COGNITIVE APPROACH TO EATING DISORDERS

By Ganga Santhosh, 1830236

The cognitive approach assumes that our thought process affects the way we behave. A cognitive approach to eating disorders analyses the same. The two major eating disorders are Anorexia and Bulimia Nervosa. Anorexia is when one feels they are overweight, when they are actually underweight and doesn’t eat. Bulimia Nervosa is a disorder caused by binge-eating or overeating. Eating disorders are complex in nature because a variety of factors underlie it and has the highest mortality rate among other disorders.  

People with eating disorders are found to have significant neurological and brain activity differences, proved by neuroimaging experiments. Their self-regulation is weakened which makes them eat more or less, shown by brain scans. Cognitive theory of eating disorders says that dysfunctional attitudes about physical appearance give rise to eating disorders. These attitudes lead to development of faulty schemas during the development of oneself which alters their reality. To deal with these distortions and irrational beliefs (negative thoughts) about body image, people attempt to lose weight, causing Anorexia. Bulimia Nervosa is caused when they eat more to redirect these negative thoughts and increase self-esteem. Dysfunctional attitudes are categorized as Cognitive distortions or automatic thoughts. These are tagged as Shoulds, All or nothing thinking, catastrophizing, Labeling, rejecting the positive, unfavourable comparisons, blaming and personalizing, overgeneralizing etc. These are basically placing demand on ourselves, ultimate negative thinking, labelling ourselves a loser, self-criticizing ourselves by comparing with others etc.

 

According to DSM-5 criteria, a person is diagnosed with Anorexia Nervosa and Bulimia when he or she has these dysfunctional attitudes and cognitive distortions.

Treatment for Eating disorders majorly includes CBT for Bulimia Nervosa. Cognitive Behavioral Therapy is a psychotherapeutic treatment method that changes one’s thought process. CBT-BN is more effective for adults. The treatment processes include breaking off from the symptoms that are binge-eating and purging and challenging one’s thoughts that give rise to the ED. CBT treatment also includes activities such as self-monitoring or journalling. This makes them aware of their thinking that gives rise to ED and also the feelings they experience. Classifying cognitive distortions is another aspect of the treatment. Questioning the evidence and real-world experiments can help in the destruction of the schemas the patient have.

Other treatment methods for Eating disorders are Acceptance and Commitment Therapy (ACT), Cognitive Analytic Therapy, Dialectical Behaviour Therapy, Solution focused brief therapy but there has not been much research on those.

From a cognitive point of view, eating disorders can only be prevented by regulating our negative thoughts and thereby regulating our eating. Journalling and other positive thought building attitude can reduce it to an extent.