6 Common Cognitive Distortions Behind Eating Disorders
Written by CCTC Staff Writer
“I’ve already eaten so bad today, I might as well binge.”
“No one will ever love me if I am in this body.”
“They didn’t answer my text, it’s because they hate me because I’ve gained too much weight.”
“I can’t believe I purged, I will never recover. I am giving up on recovery, what is the point?”
Do these types of thoughts seem familiar? These are all examples of cognitive distortions. These types of thought patterns can make fighting your eating disorder even more difficult, which is why it is important to identify these distortions and challenge them.
In this article, we will talk about:
What cognitive distortions are
How cognitive distortions play a role in eating disorders
What cognitive distortions are most common in eating disorders
How Cognitive Behavioral Therapy (CBT) can support eating disorder recovery
Ways to improve your way of thinking if you are struggling with these thinking patterns
What are cognitive distortions?
Cognitive distortions are habitual errors in thinking, meaning the way you interpret events is usually negatively biased. These types of thoughts are usually inaccurate or exaggerated. These types of distortions if reinforced can increase mental health struggles such as anxiety, depression or disordered eating.
Well, where do these come from? Research shows that some people may develop cognitive distortions as a way of coping with adverse life events. When these types of difficult events are prolonged or are more severe, the more likely it is these distortions will form. Basically, the negative thoughts become second nature and harder to control.
How do these play a role in eating disorders?
Like the examples in the beginning of this article, cognitive distortions can keep people stuck in the cycle of disordered behaviors. The thoughts and beliefs that people have about food, weight and body image are cognitive distortions in themselves. Addressing problematic thinking and unlearning these automatic thoughts is an important part of the recovery process. Without being able to step back and question the thinking driving behaviors, stopping disordered eating is not really possible.
What are the most common distorted thinking patterns?
Cognitive Behavioral Therapy was pioneered by a psychiatrist named Aaron Beck in the 1960s. Since the beginning of CBT, researchers have identified common thinking patterns that people may struggle with. Here are 6 common thinking patterns that relate to eating disorder thoughts and what a healthy reframe may look like in eating disorder recovery to compare it to:
1. Polarized thinking
Polarized thinking is when you have “all-or-nothing” or “black and white” thinking patterns. This type of thought pattern can be fueled by perfectionism and the fear of failing.
Eating disorder examples & healthy reframes:
“If I slip up with a behavior, I might as well give up on recovery.” → “I slipped up, but recovery is about doing the next best thing, not give up on myself and finding freedom”
“I already ate too much today, I am going to binge.” → “No matter how much I ate, binging is not the answer. I can cope with these emotions in another way.”
“I skipped breakfast, so I might as well skip lunch too.” → “Just because I struggled to have breakfast does not mean I can just give into my eating disorder today. I will push myself to eat lunch to get back on track with recovery.”
2. Personalization
Blaming yourself or taking responsibility for something that wasn’t completely your fault. Conversely, blaming other people for something that was your fault.
Eating disorder examples & healthy reframes:
“If I didn’t gain weight, they wouldn’t have stood me up.” → “Someone standing me up is wrong and I can feel disappointed/sad/angry. The reality is, they may have many reasons behind it, and whether or not those are right/wrong, blaming my body for it isn’t fair. Even if it was something to do with my body, I would not want someone like that in my life anyways because I deserve better.”
“I chose my eating disorder, these health issues are also my fault.” → “My eating disorder was not a choice, it served a purpose and helped me cope during difficult times. Accepting these health issues is going to bring up a lot of emotions and that is okay. Blaming myself and treating myself poorly does not help me feel better, only worse. I deserve compassion.”
“I never heard back after that interview because they judged my body.” → “While weight stigma is a real issue and could be a factor in some cases, the truth is I knew that I didn’t match their requirements 100% and they may have found someone who did and that is okay. It doesn’t mean I am a bad person.”
3. Should/must
Using critical words like “should,” “must,” or “ought” can make you feel guilty or like you have failed. If we apply ‘shoulds’ to other people the result is frustration.
“I must work out X hours to eat X food.” → “I do not have to earn my food through exercise, I am working on giving myself permission to eat what I want without punishing myself.”
“I shouldn’t have eaten that, I should be eating better/healthier/cleaner.” → “There is no ‘right’ way to eat and putting pressure on myself to eat a certain way never works out.”
“I must lose weight to be happy.” → “Happiness and my weight/body have nothing to do with each other. I can be happy in the body I am in now.”
4. Disqualifying the positive
Discounting the good things that have happened or that you have done for some reason or another or twisting positive feedback into negative reinforcement.
“She said I look healthy, that means I’ve gained too much weight.” → “It is triggering to have anyone comment on my body, period. Their intention was good, but it hurts to hear, but that does not mean I am going to let my ED take this as a way to gain control back.”
“I would have enjoyed this special day (ie: graduation, birthday, wedding) more if I were thinner.” → “This is a thought my ED wants me to believe, the truth is, my ED makes it hard to enjoy things, not my body itself.”
“She said I look great because I’ve lost weight, that is why I have to keep losing weight.” → “My eating disorder will never be satisfied with my weight, I can tell them not to comment on my weight next time they see me.”
5. Labeling
Assigning labels to ourselves, other people and things without taking consideration of the complexities humans and life possess.
“I have no self-control around food, I’m disgusting.” → “Certain behaviors today may have made me feel like I had no control around food, but that is not true all the time. One challenging day/moment does not mean I am disgusting. I am working on this in recovery and it is OK to give myself some grace.”
“I am such a loser for struggling with this eating disorder, it is childish and pathetic.” → “Struggling with an eating disorder is not childish or pathetic, I am not a loser for struggling. I am doing what I can to fight my eating disorder and I deserve compassion.”
“These foods will make me gain too much weight.” → “No one food is going to make me gain weight in the way I imagine, this is a fear that my ED wants me to hold onto so I stay stuck.”
6. Magnification & minimization, or catastrophizing
Blowing things out of proportion (catastrophizing) or inappropriately shrinking something to make it seem less important.
“I only purge once a week, I am not even sick, I don’t need help.” → “Any type of disordered behavior is not normal and I don’t have to be ‘sick enough’ to get help.”
“If I gained weight, no one would love me anymore.” → “Those that love me would love me at any weight, that is not true.”
“I ate so bad this week, I must have gained 20 lbs. I can tell I did.” → “There is no such thing as ‘bad’ eating and thinking I can see/tell I gained that much weight is my ED trying to make me feel guilty and ashamed to return to the cycle of disordered behaviors and I won't let it.”
How can CBT support eating disorder recovery?
Learning to recognize problematic thought patterns and gaining the skills and insight to challenge them is the main goal in CBT. In eating disorder treatment, restoring weight and managing any health or medical complications is a priority. Then, re-establishing normal eating patterns and decreasing disordered behaviors is focused on. This is typically in tandem with exploring the thoughts, emotions, and behaviors that are linked to these disordered eating behaviors.
At first, it may seem difficult to identify the problematic thinking patterns as they have become so normalized for you. Over time, your treatment team can help you identify and challenge these thoughts to strengthen your healthy self and reinforce the parts of you ready to fight your eating disorder.
How to work on improving your thoughts
Many treatment programs offer Cognitive Behavioral Therapy as a modality both in group or individual settings, including our programs at Central Coast Treatment Center. Finding a provider or program that offers CBT can help you on the road to recovery.
If you are or someone you know is struggling with an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer here at Central Coast Treatment Center.