This article will discuss the following key points: 

• What are eating disorders 
• Types of eating disorders 
• What are cognitive distortions 
• Cognitive distortions in eating disorders 
• Co-morbid mental illnesses 
• Available Treatments 

Eating Disorders 

According to statistics approximately 28 million people in the United States have experienced or experience eating disorder once in their life (APA,2023)

In the Diagnostic and statistical manual of mental disorders DSM- 5, eating disorders are characterized by having consistent disruption in eating habits and behaviors which causes emotional and physical distress. It can lead to impairment in personal, social and occupational lives. 

Individuals with eating disorders most often find themselves occupied most of the time with their eating habits, their body image, their weight and body shape and it interferes with their normal functioning in life. 

Types of Eating Disorders 

DSM-V has categorized eating disorders as follows:

• Anorexia Nervosa 
• Bulimia Nervosa 
• Binge Eating Disorder
• Avoidant/Restrictive Food Intake Disorder

They are mostly associated with other psychiatric illnesses such as depressive and anxiety disorders (American Psychiatric Association, 2023)

Anorexia nervosa is associated with excessive concern about gaining weight. Those with this kind of eating disorder may tend to have obsessive thoughts about their weight and restrict their food intake. The two types are:

• Restrictive where food intake is extremely low and specific 
• Binge-Purging type where there are periods of excessive food take and then use of laxatives or diuretics to throw out the food with the fear of gaining weight.

It is often a cause of mortality if untreated where it can distort the body image to the point that those with these disorders begin to restrict regardless if they are already underweight and dealing with medical issues due to nutritional deficiencies. 

Bulimia Nervosa is a condition in which individuals have episodes of taking huge quantities of food and then induce vomiting or use diuretic or laxatives or go on fast or unusual diets. People with such conditions associate their self-esteem and identity with how their body appears and are involved in unhealthy behaviors that impair their functioning. 

Binge Eating Disorder is usually categorized with having episodes of eating large amounts of food. They experience uncontrollable desire for food and end up having excessive amounts than required.

Avoidant Restrictive Food Intake Disorder (ARFID) is often not due to the fear of gaining weight or body image dissatisfaction; ARFID may limit an individuals variety of food due to factors such as lack of interest, taste, smell, and texture which results to eating only a few specific types of food or not getting enough energy to  maintain the normal functioning of the human body. Research shows this type often occurs in childhood and can be considered a risk factor for developing eating disorders in future. 

Cognitive Distortions 

Our mind processes enormous amounts of information and it often forms a pattern of thinking to filter out the information in a specific way to form a perception. 

Cognitive distortions are the mental filters which are illogical and often increase the negative emotions and behaviors. They are the negative patterns which we form and use unconsciously to perceive our experiences in life. 

Cognitive distortions in eating disorders 

The altered view individuals hold about themselves, their body weight,and food impacts their eating habits and this forms a toxic cycle of disorderly behavior and thinking patterns. 

Following are a few ways in which individuals with eating disorders experience distorted thinking patterns. 

All or Nothing 

It is a form of black and white thinking that is categorized by perfectionism. If you think you need to achieve a certain goal and you are unable to, you think you are back at zero and effort doesn’t count. It is the type of pattern where you set an unattainable standard for yourself and it is the ideal state if that is not achieved you consider yourself a failure. 

In restrictive type eating disorder it can manifest itself in form such as:

“I didn’t have lunch, I can go over and above and skip my dinner too” 

In binge eating type it can look like this:

“I had a bigger meal than I was supposed to, I might as well binge eat as much as I want” 

Such thinking patterns reinforce the unhealthy behaviors which in turn become the reasoning for repeating the same behavior again. 

Shoulds and musts 

It is a cognitive dissonance where you often find yourself thinking  “I should have, I must, I ought to” and it often leads to feelings of excessive guilt, shame and distress. 

Use of shoulds and musts can manifest in eating disorders in ways given below:

“I must lose weight” 

“I must look a certain way” 

“I should have eaten more” 

“I should look like a certain figure (x,y,z) as portrayed in the media.”

“My body should be perfect according to the trends of the present day” 

“I should lose weight to look beautiful” 

Personalization 

A thinking pattern which highlights self blame and causes people to think that everything that happens is their responsibility or fault is called personalization. 

Person with an eating disorder can experience thoughts such as:

“If I were skinnier people would like me more”

“I am responsible for my illness it’s my fault that I eat too much” 

“I make myself miserable and obese”

“I eat too much and can’t control my weight”

“I am overweight because of myself”

Labeling 

Another distortion evident in people with eating disorders as they are often found putting labels on themselves and their situations without consciously taking into consideration the complications of human experiences. 

It is evident in the narratives such as: 

“I have no control over my eating habits”

“I am an emotional eater it’s natural”

“Eating enough food is going to make me fat”

“I can’t eat or I will be fat”

“I can’t help but eat when stressed” 

“I am a food lover and hence can’t stop eating”

Such labels lead to body dissatisfaction and fuel the unhealthy behaviors or food restriction or binge eating. 

Catastrophizing 

Making a big deal out of something less trivial or minimizing the negatives of a behavior is called catastrophizing. It’s another common dissonance associated with eating disorders. 

For instance one might think:

“I am not even sick I can eat whatever I want”

“I am already obese, I don’t need to eat food” 

“I gained two pounds, it’s alright if I don’t eat for a few days” 

Eating and Co-morbid Mental Disorders 

Research depicts people suffering from eating disorders often develop other mental disorders such as major depressive disorder, anxiety disorders( social anxiety, generalized anxiety) obsessive compulsive disorder and substance use disorder (Godart,2002) (Sander,2021)

Treatment 

It’s extremely important that individuals suffering with eating disorders seek treatment or are given proper treatments. They may experience depressive thoughts, anxiety, substance abuse, and severe medical complications if appropriate help isn’t provided. Treatment options for such conditions include:

• Medicinal care 
• Psychotherapy ( individual and group)
• Inpatient/Residential Treatment
• Nutritional counseling 

To conclude, eating disorders are a genuine concern and should be addressed immediately if observed or reported by people. It is difficult for people suffering from the illness to identify and see their disorderly behaviors due to their distorted thinking patterns hence we should all be mindful and observant of ourselves and others so we can reach out for help or provide help if needed.

References’ 

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. 5th edn

Volery, M., Carrard, I., Rouget, P., Archinard, M., & Golay, A. (2006). Cognitive distortions in obese patients with or without eating disorders. Eating and weight disorders : EWD, 11(4), e123–e126. https://doi.org/10.1007/BF03327577

Convertino, A. D., & Blashill, A. J. (2022). Psychiatric comorbidity of eating disorders in children between the ages of 9 and 10. Journal of child psychology and psychiatry, and allied disciplines, 63(5), 519–526. https://doi.org/10.1111/jcpp.13484