Body Image, Eating Disorders and Obesity in Youth: Assessment, Prevention and Treatment

Reprinted from Eating Disorders Review
July/August 2003 Volume 13, Number 4
©2002 Gürze Books

(J. Kevin Thompson and Linda Smolak, eds. Washington, DC: American Psychological Association Inc, 2001;403 pp: $39.95; ISBN: 1-55798-758-0)

This well-edited book, compiled by two authorities in their respective fields, covers a broad array of subjects of interest to those working with weight-related issues in children and adolescents.

Its four substantial sections, in turn, consider “Foundations,” i.e., developmental aspects of eating and body image in children and adolescents; and “Risk Factors,” including family functioning (and dysfunctioning), protective factors, and issues of sexual abuse (why not psychological abuse and physical abuse too??). Two more sections include “Assessment,” with separate chapters on physical status, body image and eating disturbances in eating disorders and obesity; and “Prevention and Treatment,” dealing with body image disturbances, obesity and eating disorders in children and adolescents.

All these sections are written by well-known authorities; some of this work has appeared in other recent edited volumes that have focused on developmental issues and prevention. But other work described here has not appeared in the mainstream.

Several chapters contain excellent evidence tables outlining major findings of the individual studies reviewed in the text. Although the 14 chapters in this volume include many superb ones, several, out of my usual range of reading, particularly caught my eye. Fischer and Birch’s chapter on early development reviews what is known about the role of maternal diet in early taste and flavor experiences, influences of breast and formula feeding, food acceptance patterns in infancy and toddlerhood, and very early parental influences and modeling in shaping and controlling food choices, preferences and dislikes. Dounchis, Hayden and Wilfley’s review of obesity, body image and eating disorders in ethnically diverse children and adolescents draws attention to the tremendous epidemiological health problems associated with high rates of obesity in children and adolescents of particular ethnic groups (the “New World Syndrome”). It discusses what is currently known of the social and cultural forces contributing to this emergence. Empirical data on effective prevention and intervention in these areas is, unfortunately, extremely limited.

Levine and Smolak review primary prevention, providing an excellent synthesis and literature review of body-image disturbance and eating disturbance, and Robinson and Killen do the same for obesity prevention. A final chapter by Sarwer on plastic surgery in children and adolescents takes us a little bit afield, considering the lengths to which children–and their parents–go to contend with body image dysphorias and body dysmorphic disorder symptoms, in addition to dealing with socially and sometimes physically impairing disfigurements. National statistics on cosmetic surgery for adolescents reveal that nearly 25,000 procedures were performed in 1998, about a third of which were for rhinoplasty. Here’s a bit of trivia for you: In 1998 surgeons performed 1840 breast augmentations for adolescent females and 1862 breast reduction surgeries for gynecomastia in adolescent males.

All in all, this worthwhile collection will be most useful for individuals involved in school and community-based programs concerned with early prevention of body image disturbances, obesity and eating disorders.

— J.Y.

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