Book Review

Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Methods, theory, and research

N Engl J Med 1995; 333:1159October 26, 1995

Article

Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Methods, theory, and research
Edited by David R. Allison. 634 pp. Newbury Park, Calif., Sage, 1995. $65. ISBN: 0-8039-4791-7

Although there is agreement that disorganized eating behavior and abnormal body weight are crucial issues in general medicine and psychiatry, there is a frustrating lack of agreement about how to measure these types of behavior, the consequences, and patients' attitudes. This book is a comprehensive review of methods of assessing eating behavior and weight-related problems. It attempts to deal with theory, methods, and clinical implications and it goes a long way to establish quantitative methods in these critical areas of human behavior, largely succeeding in its goal with some minor inconsistencies and omissions.

The challenge of introducing psychologically sophisticated assessment methods to medical practitioners, who weigh, measure, counsel, and scold patients for their eating behavior and weight, is formidable because the language and constructs needed to understand these assessments are not part of the training of those who deal with the medical consequences of abnormal eating behavior and weight. The introduction to the book instructs readers in the basic concepts of reliability, validity, norms, and factor analysis.

The range of topics, appropriately broad, includes eating behavior, attitudes toward weight and shape, measures of quality of life, and the psychopathologies that often accompany these disorders. The chapters that reproduce the actual scales used and show sample graphs or tables for scoring results are especially helpful, since they transform measurement tools from abstract concepts to useful hands-on instruments. The final chapter, “The Big Picture,” does this perhaps most successfully by including tables that list the specific questionnaires or other measurement tools most suited to the assessment, follow-up, and prognosis of weight and eating disorders.

The book successfully combats the tendency of such works to scholarly overinclusiveness. Two minor drawbacks are the spreading of the discussion of new, useful tests such as the Eating Disorders Examination over several chapters and a general lack of critical incisiveness about the comparative value and usefulness of the many tests described. The chapter on the assessment of general personality and psychopathology leaves out some of the most commonly used categorical measurements of personality, such as the structured interview for disorders of personality. The chapter on the psychological problems of patients with eating and weight-related disorders in a general medical setting and the chapter on human-body composition are useful for consultation purposes. The estimate of the prevalence of obesity in the first sentence of the book — “as high as 25 percent in the U.S. adult population” — is based on a 1987 statistic and is therefore out of date; more recent estimates set the level at 35 percent or greater.

There are no other works with which this book can be compared, because it is innovative and establishes a foundation of resources for clinicians seriously interested in the assessment of attitudes toward, behavior in, and some physical measures of eating and weight disorders. For clinicians to go beyond a general agreement that eating and weight are important health issues, they must learn to use these measures. For this book to be useful in that regard, it requires the inclusion of more guidance on choosing and implementing the tests described. On the whole, however, it succeeds in its goal of being a handbook for the assessment of eating behavior and weight-related problems.

Arnold E. Andersen, M.D.
University of Iowa College of Medicine, Iowa City, IA 52242