Cognitive Behavioral Theory and Eating Disorders

We got the following handout in group today. My notes are in white, and the handout is in black.

Cognitive/Behavioral Theory

High Value on Weight/Shape eating disorder starts with "I want to be thin."
Inaccurate Beliefs in 3 areas: develop rules & distorted thoughts on how body works

  1. Body weight expectations
  2. Self-worth based on Shape/Weight If I am thin, ...
  3. Eating Patterns (inaccurate beliefs about the digestive system, metabolism, food, and how to influence your body weight) i.e. fat phobic, low carb, high protein, etc

Beliefs about Food and Body

Dissatisfaction with Body Shape/Weight

Rigid, Restrictive Eating Pattern designed to control Body Shape/Weight

Eating regulated by Self-generating Rules rather than through Internal Signals of Hunger and Satiety
Rules: How often
How much


Physiological and Psychological Deprivation

Strong hunger cues, focus on food, loss of control

Binging (Pleasure, anxiety about weight gain, devalue self)


  • to compensate for calories consumed
  • to decrease anxiety over concerns about weight gain
  • to regain a sense of self-control

Thoughts about lack of self-control; failure and anger for breaking rules.
Reinforce beliefs of low self-worth,
Strengthen the desire to gain control.

Some of my rules are:
Eat only apples, carrots, skim milk
I can’t eat my morning snack until 10 am
If I eat too much, I must exercise for 3 hours and not eat tomorrow.
Exercise must be “pure” exercise; gardening etc doesn’t count.

One of my inaccurate beliefs is:
I don’t deserve to eat because I’m fat.

And this little tidbit from the ED Nurse: For eating disordered people, it takes much longer to empty the gut after eating. If a healthy person eats a big burrito, the healthy gut processes the big burrito in 1/2 to 1 hour. The eating disordered gut takes 2-3 hours to empty.

This is due to paralysis of the gut which is caused by eating too little for too long. This sensation is part of what causes people with eating disorders to be less tolerant of feeling full than healthy people.


How does the binge/purge cycle work?

Have you ever wondered how it is that you or anyone could do something like a binge/purge? It seems even more mind boggling that someone could get trapped in the binge/purge cycle. However, there is good physiological reasons for it. (From my group therapy session)



Healthy people have a sugar-insulin balance. Which came first, the cycle or the inbalance? That’s a good question.


Yuki and I went swimming today during lunch. It started raining while we were swimming. I didn’t mind. We get out of the pool and walk thru the rain to the locker room to get dressed. We walk out of the locker room, and both of us are surprised it’s raining. We were in another state of consciousness while exercising, and it just didn’t translate to the state of going back to work. It was really weird.

News Notes for Monday



Eating Disorder