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Solving the Anorexia Puzzle provides an overview of biological, psychological, and sociocultural perspectives on anorexia nervosa, as well as advances the authors' perspective regarding the potential existence of a subtype of anorexia they have termed "activity anorexia." A consistent theme in the work is to strongly de-emphasize (and criticize) person variables such as psychodynamic or cognitive perspectives, and to give greater weight to environmental variables. These include sociocultural influences on eating, body weight, and exercise, and most Importantly, biological and motivational factors hypothesized to account for the activity anorexia pattern. The book is organized into three parts. In Part I, the authors review various perspectives on anorexia nervosa, including the medical model and psychoanalysis, the social-cognitive model, and the behavioral model. A hasic background is provided regarding the symptoms, physical sequelae, incidence, riak factors, and disease course of anorexia nervosa. Part I concludes with a review of what they classify as "Indirect" treatments for anorexia (i.e., psychoanalysis, insight oriented therapies, family therapy, and cognitive therapy), and "Direct" therapies (i.e, behavior therapy and medical intervention). The designation of"Direct" is bestowed on those therapies which directly effect changes in eating, exercise, and weight. Part II represents the meat of the book in that it presents their model of ·activity anorexia. The chapters address the behavioral, motivational, and biological hllsis of the activity anorexia pattern, as well as the sociocultural conditions which ' initiate activity anorexia. Briefly, the model postulates that cultural values regarding weight and exercise result in the presence of reinforcement contingencies ' regarding these variables. The activity anorexia pattern is initiated when pronounced food restriction is combined with substantial increases in physical

A Review of Solving the Anorexia Puzzle by W. F. Epling and W. D. Pierce