To start with, a declaration of interest: I really should be negative about this book, as it is a direct competitor of a book on the same subject that colleagues and I published the previous year. However, it is very hard to be negative here. Fairburn's book provides a strong focus on “the right stuff” in this field: evidence-based practice, understanding the individual case, and the use of behavioural change as a key element in helping sufferers to recover (rather than the “behaviour-free” cognitive therapy that many seem to employ in their everyday practice). In short, I like this book a lot, and recommend it to any clinician who wants to work effectively with patients suffering from eating disorders.

The book is full of useful clinical material, from the body mass index chart inside the front cover to the self-report measures at the end. Furthermore, the reproducible material is all available online (the web link is at the end of the contents page, so get the book in order to access this – I would feel uncomfortable giving the link for people to use the material without having read the book itself). The material is presented around a core protocol of CBT plus adaptations for specific problems, patients and settings, but make sure that you do not skip the core material (chapters 5–12) in your rush to get to the adaptations (chapters 13–16). That would be to miss out on vital material in understanding and treating the eating disorders. The chapter referring to in- and day-patient settings might be the most limited in utility, as there are problems of implementation (some of which are spelt out on pp. 238–239, but most clinicians in such settings will be able to add more).

For the clinician who is starting out in this area, this book will be an invaluable guide, as long as you are bold enough to face the patient's anxieties about change without losing sight of the principles that underpin this protocol. However, even we grizzled veterans will find much that is useful (if we are willing to listen). My personal favourite (and one that I now use where appropriate with my underweight patients) is the very simple idea of describing the process of putting weight on as “weight regain” rather than “weight gain”. It is horribly embarrassing not to have seen this obvious point many years ago, but my patients really seem to find this change in language very helpful in accepting what needs to be done without feeling that they are entering uncharted territory.

Where do I disagree with this book's conclusions? Really, there are just a few substantive points that I would disagree with. First, I was not convinced by the argument about the futility of Socratic questioning. The author describes this approach as unhelpful as it can be confusing for the patient, whereas I find the confusion to be a vital element. There is nothing quite so satisfying as seeing patients realise that their absolute certainties are unhelpful, and helping them to start to find new ways of understanding their bodies, their cognitions and the world. Second, Fairburn describes behavioural experiments as being of limited utility with the key behavioural targets of eating and weight. I disagree because: a) behavioural experimentation is widely regarded as the single most powerful way of changing cognitions (even if it does take several weeks to do the first experiment properly, it is a skill that patients can learn to implement themselves, both during the latter part of therapy and well beyond when they stop seeing us); and b) behavioural experiments can be very valuable with this population for addressing a lot of their comorbid problems. Finally, I found the material on body image useful but rather thin. There are a number of additional approaches that might have been worth mentioning here, particularly the use of surveys to reduce the impact of “mind reading” (where the patient's beliefs are beyond direct challenges because they depend on “knowing” what other people think). Overall, the book gives the impression of sticking closely to a research protocol rather than offering a variety of techniques and material that could be employed within the flexibility of a clinical setting, especially when patients are not doing well with the standard techniques.

In summary, I wanted to say that this book should be on the shelf of every clinician working in the eating disorders. However, it will do a lot more good if it is open on the desk. It is particularly useful for those starting on the path to evidence-based practice (whether new to the field or not), and for those who want an update.