Binge eat? A self-help guide for sufferers and carers

If you binge eat or have bulimia, this new book will help you map your way to freedom:

Getting Better Bite by Bite – A survival kit for sufferers of bulimia nervosa and binge eating disorders

AED Forum Newsletter, Book Review Corner Peter Doyle, AED Book Reviewer Getting Better Bite by Bite: A Survival Kit for Sufferers of Bulimia Nervosa and Binge Eating Disorders (Second Edition) by Ulrike Schmidt, Janet Treasure, and June Alexander (Routledge, 2016, 168 pages)

It is no surprise that this book was originally written as a compendium of ideas and strategies for patients in the Eating Disorders Clinic at the Maudsley Hospital. From the outset, Getting Better Bite by Bite engages readers to realistically and wholeheartedly consider what it will take – and what it will mean – to change their lives and become free from bulimia nervosa or binge eating disorder.

Drawing upon years of clinical experience and the most up to date treatment research, this volume can be used as a self-help guide to changing long-standing eating disorder patterns and get readers on the road to recovery. In fact, research has found that use of this book is an efficacious therapeutic intervention.

Motivational Enhancement Techniques – Are You Ready?
Chapter 1 begins by using motivational enhancement techniques to help readers take stock of whether they are ready to make the changes and commitments necessary to overcome their eating disorder. Helpful selfassessment tools and questionnaires are provided, including a section to write out the pros and cons of change. The main tenets of cognitive behavioral therapy are outlined, including establishing self-monitoring in the form of a diary, as well as formal steps for problem solving and goal setting. Readers are encouraged to find at least one support person with whom they can share their journey openly and get instrumental as well as emotional support throughout. Perhaps most importantly, the authors help readers to set realistic expectations, both in terms of the amount of effort it will take to change and how things might be different moving forward if they are able to make those changes.

Common Misconceptions and Step by Step
Common misconceptions about dieting, self-control, and weight management are addressed and readers are provided clear rationales and skills to get out of the repetitive and problematic cycles they may find themselves struggling to break.

Step-by-step plans are provided to help stop vomiting and other forms of purging, with recognition that different patterns of behavior might require different plans, so multiple plans (and a way to decide which one is right for the reader) are provided.

The authors promote body acceptance and challenge myths about appearance and weight to help readers think about their bodies, weight, and shape in positive, self-affirming ways. Relapse prevention strategies are outlined and readers are encouraged to challenge all-or-nothing thinking that says a slip is akin to being back at square one.

Putting Skills into Practice
Although the main focus of the text is to provide skills and suggestions on how to put these skills into practice, the authors anticipate many of the more common issues readers may struggle with that are not so behaviorally focused.

In Chapter 9, “Childhood Wounds,” issues of sexual, physical, mental, and emotional abuse are covered and suggestions provided for how readers might understand those experiences and how to get out of patterns of self-blame and guilt. Subsequent chapters bring the same insight and sensitivity to issues of loneliness, depression, self-efficacy, and selfdestructive behaviors.

Vignettes tell Real Life Story
Throughout the book, vignettes are provided to make the material come to life with a personal touch. Stories illustrate the skills and points being covered in that chapter, but also allow for the authors to speak to the nuances and struggles that people can face when they try out these skills in “real life.”

One such section shares the insights of four women who are each struggling with the initial anxiety of trying to cope without using eating disordered behaviors. Their strategies range from doing needlework to reliance on spiritual strength to reminders of how eating disordered behaviors will prevent longer-term goals. Provided in their own words, these stories convey concepts in a way that works to resonate more than a bulletpointed list ever could.

Relationships Matter, Too
In keeping with the validating and practical tone of the book, the final chapters focus on helping readers to manage the challenges of integrating their new selves into all areas of their lives. Perhaps big changes have been made to eating behaviors and self-esteem after working through the book. However, relationships with friends and family, sexual relationships, and work-life balance may be among the many interpersonal issues that still are problem areas for the reader. And while readers have hopefully made great strides toward a full and lasting recovery by using this book, further resources are provided to acknowledge that recovery is not a unitary event.

Schmidt, Treasure, and Alexander have woven a uniquely authoritative volume that is as engaging and emphatic as it is practical and directive. Getting Better Bite by Bite is an invaluable resource for sufferers as well as carers.