Eating Disorders: A Guide to Medical Care and Complications (2nd edition) by: Philip Mehler, MD and Arnold E. Andersen, MD. Baltimore, MD 271 pages, $30.00 ©2010 Johns Hopkins University Press Order online at Bulimia.com

Written by two of the most experienced physicians currently working with medically ill eating disorder patients, this excellent second edition merits reading by a wide audience.

Dr. Philip Mehler, Professor of Medicine and Chief of Staff at Denver Health Medical Center, is also Medical Director of the Acute Comprehensive Urgent Treatment for Eating Disorders (ACUTE) program, noted for treatment of the “supersick.” Dr. Arnold Andersen (a member of the EDR Editorial Board) is Professor of Psychiatry at the University of Iowa. After 15 years of running the eating disorders programs at Johns Hopkins, he initiated and has been Medical Director of the extensive eating disorders programs at his university. In addition to conducting significant clinical research, Mehler and Andersen have treated and followed literally thousands of severely medically ill eating disorders patients. This volume reflects their extensive and deep knowledge of problems likely to be encountered, and offers ways of treating them.

Each chapter begins with a list of the most common and clinically important questions primary care clinicians are likely to have in relation to the subject under consideration. The vignette-laden chapters, replete with user-friendly charts and diagrams, then go about discussing these issues in clear, direct and practical English, offering specific guidance about all sorts of assessment and management issues. It goes without saying that core topics such as medical evaluation, nutritional rehabilitation with guidelines for refeeding, as well as electrolyte, gastrointestinal, cardiac, orthopedic, gynecological, oral and dental problems are addressed in a first-rate manner. But, there’s much more.

Tucked in among these chapters are large numbers of pearls. For example, in addition to a table in the chapter on diagnosis and assessment actually labeled as “Pearls in Diagnosis,” the chapter includes a wonderful table listing “Clues to secretive eating disorders.” A section on “myths” about eating disorders will serve both primary care clinicians and families. The section on collaborative treatment approaches, including rationales and guidelines, is among the best I’ve seen on this topic.

Other treasures include excellent sections on athletes and eating disorders, ethical conflicts in caring for patients with anorexia nervosa (particularly concerning involuntary care), and – to be expected in book authored by Andersen – a section on males with eating disorders. In addition, a strong chapter on using medical information psychotherapeutically “nails” psycho-education, and an equally strong chapter on medical information for nonmedical clinicians and educators will be helpful in numerous settings.

A very worthwhile appendix on “Behavioral Guidelines for Staff to Use with Patients who have Eating Disorders” draws together the significant wisdom and experience that the authors have acquired in their treatment venues and constitutes a “must- read” for clinicians working in inpatient, partial hospital and other team settings. Those new to the field will learn important lessons usually hard won over decades. Those already experienced in these matters will want to compare practices with these master clinicians, and to use the detailed list of recommendations as a checklist against which to measure their own policies and practices.

— JY