Serena Strickland is a GP Trainee working in North Devon, close to the ocean where she can indulge her passion for sea swimming.
Sick Enough answers the questions patients and doctors often have around the management of eating disorders. Written by a medical expert in eating disorders, the book starts by covering the physical and psychological effects of starvation, and goes on to discuss hormonal factors, effects on bone density and medical implications of restrictive and purging behaviours. The author beautifully illustrates each chapter with case examples describing the medical and psychological issues faced by patients with eating disorders and is written in accessible language for both the lay and medical community.
Many patients with eating disorders are not acutely unwell, but are still ‘sick enough’ to require medical support.
There are clear chapters describing the physical and psychological effects of starvation, purging and disordered eating patterns. There is a clear and firm rejection of diet culture throughout, with an associated empathy and acceptance of all body types. In addition, there is recognition that many patients with eating disorders are not acutely unwell, but are still ‘sick enough’ to require medical support and attention.
Helpfully there are sections on often poorly understood and perhaps less conventionally recognised health conditions, including POTS (postural orthostatic tachycardia syndrome), Irritable Bowel Syndrome, Small Intestinal Bacterial Overgrowth and Pelvic Floor Dysfunction. The author makes helpful suggestions with regards to symptom management and provides useful analogies to explain medical terminology.
…the impact of societal body ideals on a wide spectrum of population.
Dr Gaudiani considers the impact of societal body ideals on a wide spectrum of population and includes chapters on eating disorders in people with larger bodies, diabetes, gender and sexual minorities, and elite athletes.
Finally, there is space to consider patients who refuse treatment and discussion of psychiatric palliative care in patients with severe and enduring eating disorders which do not respond to medical treatment.
Although written with reference to the American healthcare system, this book has learning points applicable to everyday practice in the NHS. There is an acceptance that medicine cannot always provide answers to suffering and a beautiful section describing the importance of ‘bearing witness’ to unmeasurable illness.
This book is a must-read for professionals, patients with eating disorders and their families.
Jennifer L. Gaudiani. Sick Enough: A Guide to the Medical Complications of Eating disorders. Routledge 2018. ISBN: 978-0-8153-8245-4