A Collaborative Approach to Eating Disorders
Jane Alexander
Janet Treasure
Great Britain: Routledge, 2012
ISBN 978 0415 581 462, $57.00
This book is an essential clinical resource for general practitioners. It is a well written, true collaboration by an impressive international panel of leading experts, which includes a number of Australians. The co-editors are an Australian writer who is in the recovery phase of anorexia, which she has battled since childhood and a Professor of Psychiatry at Kings College London who is the director of an eating disorder unit in South London.
It is now broadly understood that eating disorders are not lifestyle choices but illnesses with complex aetiology, including interactions between genetic, neurobiological, psychological and sociocultural risk factors. The prevalence of anorexia nervosa and bulimia nervosa is estimated to be 2–3% in Australia, it should be noted that anorexia has the highest mortality rate of any psychiatric illness. Eating disorder not otherwise specified – bulimic type, is increasingly prevalent with rates noted to be as high as 5.5%. It is recognised that many individuals with this illness remain undiagnosed for years with the subsequent risk of significant psychological and physiological comorbidity. It follows that most Australian GPs would have a number of individuals with disordered eating attending their practices.
This book is written for GPs with the aim to increase understanding of the evidence basis for the risk and resilience factors for eating disorders, the range of clinical presentations and confidence in the treatment model options with a focus on the importance of family based approaches. The final section explores the requirements for changing the societal and professional cultures, which promote the development and maintenance of disordered eating. An area of emphasis is the importance of bridging the gap between research and primary care practitioners.
This book clearly begins to bridge this gap. It is skillfully written using case studies and quotations of sufferers to emphasise important points and to bring colour and life to the sometimes dry but essential evidence based content. It is heavily and meticulously referenced and will be an important desktop resource for GPs to use when faced with individuals with disordered eating.
In Australia, the costs for accessing specialised eating disorder treatment can be prohibitive for many, for these individuals the role of the GP is often integral. This book should be compulsory reading for all GPs as it provides the necessary tools for us to approach individuals with disordered eating with compassion and the confidence and knowledge to create a management team to assist them in becoming empowered to achieve sustained recovery.
Gillian Singleton
Melbourne, Vic
Cautionary Tales – Authentic Case Histories from Medical Practice
John Murtagh
Australia: McGraw-Hill, 2011
ISBN 978 0070 285 408, $59.95
‘Experience is the name everyone gives to their mistakes’ (Oscar Wilde). When it comes to experience in general practice it is hard to look past Professor John Murtagh. In ‘Cautionary Tales’, Professor Murtagh shares his collection of case histories from over 44 years of practice. This book aims not just to tell of medical stories but to share cautionary tales and advice to contribute to ongoing medical education through promoting wisdom and better judgement. However, this book does much more than share medical wisdom and stories, it also inspires and emphasises the privilege of being a general practitioner and highlights the extraordinary variety of clinical work that a GP undertakes.
In 23 chapters, Professor Murtagh and others share cautionary tales of when clinical situations were not exactly as they may initially seem. This book provides an opportunity for discussion of embarrassing moments and simple mistakes in a nonjudgemental fashion which demonstrates we all are human and we all make mistakes (even the great John Murtagh). Each tale has a ‘discussion and lessons learnt’ which enhances the learning value of the tales. I would suggest the book is best read in several sittings to allow the reader to take in all of the tales and reflect on the errors made and lessons learnt and maximise the learning experience.
The last chapter of this book explains a safe diagnostic model assessing the most likely diagnosis, the diagnosis not to be missed, the common pitfalls, masquerade disorders and hidden agendas which GPs can apply to their patients.
The number of cases so clearly recalled by Professor Murtagh is astonishing, demonstrating the vast number of patients and depth of experience that he has. The excellent diagnostic skills of Professor Murtagh and his humility are also well demonstrated in this book and were very inspiring to this young GP. It has reminded me of the importance of vigilance and humility, as well as to know my patients, follow them up and take all concerns seriously. I would recommend this book to all GPs as both an inspirational and educational read.
Nyoli Valentine
Adelaide, SA