Cognitive Distortions in Eating Disorders

By Alexandra Forsythe, Eating Disorder Recovery Coach with KHF

Cognitive Distortions: How do they relate to eating disorders?

Cognitive distortions are the inaccurate beliefs one has about themselves, the future, and the world. Eating disorders are one of the mental health disorders where these distortions are a common occurrence. Although these negative thoughts can take a large portion of our thinking, the good news is, you have the ability to challenge and change these thoughts. 

Examples of Cognitive Distortions in Eating Disorders:

• All-or-nothing thinking: “If I eat one cookie, I’ve completely failed and might as well binge.”
• Overgeneralization: “I felt fat today, so I’ll always be disgusting and unattractive.”
• Minimization: “Sure, I haven’t eaten all day, but that’s not a big deal; people do worse.”
• Emotional reasoning: “I feel gross after eating, so I must be gaining weight already.”
• Mind reading: “They’re looking at me because they think I’m fat and out of control.”
• Personalizing and blaming: “My friend skipped lunch today because I made her uncomfortable with how much I ate.”
• Magnification: “I gained one pound, this is a total disaster, and I’ve completely lost control.”
• Mental filtering: “All I see in the mirror is my stomach; it doesn’t matter that my clothes fit better.”
• Shoulds and oughts: “I should never eat carbs if I want to be healthy.”
• Labelling: “I ate dessert, so I’m a failure.”

Do any of these sound familiar to you?

If so, you’re not alone. Becoming aware of these thought patterns is the first step in changing them. With time and effort, you can begin to respond differently.

You might not be able to control your first thought, but you can learn to redirect the second, third, and fourth thoughts. That’s where change happens.

Assignment:

1. Identify the distortion: Write down your negative thought(s), and pair it with one of the cognitive distortions. 
2. Examine the evidence: Don’t assume your thought is true; examine the actual evidence for the thought. For example, if you think that you never do anything right and fail at eating disorder recovery, you may want to list all the things you have done successfully. 
3. Imagine a friend said this about themselves. What would you say back to them? Now, say that to yourself. And how would you say it to your friend (probably gently)? Use that same tone with yourself.
4. Try a small experiment: Reach out to someone you trust: your coach, therapist, or friend, and ask for their perspective. Is your thought really accurate?
5. Problem solving: Instead of thinking you’re bad and blaming yourself, think of all the factors that may have contributed to the thought. Was it triggered by a stressful situation, social media, lack of sleep, or hunger? Write it down. Are there any patterns? If you can identify triggers, you can take steps to manage or change them in the future.

Recovery takes practice.

It won’t happen overnight, but it also won’t happen without your participation. Recovery is not a passive process; it’s a daily choice to engage, to reflect, and to respond differently. Every time you challenge a distorted thought, you’re taking a step toward healing.

If you or a loved one is struggling with an unhealthy relationship with food and or body, you can always reach out to me or the Kirsten Haglund Foundations Virtual Transitional Living Program for more support. You don’t have to do this alone.

Resources:

• Burns, D. D. (1980). Feeling good: The new mood therapy. William Morrow.
• Costin, C., & Grabb, G. S. (2017). 8 keys to recovery from an eating disorder: Effective strategies from therapeutic practice and personal experience (2nd ed.). W. W. Norton & Company.