Almost Anorexic

Editorial Reviews

Almost Anorexic: Is My (or My Loved One’s) Relationship With Food a Problem? is part of a groundbreaking series of books by Harvard Medical School faculty, in partnership with Hazelden and other experts, intent on defining the broad continuum between a normal behavioral pattern and clinical pathology. As with other mental health diagnoses and addictions, eating disorders generally develop slowly, with mild symptoms intensifying over time. By identifying the “almost” phenomenon, it is possible to avoid a full syndrome and all the attending pain, loss, and medical and economic con- sequences of these disorders. The “almost effect” could make a significant difference in the lives of so many who are headed toward, or on the cusp of, a serious diagnosis—and not a moment too soon as more and more struggle with mental health issues and addictions, and eating disorders become globalized.

Almost Anorexic is a unique contribution to the eating disorders self-help literature, and one of the few resources to address the whole spectrum, from subclinical variations, to full syndrome diagnoses of anorexia nervosa, bulimia nervosa, binge eating disorder and everything in between. That “in-between” zone subsumes emerging subclinical presentations as well as the DSM-5 category called “Feeding and Eating Disorder Not Elsewhere Classified,” previously categorized within “Eating Disorders Not Otherwise Specified.” This includes atypical anorexia, subthreshold bulimia, subthreshold binge eating disorder, purging disorder in the absence of binging, night eating syndrome, and other variants. The authors rightfully point out that subclinical and atypical eating disorders result in medical issues and outcomes as serious as those related to full syndrome eating disorders, and can be associated with other psychological diagnoses such as depression and substance abuse. These “diagnostic orphans” have received inadequate attention in both the professional and the self-help literature, manifesting in seriously ill patients who feel isolated, and misunderstood, and who never receive proper identification or treatment. At least one third of the cases presenting for treatment at specialized eating disorder programs fall in to this category. It is about time that they get the full serious attention that Almost Anorexic provides.

For those of us who have been frustrated by the gap between research and practice, Almost Anorexic is a dream come true. Co-authored by experienced clinician and researcher, Jennifer J. Thomas, and Jenni Schaefer, a writer and musician who has fully recovered from a very serious eating disorder, Almost Anorexic blends the most personal accounts of the illness and recovery processes with the most current scientific knowledge and clinical approaches to eating disorders. In her journey to recovery, Jenni used the metaphor of “Ed” to help separate herself from the eating disorder that was waging war with her life and well-being, This cognitive reframe allowed her to differentiate herself and her healthy voice from the destructive and engulfing script of her eating disorder, and has become a popular and effective treatment tool. The authors’ blend of acquired wisdom and clinical expertise builds a vital bridge between the lived experience of the illness and the clinical perspective and interventions that move someone struggling with an eating disorder toward recovery.

The first section, “Getting to Know the Ed in Your Head,” shows how “Ed” operates in a sufferer’s life, with chapters on the symptoms and diagnoses, the erroneous beliefs about weight, food and body image, and the pathological behaviors that soon become woven into the normal fabric of one’s life. They also describe “Societal Ed,” the ever-increasing cultural contributions to eating disorders, including the fashion industry, the rampant misinformation about weight and dieting that hooks people into constant atte