The Parent's Guide to Eating Disorders: Supporting Self-Esteem, Healthy Eating, and Positive Body Image at Home, 2nd ed, by M. Herrin and N. Matsumoto. Carlsbad, CA: Gurze Books; 2007. $18.95.
The author Marcia Herrin combines her experiences as an eating disorder survivor, a registered dietitian, and a mother in this informative, second-edition guide for parents. Using the Maudsley approach to treat a child with an eating disorder, compared with other treatments, she gives parents the opportunity to be an "essential resource"1(pxiii) in their child's treatment, releasing them of feelings of blame and guilt. Marcia Herrin and Nancy Matsumoto suggest that it is possible to treat a child's eating disorder by using parental control with a high probability of success.
The book focuses on using the Maudsley approach as an essential resource and on what parents may be able to do at home, with or without the use of a Maudsley-trained professional, to treat their child who has eating issues or an eating disorder. A step-by-step approach is described for parents who may suspect their child has an eating problem. Checklists by Herrin and Matsumoto provide parents the tools they need to keep track of their child's behaviors. Each type of eating order is addressed, including the classical types of anorexia nervosa and bulimia, male eating disorders, binge eating, and eating disorders not otherwise specified which are all on the rise.
Marcia Herrin is one of the few eating disorder professionals in the United States who has adopted the Maudsley approach in the treatment of adolescent disorders. In her practice, she gives parents a "nutrition-focused take"1(p206) of the approach, entitled "Parent Assisted Meals and Snacks (PAMS)" and begins with the coached family meal. This book guides parents on how to use PAMS to begin refeeding their children at home. The patient cases and interviews presented in the book show that eating can be normalized again at home by using a basic meal planning approach. Herrin is honest about the time and dedication that is necessary for all family members to devote to treatment and the perseverance necessary to overcome an eating disorder by using parental control. She presents difficult scenarios such as parents' first conversation with their child about their eating concerns and parents' struggle to regain control when their child wears off the meal plan. Each scenario ends in success.
Guidelines are given on how to adapt the basic meal plan to meet the child's needs and preferences, considering his or her type of eating disorder, whether or not he or she needs to gain weight, and his or her level of physical activity. As Herrin eloquently states, "the best gift you can give a child struggling with eating issues is the ability to eat in an organized, carefree fashion; to give up diets; and to be educated enough to make sound, confident food choices."1(p164) Herrin also addresses how to handle and normalize exercise, including how to draft and execute an appropriate exercise plan and work with a child's coach if team sports are involved.
To keep the child on the correct path, it is often necessary to approach school personnel, camp personnel, or anyone else who has an impact on that child's behavior. Practitioners who work with this population know that parents want to keep life as normal as possible for their child and prevent others from sending the wrong messages. However, these are difficult situations to handle, especially without the guidance of a trained medical or mental healthcare professional. Herrin and Matsumoto address these possible situations, using anecdotal experiences from past successful cases. Their section about friends is especially helpful. They point out that when parents voice their observations, both positively and negatively, about their child's friendships, it is more beneficial to help their child make the right decisions than dictating with whom they can or cannot be friends.
For dietetics practitioners, eating disorders can be very difficult to treat. Attempting to first treat a child or an adolescent at home, without the aid of professional treatment can be complicated and risky. The Maudsley approach is not appropriate for all children or adolescents with an eating issue or disorder. For example, research has shown that family therapy is more effective for the younger adolescent with anorexia nervosa.1,2 Herrin and Matsumoto address this appropriately by concluding their book with guidelines on when to seek professional help, and resources to direct families to the appropriate healthcare professionals. This includes finding a Maudsley-trained professional if parents remain interested in following the Maudsley approach. Most importantly, they explain that there is no "magic bullet" cure to an eating disorder, emphasizing again that "recovery requires the effort of the entire family, hard work, patience, and perseverance."1(365)
Andrea Berez, MS, RD, CSP
Pediatric Dietitian Pediatric GI and Nutrition and Adolescent Medicine, UMD NJ-Child Health Institute of NJ 89 French Street New Brunswick, NJ
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