Working through Eating Disorders with CBT
By tackling the way we think about ourselves, our bodies, and food, and using this to inform changes in our eating behaviours, CBT provides a powerful method for breaking free from the powerful grip of anxiety, guilt and shame that can control our relationship with food.
The benefits of CBT for a range of food-related concerns
Issues with food and eating are relatively common for both men and women: even if our problems are not at a level recognisable as Anorexia or Bulimia or another diagnostic category, many of us struggle with our body image, seem to be on a constant diet, find ourselves trapped in cycles of binge eating, or experience anxieties at the prospect of meal times.
The treatment of choice for a range of food-related concerns (as recommended by NICE – the National Institute for Health and Clinical Excellence) is CBT Cognitive Behavioural Therapy, which takes a present-tense, solution-focused approach to guiding people towards a healthy relationship with their bodies, food and eating.
The most important factor which influences the effectiveness of CBT for food issues is a recognition of the problem and a desire to change: if you acknowledge that you have a difficult relationship with food that you would like to conquer, the hardest part is already over.
Because of its tasks which require effort in changing the things we think and do in relation to food, and which require us to carry these changes out of the therapeutic setting home with us, it is much harder to commit to CBT without an accompanying commitment to change.
CBT empowers you to learn about your symptoms and behaviours surrounding food, whether they be the avoidance or excessive consumption of it or consuming thoughts or anxieties about it. By encouraging you to recognise and change unhelpful patterns of thinking about food, your body and yourself, CBT can help you to break free from a daunting cycle of negative thoughts and behaviours that can seem impossible to navigate your way through alone.
Often, a therapist will ask you to keep a food diary of your eating patterns including any bingeing or purging (through vomit, laxatives or excessive exercise), and the events, thoughts and feelings that preceded them. This helps you to understand how to predict the triggers for these symptoms and when they are most likely to occur.
The goal of Cognitive Behavioural Therapy is to furnish people with the tools to become their own therapist: this is why CBT is generally brief in nature (lasting approximately 16 to 20 sessions), because each session brings us a step closer to independence in managing our problems. Historically, other forms of treatment for problematic eating such as psychoanalytic approaches could last for years, often leading to relapse once treatment was discontinued. CBT by comparison has displayed excellent recovery rates for a variety of eating problems.
CBT itself recognises that recovery is not an objective standard: the therapist seeks to find out from the client at the beginning of therapy what ‘recovery’ means to them, and what they are hoping to get from treatment. This facilitates the collaborative setting of goals, which subsequent sessions are geared towards achieving in manageable and gradual steps, through a series of behavioural tasks that are tailored to the person’s specific concerns.