Why should attractive, usually well-behaved and excellent students embark on the self-destructive role of slow starvation in puberty and early adolescence? Such are the profiles of many patients, primarily young girls, who suffer the syndrome of anorexia nervosa (literally, nervous lack of appetite). Psychiatrist Hilde Bruch, who has treated many of these patients, writes a fascinating account of this strange behavior. She concludes that these children are essentially afraid of becoming teenagers; they have spent theft whole lives pleasing theft parents and living up to parental images and demands. They do not know who they are, what they want. But they discover a way to gain power by the simple act of not eating. For the first time they are in control and they become the center of attention. Their endurance, will power, theft capacity for denial and duplicity, but withal, theft obsession with food, are formidable. Bruch is endlessly absorbing in her narrative case histories. These often reveal a pattern of repressed hostility, of superficial happiness but inner tension between parents. Getting the patient to cooperate, to gain even a tittle weight so that she is psychologically reachable (for extreme food deprivation affects nervous system functioning), is the first step, followed by many sessions of therapy (which usually entails other family members as well). Browsers might assume this book to be of parochial interest to psychologists, physicians, or families who face the problem. But Bruch's description of middle- or upper-class families--where parents are often intelligent, professional people, perfectionist and hard-driving--has greater ramifications. The pattern of family dynamics which leads to anorexia in some children may take a different but equally destructive route in others. In this respect Bruch's incisive analysis provides a cautionary tale for a variety of what might be called ""affluent"" neuroses.