Few topics in the field of eating disorders engender as much emotional debate as that of prevention. Too often, preventative plans against eating disorders are highly praised, but not carried out in practical actions. It is often easier and more immediately fulfilling to focus on treatment and not to wait for the long-term effects of prevention, despite the fact that treatment alone does nothing to reduce the incidence of eating disorders.

The Prevention of Eating Disorders offers a survey of modern approaches to eating disorder prevention, arguing that models of prevention as opposed to treatment are conceptually flawed.

The first half of the volume addresses general approaches and dilemmas, including feminist and participatory approaches to the problem and the role played by fashion magazines and television in promoting risk factors such as thin ideal body images and dieting. The second half provides examples of concrete strategies and projects aimed at prevention, including school based programs, approaches to early identification and prevention by general practitioners, and the principles of screening programs.

Research and Treatment in the Psychobiology of Bulimia Nervosa 1 2 K. M. Pirke and W. Vandereycken When we were preparing this book, the main purpose was to gather the latest in sights from both basic and clinical research in bulimic disorders. The burgeoning scientific interest in eating disorders forced us to restrict the focus in such a way that attention was only paid to psychobiological aspects of (disturbed) nutrition and be havior. This implied that other important aspects, like sociocultural and familial fac tors, had to be excluded. But it turned out that even with such a restricted scope the subject was not an easy one. A review of the contributions to this volume clearly shows that our present understanding of bulimia nervosa is still very small. Reviewing the hypothalamic and especially neuroendocrine regulation of nutrient balance, Bray has emphasized the importance of the autonomic nervous system in regulating food intake and energy expenditure. The role of insulin, adrenal steroids, gonadal steroids, and growth hormone in modulating nutrient intake and storage were discussed. The studies by Jimerson et aI. , Schweiger et aI. , and Fichter et al. show that all these factors are altered in bulimic patients, indicating that the whole system of regulating food intake and storage is severely disturbed in bulimia nervosa. Evidence has been presented that neurotransmitter alterations may occur in bulimia: Jimerson et al.

More and more clinicians as well as researchers realize that anorexia nervosa and bulimia nervosa often are extremely difficult to treat and that the short-term outcome can be very misleading. In many cases these disordersprevail for a long period of time and can have serious consequences for the patient's further life. This book gives a detailed over- view oftoday's knowledge regarding the long-term outcome of the treatment of anorexic and bulimic patients, many of whom were treated in highly spezialized centers. Experts from bo- th Europe and the U.S. report on theirmost recent research. Their studies include medical as well as psychosocial and psychiatric aspects of eating disorders. Clinicians with long experience in the treatment of eating disorder patients discuss the important practical implications of these rese- arch findings. The information given in this book is helpful for both treatment and prevention of eating disorders. Finally, concrete guidelines show as how to conduct further follow-up studies in this field.