AED Newsletter

AED Newsletter: 1.1.2009

Book Review Corner

Angela Celio Doyle, PhD

"My Thin Excuse: Understanding, Recognizing, and Overcoming Eating Disorders"
By Lisa Messinger and Merle Cantor Goldberg, LCSW

The early days in the development of an eating disorder are often overlooked by family, friends, and health care professionals. In "My Thin Excuse: Understanding, Recognizing, and Overcoming Eating Disorders," Lisa Messinger and Merle Cantor Goldberg, LCSW, offer a riveting view into the onset of an eating disorder as it unfolds in the form of chronological entries from Lisa’s adolescent diary. Lisa Messinger, a successful journalist, and Merle Cantor Goldberg, a licensed social worker with over 35 years of experience treating eating disorders, have partnered to present Lisa’s story in an honest and captivating manner to help educate families, friends, and those suffering from an eating disorder on the identification, causes, and treatment of the illness. Although Ms. Goldberg was not Lisa’s therapist, she provides a knowledgeable commentary on themes and issues raised in Lisa’s diary entries that are common to individuals struggling with eating disorders.

Lisa’s diary entries begin when she is 15 years old and faithfully document her thoughts and feelings over the subsequent seven torturous years of binge eating, driven exercise, obsessive dieting, and her eventual treatment and recovery. Lisa takes us along with her on her journey as she is overtaken by anxiety about her weight and calories, as well as her struggles with larger questions of identity and intimacy. Lisa grapples to find the answers to her anxieties: should she commit to a rigid diet to get her eating and her life under control or is her diet actually the problem? We enter her world and experience her feelings of “ecstasy” when she loses weight and, conversely, her feelings of being wildly out of control and panic-stricken when she binge eats.

Lisa’s diary entries are punctuated by therapist Merle Cantor Goldberg’s “Insight” chapters. In Merle Cantor Goldberg’s prelude “Problem? What Problem?”, Ms. Goldberg first invites readers to answer screening questions intended to help identify the presence of an eating disorder. The first of Ms. Goldberg’s Insight chapters (“How to Identify an Eating Disorder”) provides valuable information on anorexia nervosa, bulimia nervosa, binge eating disorder, and disordered eating in terms that are easy to understand. In the second Insight chapter (“Getting Thin is Not the Answer”), Ms. Goldberg comments on Lisa’s increasingly distorted thinking and describes several myths or “fairy tales” about the relationship between thinness and happiness, popularity, love, and control that may serve as the faulty foundation of an eating disorder.

In the third Insight chapter (“Why Self-Treatment Doesn’t Work”), Ms. Goldberg provides a commentary on Lisa’s growing ambivalence about her eating disorder leading to the realization that self-help will not be enough to rescue her from the eating disorder. This chapter concludes with a well-written guide to how to talk to a loved one about a suspected eating disorder and thoughtful advice on what you can realistically expect when raising the issue of eating problems with someone who is struggling. The fourth Insight chapter (“Seeking Help for Yourself or Someone You Care About”) offers a solid primer on how to seek help and who may constitute a treatment team (e.g., therapist, primary care doctor, nutritionist). The final Insight chapter (“Advice for the Rest of Your Life”) ends My Thin Excuse on a realistic yet hopeful note. Ms. Goldberg discusses relapse as a predictable part of recovery but encourages readers to forge ahead on the path to recovery. An Epilogue by the now-adult Lisa rounds out the book by providing an inspiring and energizing update on her life, where she reflects on her successful recovery.

Although Merle Cantor Goldberg’s commentaries are anecdotal rather than empirically-based, her contributions are valuable due to their roots in over three decades of experience in treating individuals with eating disorders. Her language can be confusing at times as she shifts to address her different audiences; sometimes, Ms. Goldberg is speaking directly to the individual with an eating disorder while other times she is speaking to family or friends of the individual. However, the ability of Ms. Goldberg to speak to both audiences with an authoritative yet warm voice is a strength of this book.

In the growing field of autobiographical books by individuals with eating disorders, "My Thin Excuse" presents a unique pairing of a fascinating first-person account of an eating disorder with insightful commentary by a veteran eating disorder therapist. Individuals who wonder if they may have an eating disorder or who are already in the grips of an eating disorder and are uncertain of what to do will benefit from reading this book. Likewise, friends or family who suspect a loved one of having an eating disorder will appreciate the chance to take a virtual walk in the shoes of an individual with an eating disorder with Merle Cantor Goldberg as their guide. "My Thin Excuse" provides a sad yet captivating narrative of the insidious onset and evolution of a young woman’s eating disorder and valuable information pointing towards hope in the form of recovery.