in my office, frantic that her daughter refuses to eat anything except noodles with butter and doesn't seem to be growing taller. Later that day, a father becomes distraught when he describes how his son has been more and more withdrawn, eating less and less, and losing more and more weight. And yesterday, an adolescent girl talked about how she desperately wants to lose weight but can't seem to stop herself from bingeing on any food she can find.Most child psychiatrists have heard some version of a story of disordered eating, and yet most child psychiatrists (and indeed most physicians) have surprisingly little training in assessing and treating eating disorders in any age group. In children and adolescents, specifically, it is difficult to learn about the epidemiology of eating disorders, as is the case for many psychiatric disorders. In general, fewer studies are conducted in the pediatric population, and there are lower numbers of kids with eating disorders in the general population than, for example, kids with anxiety; therefore, it is more difficult to detect. In addition, there can be a tremendous amount of shame and secrecy associated with having an eating disorder, so our patients often don't present, and even clinical cohorts may be underrepresented.Despite these difficulties, however, it is quite surprising that child psychiatrists do not have more exposure to eating disorders during their training. Anorexia nervosa is the third most common chronic illness among adolescents (after obesity and asthma) (Herpertz-Dahlmann, 2008). Rates of eating disorders can vary dramatically among studies; the point prevalence for anorexia nervosa lies between 0.3 and 0.9%, and the lifetime prevalence for anorexia nervosa for 20-40-year-old women can be as high as 1.2-2.2%. In more simple terms, 20,000,000 women and 10,000,000 men will have a clinically significant eating disorder at some time in their life. Moreover, 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat, up to 60% of female teens diet regularly, and ∼45% of female teens smoke cigarettes to control weight (National Eating Disorders Association, n.d.).Perhaps even more important, however, is that the onset for eating disorders is typically between the ages of 10 and 20. As child psychiatrists, we need to be educated about eating disorders (National Eating Disorders Association, n.d.).Until a few years ago, I was firmly ensconced in the work of general child and adolescent psychiatry, and I saw only the occasional child or adolescent with an eating disorder. Then I had to move to a new city, and I was offered a job on an inpatient eating disorders unit, despite having almost no experience working with patients with eating disorders. Becoming a subspecialist in child and adolescent eating disorders proved to be a steep learning curve, one that required a lot of supervision, and a lot of reading. Four years into this work, I have a much firmer grasp on the topic than I did when I started, and my clinical expertise has increased tremendously; however, I still do (and always will) depend upon updates and reviews of evidence-based treatment recommendations. I am particularly partial to reviews that include not only research results, but also practical and concrete recommendations for clinical work.In the last few years, a number of treatment handbooks for eating disorders have been published, including the 2014 2nd edition of Evidence Based Treatment for Eating Disorders: Children, Adolescents, and Adults (Eating Disorders in the 21st Century) (edited by Ida Dancyger and Victor Fornari), and The Oxford Handbook of Child and Adolescent Eating Disorders: Developmental Perspectives (edited by James Lock). …