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Dr. Bruch - author of studies on overweight, schizophrenia, and child development - bases this work about two types of eating disorders on 40 years of research at three leading hospitals. Both obesity (gross overweight caused by excessive eating) and the rarer anorexia nervosa (emaciation resulting from self-starvation) are, the author feels, related. Both represent an inability to identify hunger correctly or to distinguish it from other states of bodily need or emotional arousal. The author supports this thesis with postulates evolved from testing, other findings in the field, and numerous case histories. Throughout Dr. Bruch insists on considering - in both analysis and treatment - biological, organic and psychological factors as interacting phenomena. It is not simply a matter of isolated drives. She discusses obesity as it occurs in the various age groups, paying particular attention to childhood and adolescence, during which a learning deficit can adversely affect the individual's ability to control body functions. Dr. Bruch has stem words for the normally plump among us who strain for the fashionable ideal - this can produce serious psychological tensions. The sections on anorexia nervosa profile the sufferer's lonely battle with the world - a refusal to accept anything his parents (symbolically) have to offer. She doses with suggestions for successful therapy which stress the patient's awareness of self which must precede responsibility for the self. This is a difficult book for the layman, sometimes repetitious and given to occasional professional in-fighting. However, there are accessible sections written with instructive force and style, and one soon shares the author's concern and compassion for those who through misuse of the eating function attempt to deal with a hostile world. (Kirkus Reviews)

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