Honest answers to difficult questions

Eating disorders are, by nature, confusing, complex and have the capability to shatter lives. So a book that combines lived experience of individuals, carers and clinicians with an explanation of the most up-to-date treatment approaches is particularly welcome.

Lucia Giombini and Sophie Nesbitt are clinical psychologists working with people with eating disorders in both private practices as well as hospital settings. They believe that it is only through a collaborative relationship between professional, patient and family that recovery can be successful.

The book is also shaped by collaboration; the authors ask clients and families they have worked with over the years what questions they really wanted answers to during their treatment and their excerpts are studded throughout the book. For me, as a psychotherapist and a parent with lived experience of caring for someone with anorexia, they were the most impactful. Other people's stories of recovery reminds us that an eating disorder journey is never linear and there is no such thing as a 'one-size fits all' treatment plan. But there is always hope.

The book covers questions we most want the answers to. 'What Are Eating Disorders?' reveals more than we may already know; Orthorexia, for example – when an interest in healthy eating becomes an obsession with only eating 'pure' foods – can be especially difficult to diagnose. On food itself, the book asks what, other than nutrition and survival, does it represent?

The joy of food for food's sake is often the first casualty of an eating disorder and it's soon replaced by shame and fear. The authors explain that it is vital for clinicians and therapists to create trust and connection with clients to explore the meanings that have been attributed to eating.

The book also highlights how, in the West particularly, food and its badness/goodness labelling has changed us all. How commonplace is it for us to discuss what we are eliminating from our diets or to measure calories on trackers or menus. What must it be like for someone struggling with an eating disorder in this environment?

The point is also made that although food if often the tool used or avoided to highlight psychological distress, it is the themes that lay underneath the symptoms; identity, acceptance by self and others, attachment and self-worth that the right therapist can explore. However, an issue the book can't help with is how someone can find the right therapist. When a family is in crisis, how do they know if that therapist is the right one for them and what choices do they have?

There's also a chapter that asks what we all want to know, 'Is Recovery Possible?' A recovery from an eating disorder can be a slippery concept to define and the authors address this. Although recovery is sometimes labelled as 'eating normally' with a reduction of physical symptoms, it really is a journey that sometimes defies definition. However, an emergence of a resilient self with new values and skills that help someone to live a satisfying and hopeful life is used by the authors as a guide.

An informative, useful resource, this book feels more valuable for its nod to the expertise of the lived experience of the client rather than the psychologists. 

Reviewed by Jennifer Gledhill, Deputy Editor