By Caroline Christian, M.S.
3rd Year Graduate Student In our society, there are codes for how we treat one another. Imagine you are watching as someone walks up to a stranger and says, “Oh my gosh, you are so fat, there is no way anyone will ever love you.” What would your reaction be? Shock? Horror? Disbelief? You may even feel the need to walk up to the person and let them know that is not acceptable, or to comfort the other person. Or imagine saying to a friend, “Ew, your body looks gross today. You shouldn’t leave the house.” Or imagine if a friend said to you, “You need to lose weight, let’s not eat today.” What would your response be? These are examples of statements you would likely never say, or probably even think, about another person, because it would be rude, hostile, and may even end relationships. So why do we accept these statements when they are said to us by an eating disorder? Individuals with eating disorders experience urges to engage in maladaptive behaviors, which are often driven by eating disorder thoughts. As discussed in the book, “Life without Ed”, by Jenni Schaefer, eating disorder thoughts often feel like another voice or entity (Ed) living in your head, chiming in on how you eat, socialize, and view your body (if unfamiliar with the eating disorder voice, you can read more here). The examples, “you are so fat,” “you shouldn’t leave the house today,” and “you need to lose weight” are just a few Ed thoughts that individuals with eating disorders may feel constantly bombarded with, especially around meal times, social gatherings, or situations involving seeing one’s body. Even if you don’t have an eating disorder, you likely still hear thoughts like this from time to time when looking in the mirror, trying on clothes, comparing yourself to friends, or eating at a restaurant. Although not typically accepted towards others, having critical thoughts about one’s own body and eating habits is so engrained in our society. We are taught that these self-critical thoughts are there for a reason: to motivate us to be “healthy,” to be the best version of ourselves, to be liked, and to have the most friends. These myths leading to shame, unhealthy weight-loss behaviors, and the impossible pursuit of perfection can hold us back from self-love and living life to the fullest. We are told we need to hate ourselves in order to motivate positive change, but in reality, the best motivator to want to take care of yourself is to love and accept yourself exactly as you are. Below are tips from evidence-based therapies for eating disorders, anxiety, and obsessive-compulsive disorder that may help you respond to these intrusive eating disorder thoughts that people of all backgrounds experience. The severity of these thoughts may widely differ for all people, but these tips can be helpful for folks that are young and old, men, women, and gender minorities, and people with and without eating disorders. For individuals at various stages of eating disorder recovery, we hope this is a helpful supplement or refresher, but strongly recommend working with an eating disorder specialist to practice responding to Ed thoughts. Resources for seeking treatment are included the very bottom of this page. 1. Practice logging thoughts to notice when Ed thoughts come up. The first step in responding to unhelpful thoughts is to notice when they arise. Starting a log or diary of thoughts can help identify when thoughts come up, if there are patterns in what triggered the thought, and how these thoughts impact your day. For example, you may notice you have self-critical thoughts about your body when you look in the mirror, and that these thoughts contribute to shame and make it harder to focus at work. Even just building this awareness can help you reclaim your life from Ed thoughts. It can also help you decide if and when it may be most helpful to use the other skills below. 2. Telling Ed “maybe, maybe not.” One quick response to Ed thoughts is, “Maybe, maybe not.” This skill comes from acceptance-based and exposure-based therapies, and stems from the idea that you can accept uncertainty without having to respond to it with anxiety or unhealthy behaviors. For example, if Ed says, “Nobody will like you because you look fat,” you can say “Maybe nobody will ever like me, but maybe they will.” This dismission of Ed prevents the thought from spiraling and can help you become comfortable with the discomfort of uncertainty. For example, in reality, there may be people in society who judge others based on weight, but ruminative thoughts about the past and worried thoughts about the future don’t have to dictate how you feel in the current moment. 3. Treat yourself like you would treat a friend who heard Ed thoughts. Treating yourself like you would treat a loved one is the primary tenant of self-compassion. As exemplified in the first paragraph, many of us would never say the things Ed tell us to a friend or accept such comments from a stranger. Self-compassion is a great tool to use all the time, but especially when 1) you’re going through a hard time or 2) you feel like you’ve made a mistake. Self-critical thoughts about food and body can be especially loud during these times, so when you hear those thoughts (e.g., “you aren’t good enough”; “you shouldn’t have eaten that”), try to respond to yourself like you would a friend going through that same tough time. For example, if your friend is having Ed thoughts about her body after looking in the mirror, you may compliment her, remind her of other things you like about her, give her a hug, or invite her to do something fun or relaxing. Many people rarely afford the same compassion to themselves. Start to practice directing this kindness inward and see how it may change your outlook. 4. Challenge Ed thoughts. Another tool for responding to these thoughts comes from cognitive-behavioral therapy. Most self-critical thoughts have logical fallacies in them, like assuming something is black-or-white, exaggerating possible negatives, trying to predict the future, or assuming you know what another person may think. If you notice you have a thought that is based on a myth or misconception (try noticing them in the examples above!), you can challenge the thought and replace it with a rational alternative. You can challenge a thought by putting it on trial, and listing evidence (facts, not feelings) that support the statement is true, as well as evidence that contradicts the thought. For example, there probably isn’t much evidence that your friends think you are fat, but a lot of evidence that your friends like you for who you are! Writing out this evidence can help you see the reality of the situation; not just what Ed sees. 5. Let Ed thoughts come and go without changing behaviors. Importantly, self-critical thoughts are usually accompanied with something you should do or change, including unhealthy weight loss behaviors. It can be hard not to let these thoughts motivate you to do things that may be harmful or hurtful. However, there are several skills you can use to let these thoughts go, without giving them power or feeling like you must engage in behaviors. One example is the “leaves on a stream” meditation. In this meditation, you picture yourself in a wooded area by a stream. You picture the leaves from the trees around you as they fall from the trees, land on the stream, and slowly get swept away. When doing this meditation, as thoughts come up, especially unhelpful Ed thoughts, you can acknowledge the thought, place it on a leaf, and slowly watch it float away. There are also versions of this meditation where you put your thoughts on clouds, or a conveyor belt – whatever is best for you! The idea behind this meditation is that you can experience thoughts without valuing or buying into them, and that the thought does not have to continue to stay in your mind. Practicing this meditation can help you get better at letting go and saying no to Ed thoughts. 6. Model these skills for loved ones. It is important to note that most people have self-critical thoughts and varying levels of practice responding to them. When interacting with friends and loved ones, it can be helpful to spread positive messages about food and body image and be mindful of saying things that enhance other’s Ed thoughts. Even saying critical thoughts about yourself, like “Do I look fat in this dress?” is a form of fat talk that can influence other’s perceptions of themselves. Instead, try to be self-compassionate, present-focused, and nonjudgmental of thoughts even when you are around others. By doing this, you may help others that have similar struggles with self-criticism or intrusive Ed thoughts. You can read more about how to spread positive food and body messages in this blog! Responding to these self-critical thoughts about food and body image is not easy at first, whether you have an eating disorder or not. However, being aware of and responding to these thoughts can give them less power in your life, opening you up to a fuller life with self-compassion, self-acceptance, and present-focused awareness. As thoughts like, “I should lose weight so people think I am attractive,” or “I look so bloated and gross right now” come up in real life, let yourself replace these thoughts with rational thoughts, like, “My loved ones care about me, not my weight” and “It is normal that my body shape fluctuates.” Even though it may feel difficult at first, I encourage you to practice these responses and find the ones that are most helpful for you. Resources for seeking treatment: https://www.edreferral.com/ https://www.nationaleatingdisorders.org/help-support/contact-helpline https://map.nationaleatingdisorders.org/ (for those in Louisville or Kentucky) https://www.louisvillecenterforeatingdisorders.com/
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