Cognitive Behavioral Theory and Eating Disorders

We got the following handout in group today. My notes are in red, 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, Type, 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.

Do You Remember Where You Were?

Just about 20 years ago, I was doing my breakfast dishes, getting ready to go to class, and Wendy Tokuda came on the local NBC affiliate to report the explosion. My tv was an old 14 inch b/w set. And still it was stunning to see.

Mission Control: Engines throttling up, three engines now at a hundred and four percent.

Capcom: Challenger, go at throttle up.

Challenger: Roger, go at throttle up.

A little burst of static accompanied a big burst of fire in the sky near Cape Canaveral 20 years ago today. The space shuttle Challenger had exploded just 73 seconds after launch:

Mission Control: We have a report from the flight dynamics officer that the vehicle has exploded. Flight director confirms that.

The explosion killed all seven members of Challenger’s crew: astronauts Dick Scobee, Mike Smith, Judy Resnik, Ellison Onizuka, and Ron McNair; engineer Gregory Jarvis, and teacher Christa McAuliffe. An investigation revealed problems with the booster design, and with the way NASA made decisions about shuttle safety. The problems resulted in the first loss of American astronauts during a spaceflight.

Hours after the disaster, President Ronald Reagan recalled the crew and its mission:

Reagan: Perhaps we forget that we’ve only just begun — we’re still pioneers. They — the members of the Challenger crew — were pioneers. The future doesn’t belong to the faint-hearted — it belongs to the brave. The Challenger crew was pulling us into the future, and we’ll continue to follow them. The crew of the space shuttle Challenger honored us by the manner in which they lived their lives. We will never forget them, nor the last time we saw them, this morning, as they prepared for their journey and waved goodbye, and slipped the surly bonds of Earth, to touch the face of God.

From Stardate.

Do you remember where you were?

Black and White


Black and white make gray.

We pass this … ahem … garden on walks, and it’s so grey. The front yard is dead. The rocks aren’t even real. The reason I took the picture was that after I walked up to the rocks to tap them, I said, “They are fake.” and Chunguita taps them and says, “They are real fakes.”
The theme for Moody Monday is BLACK and WHITE.