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Therapy for Eating Disorders

Therapy for Eating Disorders
Theory, Research & Practice

Third Edition
  • Sara Gilbert - Chartered Clinical Psychologist, Luton and Bedfordshire Community NHS Trust

December 2013 | 264 pages | SAGE Publications Ltd

‘This updated edition provides an excellent overview of the diagnosis, prevalence and causes of eating disorders, as well as a handbook for the application of evidence based interventions. A “must buy” for eating disorder services and individual practitioners!’

Sally Savage, Clinical Lead for Northamptonshire NHS Eating Disorders Lifespan Service

Affecting thousands of people every year with potentially devastating consequences, anorexia, bulimia and binge eating disorders are becoming increasingly evident in today’s fast paced, high pressured society.

Drawing on over 20 years’ experience as a practitioner, Sara Gilbert takes the reader through the complexities of working with eating disorders, drawing on practical, cognitive behavioural and educational approaches to theory, assessment, treatment and practice. Packed full of new resources for both qualified professionals and trainees, this new edition includes:

·         A summary of new research on the causes of eating disorders, dual diagnosis and co-morbidity.

·         New content on the best treatment for eating disorders and preparing clients for treatment.

·         An updated chapter examining the effects of nutrition on physical and psychological well-being.

·         New content on working with complexity and risk.

·         A fully updated reference section.

This is a vital resource for practitioners in the mental health field, including psychotherapists, psychologists, counsellors, psychiatrists, mental health nurses and dieticians.

Sara Gilbert is a chartered clinical psychologist whose specialist interest in the field of eating disorders spans 20 years. She has worked for 12 years as a clinical lead in an eating disorder service in the NHS and is now in private practice.

What is an eating disorder?
A note about psychiatric diagnosis

Eating Disorders in the twenty first century

The relationship between weight and eating disorder

Anorexia nervosa

Bulimia nervosa

Binge Eating Disorder

Feeding and Eating disorders not elsewhere classified

Other causes of weight loss or gain or unusual eating behaviours

Causes of the Eating Disorders
Psychobiological mechanisms

Psychosomatic theories

Looking for an explanation in the past

Eating disorder and other psychiatric diagnoses: is there a genetic susceptibility?

Anorexia and bulimia nervosa as sociocultural phenomena

Eating disorder as learned behavior

Eating disorder as a corollary to dieting and food deprivation


Treatment for the Eating Disorders
Psychodynamic therapies

Family therapies

The use of psychotropic medication

Cognitive behaviour therapy

An outline of the characteristics of CBT

How effective is CBT for eating disorders?


A Cognitive Behavioural and Integrative Approach to Eating Disorders
The theoretical basis of a cognitive behaviour therapy approach to the eating disorders

The structure of cognitive therapy for eating disorders

The acceptability of cognitive therapy for eating disorders

A broad interpretation of cognitive therapy for the eating disorders


Beginning the Therapy Process
The initial stages

Some questions to ask when assessing the person with an eating disorder

The use of questionnaires in the assessment of eating disorder

Is this the right time for therapy?


Preparing for change
Presenting the cognitive behavioural view and formulating the problem

Assessment of motivational stage in people with an eating disorder

Self-monitoring by the client

Setting the agenda for therapy

A focus on emotions and coping strategies


Nutritional Aspects of Helping the Eating-Disordered Client
Nutritional knowledge of eating-disordered clients

Nutritional counselling

The body's need for good nutrition

Knowledge about energy balance and weight regulation

Information about the specific effects of bingeing and purging

Information about the effects of food and eating on metabolism

Establishing a normal eating pattern with obese binge eaters: to diet or not?

Establishing weight gain with anorexics

Behavioural Techniques

Target setting

Behavioural experiments


Scheduling pleasant events

Behavioural techniques for controlling overeating (self-control)

Taking exercise

Practising 'normal' eating


Assertiveness around food

Relaxation and stress management


Cognitive Techniques
Identifying negative thoughts

Answering negative thoughts


Identifying and dealing with dysfunctional assumptions and core beliefs

Modifying assumptions and core beliefs

Exploring the meaning of eating disorder symptoms

Getting 'stuck'


Adapting to Different Situations and Dealing with Endings
Working with severe and complex cases

The end of the therapy relationship

Preventing relapse

Involving family members in the therapy process

Working with groups

Working in parallel with other treatments


Appendix 1: Some useful web pages

Appendix 2: Eating Problems: Resources for Clients

Appendix 3: Eating Disorders and their Effects

Appendix 4: Guidelines for Normal Healthy Eating

Appendix 5: The Effects of Strict Dieting and Starvation and of Giving Them Up

Appendix 6: Medical and Physical Problems Caused by the Symptoms of Eating Disorders

Appendix 7: Controlling What You Eat

Appendix 8: Giving Up Vomiting as a Way to Control Your Weight or Deal with Stress

Appendix 9: Learning to be Assertive about What You Eat: A Bill of Rights


`Sensible, thoughtful and full of helpful 'how to' advice for the therapist' -
Behaviour Research and Therapy

`A particularly suitable book for individuals with a general mental health training who are starting work with this patient group. It deserves to be widely read' -
European Eating Disorders Review

`An invaluable resource for anyone working in, or wishing to know more about, eating disorders' -
Dietetics Today

Written from a cognitive behavioural perspective, this updated edition provides an excellent overview of the diagnosis, prevalence and causes of Eating Disorders, as well as a handbook to the application of evidence based interventions. An extremely valuable resource for those already working in the field, and  an easy to access introduction for those mental health practitioners new to working with sufferers of Eating Disorders. The appendices provide excellent resources for use in the self help management or as an adjunct to therapy for sufferers and their families. A ‘must buy’ for Eating Disorder Services and individual practitioners!

Sally Savage
Clinical Lead for Northamptonshire NHS Eating Disorders Lifespan Service

This newly updated edition is a well-structured, accessible and thoughtful guide to the nature and treatment of eating disorders. This book will undoubtedly be valued by all practitioners working within the field of eating disorders.

Dr Alex Willner
Clinical Psychologist

Sara Gilbert shares over 20 years experience covering both practical and theoretical techniques in a clear, readable manner. The technical terms used are well explained and the book offers lots of useful strategies for those working within this field. I would highly recommend this book to anyone working in the mental health sector.

Martine Johnson

Sara Gilbert's book is a significant contribution to the literature on eating disorders and their treatment and a useful general reference manual, especially for CBT therapists and other health service providers. This third edition is enriched by the latest research findings in the field, ranging from the DSM-5 classifications to magnetic resonance imaging techniques used to detect structural changes in the brain of people with eating disorders. 

Flora Todaro Luck, Psychotherapist
Private Practice

Excellent book, and one that affords this topic the attention it needs! Begins with exploring in detail the possible causes and explanations of an eating disorder, with reference to the prevalence of eating disorders. Excellent overview of the range of treatments and interventions that could be utilised, detailing the merits of each. Would be a useful tool to underpin knowledge and aid practitioners in their work.

Mrs Surj Sall-Dullat
Mental Health Law & Policy Team, Staffordshire County Council
April 9, 2015

A book of clarity of thought, rigour and practical guidance that practitioners from any modality would benefit from.

June 12, 2014

Sample Materials & Chapters

Chapter One: What is an Eating Disorder?

For instructors

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