Self-Help Approaches for Obesity and Eating Disorders

Research and Practice
Edited by Janet D. Latner and G. Terence Wilson. New York: Guilford Press, 2007: 376 pp; $38

The past few decades have witnessed a significant ground swell in lay-led self-help programs and in increasingly well-researched, professionally guided, self-help approaches for various psychiatric and medical disorders. These trends have been quite notable in programs for obesity, anorexia nervosa, bulimia nervosa and binge eating disorder. Self-help approaches have been increasingly applied in both clinical and community settings, administered individually and in groups, in face-to-face encounters as well as by “tele-medicine” using telephone and the Internet. These developments have been facilitated by several motivations, including interests in fostering patients’ self-efficacy and self-reliance, as well as ever-increasing concerns by both individuals and providers about the costs of care, the comparative cost-benefits of various approaches, and an increased interest among third-party payers in stepped-care programs.

In such a context, this excellent, extensive, thorough, and timely collection of chapters by well-selected experts is most welcome. The sections include reviews of “unguided” as well as partially assisted (“guided”) self-help, computer-assisted self-help, and group self-help. For obesity, several chapters overview the available programs, including reviews of popular and fad diets for nutritional adequacy and safety. A companion chapter on commercial and organized self-help programs lays out the philosophies, program characteristics and costs of the major programs you’re likely to hear about from patients, including Weight Watchers, Overeaters Anonymous® the Atkins Diet, the South Beach Diet™, TOPS (Take Off Pounds Sensibly), and others. These chapters are complemented by several others considering the management of obesity within professionally administered and monitored programs, both for acute treatment as well as for maintenance and long-term care.

Guided self-help and computer-based programs for bulimia nervosa, binge-eating disorder and body-image dissatisfaction update the current state of the art and outcomes in these areas. Many major research studies are detailed, deconstructed and critiqued, and the quality of evidence in their outcomes is carefully presented. I found the chapters on the prevention and treatment of obesity in children to be practical, and the chapter on self-help for patients with the night eating syndrome to be novel and interesting.

While some programs being tested in Europe and elsewhere have not found their way into this volume, I hope that the editors will update this collection every few years and that they will include an even more extensive survey of programs. In the meantime, for readers interested in how self-help programs of various types may provide effective adjunctive care for patients, and in some instances first-line treatment options, this book offers an excellent jumping-off point.

— J.Y.