Eating Disorders

by

Nina Rovinelli Heller

• LAST REVIEWED: 06 May 2015
• LAST MODIFIED: 30 September 2013
• DOI: 10.1093/obo/9780195389678-0195

Introduction

The biopsychosocial perspective central to social work theory and practice provides the ideal lens through which to understand the prevalence, etiology, phenomenology, and treatment of eating disorders. Once considered an illness of middle- and upper-class white girls and young women of affluent countries, studies now show that eating disorders are no longer confined to these groups. Eating disorders are now identified throughout the life cycle, within a range of racial, ethnic, and gender groups, and occur in increasing numbers in non-Western countries. Although interventions aimed at modifying and eliminating the sometimes life-threatening symptoms in individuals are critical, an understanding of the social forces and individual and familial attributes that converge to create these “assaults on the body” is equally important, at both the prevention and intervention levels. Historically, eating disorders have included the diagnoses of anorexia nervosa and bulimia and, more recently, binge eating. Obesity, although not explicitly covered in this article, is an emerging public health issue. Obesity has been considered primarily a medical issue, although some researchers propose that it is a variant of eating disorders. Furthermore, although eating disorders have been generally considered to be distinct categories, they may be better understood as part of a continuum. Prevention and intervention need to be focused on “moving targets,” given the changing demographic picture of prevalence and the variable course of the illness. Considerable evidence indicates the need for multidisciplinary approaches to treatment; indeed, the bulk of the theoretical and empirical literature is from disciplines other than social work, although social workers as a group provide most of the mental health services in the United States. This article reviews literature from across disciplines, including that by social workers.

Introductory Works

These introductory works generally include multidisciplinary handbooks and manuals that address prevalence, etiology, theoretical understandings, diagnosis, and prevention and intervention. Brumberg 1988 provides a fascinating and engaging history of the complex relationship among factors related to culture, gender, and society and provides an excellent framework for understanding subsequent developments in the disorder. Edited handbooks Grilo and Mitchell 2010 and Agras 2010 are comprehensive sources providing overviews and applications to various populations. In addition, comprehensive references are very useful. Directed toward practitioners, American Psychiatric Association 2000 uses the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) organizing framework for its practice guidelines for the treatment of eating disorders.

• Agras, W. Stewart, ed. 2010. The Oxford handbook of eating disorders. New York: Oxford Univ. Press.

  DOI: 10.1093/oxfordhb/9780195373622.001.0001

  This handbook is a very comprehensive source that should be of interest to both beginning and advanced practitioners and researchers. It is divided into four parts: phenomenology and epidemiology, approaches to understanding the eating disorders, assessment and comorbidities, and prevention and treatment. The chapters on prevention and cost-effectiveness represent particularly new contributions to the literature.

• American Psychiatric Association Work Group on Eating Disorders. 2000. Practice guideline for the treatment of patients with eating disorders. 2d ed. Washington, DC: American Psychiatric Association.

  These practice parameters, organized around the DSM-IV, provide explicit guidelines for practice and focus on individual, family, group, and medical interventions.

• Brumberg, Joan J. 1988. Fasting girls: The emergence of anorexia nervosa as a modern disease. Cambridge, MA: Harvard Univ. Press.

  This book provides a fascinating historical perspective on eating disorders, gender, and culture. It is both well researched and highly readable. Read in juxtaposition to more contemporary works, this book conveys a clear sense of how culture shapes our conceptions of health and illness.

• Grilo, Carlos M., and James E. Mitchell, eds. 2010. The treatment of eating disorders: A clinical handbook. New York: Guilford.

  This volume includes thirty-five chapters covering a wide range of issues related to anorexia, bulimia, binge eating, and atypical eating disorders. This book is particularly suited to practitioners; most chapters include very specific treatment protocols and case examples.