Introduction to the Special Section

Despite increased levels of public awareness and strong research and prevention initiatives, rates of body dissatisfaction, disordered eating, and problems with body weight and shape continue to increase in populations across the lifespan. Although once historically associated with only European American girls and women, eating-related problems have begun appearing increasingly in men; members of racial and ethnic cultural groups; international populations; and the lesbian, gay, bisexual, transgender, and queer community (Cachelin & Striegel-Moore, 2006; Grabe & Hyde, 2006; Rich & Thomas, 2008; Swanson, Crow, LeGrange, Swendsen, & Merikangas, 2011), although problems manifest differently in different cultural groups (Alegria et al., 2007). Negative body image and maladaptive eating practices are strikingly common and place individuals at risk for the development of full-syndrome eating disorders. One half of adolescent girls and one third of adolescent boys report engaging in unhealthy weight loss strategies, including fasting, vomiting, and taking laxatives (Croll, Neumark-Sztainer, Story, & Ireland, 2002). Binge eating in particular has increased among adolescents in recent years, with between 20% and 60% of individuals in community samples reporting episodes of binge eating (Hudson, Hiripi, Pope, & Kessler, 2007). Young adult women are at particularly high risk for eating-related concerns; 25% to 40% experience eating problems that include extreme worries about body image, excessive weight-management strategies, and perceived out-of-control eating episodes (Mintz & O'Holloran, 2000; Schwitzer, Rodriguez, Thomas, & Salimi, 2001). These problems are prevalent across the lifespan; even individuals in midlife and the elderly report dissatisfaction with their bodies and diet to lose weight (Saucier, 2004). Furthermore, negative body image and maladaptive eating practices place individuals at high risk for the development of full-syndrome eating disorders, including anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified, which includes binge eating disorder. Eating disorder lifetime prevalence rates range between 0.9% (anorexia) and 1.5% (bulimia). Binge eating disorder occurs at even higher rates, with 3.5% of women and 2.5% of men meeting criteria presented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association [APA], 2000) for the disorder at some point in their lives, placing them at risk for obesity and other health problems (Hudson et al., 2007). For individuals who do experience eating disorders, effective treatment is critical, because these disorders may be fatal, are often chronic, and have high rates of remission (Crow et al., 2009; Wilson, Grilo, & Vitousek, 2007). These statistics represent a major public mental health concern and highlight the urgent need for professional counselors to have knowledge and skills regarding the prevention and treatment of eating disorders. Although most counselors do not specialize exclusively in the area of eating disorders treatment, many counselors routinely work with clients who present with disordered eating symptoms. However, counselors often do not feel prepared to counsel clients experiencing these problems, and many are also unclear regarding their role in prevention or early intervention to circumvent the onset of full-syndrome eating disorders. This is likely influenced by the fact that, despite a strong research base in this area, information on best practice prevention and treatment of eating disorders is not generally taught in counselor preparation programs and is not well disseminated among mental health practitioners (Simmons, Milnes, & Anderson, 2008). In making strides toward bridging this gap between research and counseling practice, this special section is dedicated to informing counselors' work with diverse client populations who are experiencing problems related to disordered eating. …