Family Eating Disorders Manual: Guiding Families Through the Maze of Eating Disorders

Reviewed by Jessica Setnick

The Family Eating Disorders Manual is obviously intended to be read by family members of an individual with an eating disorder. However it also contains a wealth of concise, helpful information for the new or experienced professional. I wish this book had been available 15 years ago, or any time between now and then, as I would have recommended it to every one of my patients’ families. Before I had even finished reading it, I had already recommended it to a colleague who asked me how to help her sister, whose daughter is in treatment.

The credentials of the many authors are impeccable. Even before the publication of this manual, their combined contributions to the eating disorders field have impacted much of our current knowledge and practice. Unlike other books written by multiple authors, The Family Eating Disorders Manual is cohesive and structured. Although each chapter lists its individual authors, the topics flow and the format is standardized, unlike many compilations that are simply a hodge-podge of chapters each written by someone else.

The overarching theme of the book is that family members did not cause their loved one’s eating disorder, but if they are willing to choose the path of education and compassion, they can support and enhance their loved one’s recovery. The preface states that the book is based on the Center for Balanced Living’s family education program, developed in 2006 and then refined based on input from participants and data analysis.

Five of the first six chapters are set up as the response to questions we have all been asked innumerable times, such as “What’s happening to my loved one?” and “What can I do?”. The answers start out broad (“The neurobiology of decision-making and eating disorders”) and hone in on practical tools and suggested responses. The latter chapters and appendices cover behavior change theory as it applies to eating disorders, nutrition basics, caring for the caregiver, and an explanation of the treatment team approach and typical levels of care. Each chapter ends with “Questions for Reflection,” providing space for the reader to write his or her own answers and notes and enhancing the collaborative tone of the book.

Naturally, I took special interest in Chapter 8: Food as Medicine, ably written by Dietitian Sonja Stotz. I was initially skeptical, wondering if I would have to rip out this chapter before giving anyone the book, as I have been burned by family-oriented folks who discount dietitians. So please appreciate the significance of my conclusion: I wouldn’t change a thing.

Sonja articulately conveys the role of each member of the refeeding triumvirate – dietitian, family member, patient – while emphasizing the absolute necessity of both communication and structure. I especially appreciated her description of the many factors the dietitian takes into account when developing the recovery meal plan, something that might give those do-it-yourselfers pause. My favorite part of the chapter was everything – the way it encompasses so many positive messages while emphasizing appropriate boundaries. In other words, everything I like about the manual as a whole.

The Family Eating Disorders Manual fills a gaping void in the eating disorders field, and is not just for individual family members. It could be used as a leader’s guide in multi-family support groups, and a quick refresher for a professional who needs to catch up on the latest in the field. Offering a combination of education as well as strategy, the latest in research plus the voice of experience, empowerment along with respect, this book will be recommended daily by eating disorder professionals who will be thrilled that they didn’t have to write it themselves.

Kindle version $19.99 through Amazon http://amzn.to/138vhRR

Printed version $45 through Gurze Books http://www.bulimia.com/productdetails.cfm?PC=2063

PDF Downloadable version $19.99 Available through The Center for Balanced Living http://www.centerforeatingdisorders.org/main/index.php?page=121&module=263

Eating in the Light of the Moon: How Women Can Transform Their Relationships with Food Through Myth, Metaphor, and Storytelling (ISBN: 0-936077-36-0);

By: Anita Johnston, Ph.D.

Weaving a rich tapestry of multicultural myths, ancient legends, and simple folk-tales, Anita Johnston inspires women to free themselves from disordered eating by discovering the metaphors that are hidden in their own life stories.

Spiritual Approaches in the Treatment of Women with Eating Disorders, by P.Scott Richards, Ph.D., Randy K. Hardman, Ph.D., Michael E. Berrett, Ph.D.

Reviewed by Garalynne Binford

Spiritual Approaches in the Treatment of Women with Eating Disorders was written by clinicians, all trained in psychology, at the Center For Change eating disorder treatment center in Utah.  The writing is aimed primarily at experienced mental health practitioners working in the eating disorders field, with the hope that spiritual approaches will be incorporated and researched more in eating disorder treatment settings. Although I am a religious person, I have not had significant experience with spiritual approaches in eating disorder treatment. This book painted a clear picture of how the interplay between spiritual beliefs and eating disorders can be indispensable to recovery. I believe that if I were recovering from an eating disorder, I would want to have spirituality incorporated in my treatment.

The book was organized well, beginning with an introduction, theory and supporting research, moving into outlining a theistic spiritual framework, and then specifically and comprehensively describing the spiritually-informed treatment used at Center for Change.  A brief basic introduction to eating disorders is provided, including the multi-disciplinary team (including a dietitian) in treatment, and then the majority of the book assumes a level of familiarity with eating disorder treatment. The primary focus is, as one would expect, on incorporating spiritual approaches into psychological therapy, with a strong emphasis on evidence and research. The authors review existing research as well as extensive suggestions for future research.  Two information-packed chapters report data from the authors’ own outcome study, which appeared well-designed.

Although there was very little information related to food or eating, per se, lots of practical suggestions for treatment were discussed.  Two concepts particularly struck me as useful.  One concept was the heart, or core spiritual self.  Getting patients to tune in with their heart can help them make decisions that are most congruent with their spiritual beliefs.  Another concept was miracles.  Asking patients to actively look for (and expect) miracles in their lives can help patients have a more tangible experience of their spirituality.  The last section, Case Reports and Patient Perspectives, was especially meaningful to me.  The authors provided several detailed accounts of spirituality influencing (and largely accounting for) their own patients’ recovery in a wide variety of circumstances, including results of qualitative studies that were performed. The recovered patients’ own accounts of the role of spirituality in their recoveries were hugely inspirational.

I would definitely recommend Spiritual Approaches in the Treatment of Women with Eating Disorders to anyone offering psychological therapy in eating disorders, and certainly to anyone with an interest in spirituality or religion.  Although many eating disorder dietitians will find the content not readily applicable to their work, it will provide reassurance that helping patients nourish themselves can be part of those patients’ spiritual journey. When I had finished reading this book, I found myself wanting to read a book on the same topic directed toward patients.  It would be lovely to see something like that in the future.

Spiritual Approaches in the Treatment of Eating Disorders is available for $59.95 through Gurze Books at http://www.bulimia.com/productdetails.cfm?PC=1475.

Love Me, Feed Me: The Adoptive Parent’s Guide to Ending the Worry about Weight, Picky Eating, Power Struggles and More, by Katja Rowell, MD

Published 2012 by Family Feeding Dynamics LLC, ISBN #0615691315

Reviewed by Kathryn Zavodni, MPH, RD, LDN

Love Me, Feed Me is a comprehensive guide to solving childhood feeding struggles and weight concerns. Although written specifically for foster and adoptive parents, Love Me, Feed Me is relevant and beneficial for any type of caregiver dealing with feeding frustrations. Elaborating on Ellyn Satter’s “Division of Responsibility,” Love Me, Feed Mepresents the “Trust Model” of child feeding and examples to help with its implementation. The basic premise: given appropriate structure and a pressure-free environment, children can learn to eat competently and self-regulate their intake. Simply put, adults are guided to prioritize how children eat over what they eat. Additional focus is given to specific concerns often observed among foster and adopted children, such as special needs, sensory issues, food obsession, and selective eating.

Eating disorder dietitians already appreciate the critical importance of the “how” of eating, so although Love Me, Feed Me is not about eating disorders, per se, it can reinforce and support our teachings and recommendations in the minds of the parents of our youngest patients.  It is also an invaluable reference for new dietitians and any provider who works with children and parents (foster, adoptive, biological, or any combination thereof) with feeding or weight concerns.

The author, Katja Rowell, MD, is a primary care physician turned childhood feeding specialist. In her medical practice, she grew frustrated with the failure of conventional medical advice to help individuals and families correct problems (real or perceived) with eating and weight concerns. She ultimately left her medical practice to focus her attention on helping families establish healthy feeding relationships.

Dr. Rowell’s casual, conversational writing style and her message of encouragement and validation make this an easy cover-to-cover read. The reader in a hurry can use the comprehensive index to find the most pertinent and useful information. Love Me, Feed Me also provides a wealth of information in appendices, for example Medical Issues That Can Affect Feeding; Tips for Dealing with Health Care Providers; and Snack and Meal Ideas.

This book is a must-read for foster and adoptive parents at any stage along the parenting journey. It will also be immensely useful for any parent struggling with a child’s feeding or weight and dietitians looking for another voice that supports the goal of developing internal guidance and “competent” eaters.

Love Me, Feed Me is available in paperback for $17.95 here: http://amzn.to/11f0Fip.

The Kindle version is available for $9.99 here: http://amzn.to/141NbYp.

The Emotional Eater’s Repair Manual: A Practical Mind-Body-Spirit Guide for Putting an End to Overeating and Dieting

Written byJulie M. Simon, MA, MBA, LMFT

Reviewed by Meagan Rothschild

Don’t let the title fool you. The Emotional Eater’s Repair Manual is for a population much broader than strictly emotional eaters. While it is a must read for anyone struggling with overeating, it is beneficial for any reader with an interest in developing a healthy lifestyle through mind, body and spiritual balance.  This book outlines a program that would be a helpful strategy in the toolkit of any Eating Disorder Dietitian, particularly those looking to enhance their counseling approaches and techniques.

Julie Simon, MA, MBA, LMFT has developed a realistic approach to overcoming the underlying causes of imbalanced eating based on her Twelve Week Eating Recovery Program. Her extensive experience is evident as she follows her principles and practices with patient dialogue, clearly demonstrating the various situations in which each skill would be useful in practice.

The Emotional Eater’s Repair Manual “presents five self-care skills, five body-balancing principles, and five soul-care practices that can end overeating and dieting forever.” The author suggests reading and practicing each principle as it applies to the reader’s individual interests, something that I greatly appreciated about this book. It is broken up into three parts as follows, Part 1: Mastering Self-Care Skills, Part 2: Tuning Up Biochemistry, and Part 3: Filling Up Spiritual Reserves. I found myself bookmarking nearly every page in the self-care skills chapter, but skimmed over the nutrition and spiritual parts as they were not applicable to my current needs.

Chapter 8, Principle 1 is easily one of the most important parts of the book from an emotional eating recovery standpoint. It addresses hunger and fullness cues and suggests charting physical hunger versus emotional hunger via fullness scales and daily eating logs. Chapter 9, Principle 2 offers a wealth of nutrition knowledge, but is heavily based on vegetarianism. While the book does not force the reader into following a specific diet, Simon’s nutrition suggestions in this chapter may not be appropriate for all eating disorder patients, especially those with a tendency to restrict. That being said, she does provide general nutrition information that would be very helpful for a reader seeking basic nutrition knowledge. Overall, I agree with her philosophy of providing self-care skills and sound nutrition practices, not a quick-fix diet, to develop a healthy lifestyle void of emotional eating.

Print version $11.53 through Amazon: http://amzn.to/RwUX85

Kindle version $10.33 through Amazon: http://amzn.to/Vo4FaY

Making Peace with Your Thighs: Get off the Scales and Get on with Your Life

Dr. Linda Mintle, Integrity Publishers, 2006

Reviewed by Samiha Ahmed

Making Peace with Your Thighs: Get off the Scales and Get on with Your Life is an easy-to-read book about battling negative self-perceptions. The author does a great job of exploring the many factors in the American environment that contribute to negative self-esteem, then demonstrating how this negative self-image relates to everything we do. The information would be very useful for individuals battling with eating disorders, anyone on an eating disorder treatment team, and even family members or friends of those with eating disorders. I have already recommended the book to a few people that I know would benefit from learning how to spin a negative self-image into a positive one.

The author, Dr. Linda Mintle, PhD, is a licensed marriage and family therapist with experience as a social worker and as a national speaker. She has experience working with psychiatric disorders, focusing on eating disorders, and with her background as a therapist, she is able to provide accurate information on patients and their views from her experience. Dr. Mintle connects to the reader by using anecdotes from her life, both serious and entertaining, while interjecting humor into otherwise bleak situations. She comes across, through her writing, as an empathic individual who is easily approachable with her laid-back attitude and the experiences she has gone through that she highlights in the book. She is very rooted in her religious belief which permeates not only the book but every other aspect of her career. I have a very different religious background but nevertheless was able to relate to a lot of her belief system and approach.

Over all, the book was well organized. The chapter titles were clever – for example, “Thighs and Sighs of the Times,” “You and Me and Body Make Three” and “Dates and Mates” – and the material in each section is explained thoroughly. I had an easy time relating to the material and understood the references. The drawbacks, though few, are understandable given Dr. Mintle’s perspective as a counselor. For example, she included a lot of information about eating disorders but only mentioned dietitians by name in one small area as a passing thought for meal planning. This was disappointing as there were many instances that dietitians could have been highlighted, especially given the case studies she used. There was one part that did not sit well with me, which was the section on weight loss towards the last quarter of the book. Dr. Mintle suggests that the key to weight loss is “simply” to eat less and exercise more, which of course could be very triggering to the very individuals who would benefit from other areas of the book.

Even with these drawbacks, Making Peace with Your Thighs: Get off the Scales and Get on with Your Life is a gem thatprovides valuable assistance for anyone on the journey to self-acceptance, whether they are a patient or a professional. Analyzing the effects of media, family, friends and the dreaded mirror in our lives can help readers see ourselves in a new light.

Making Peace with Your Thighs: Get off the Scales and Get on with Your Life is available in paperback through Amazon at http://amzn.to/1800Hf2.