Cognitive Distortions & Cognitive Impairment
What Are Some Examples Of Distorted Thoughts?

Cognitive distortions, also known as cognitive impairment or distorted thinking, are common in people with anorexia and those who suffer from other eating disorders. Treatment often requires intense cognitive behavior modification.

When related to eating disorders, cognitive distortions can be thought of as reasoning errors, dysfunctional thoughts or irrational ideas.

These habitual thoughts unconsciously influence a person's perceptions, emotions and behaviors.

Each one of us has a pre-defined cognitive style and set of relatively stable (we hope!) thought patterns that serve to organize and interpret information.

In people with eating disorders, thought patterns exist that are the result of processing errors in the brain.

This sort of cognitive impairment distorts our experiences and can result in varying degrees of mood disturbances.

The tricky part for health care workers is determining which cognitive distortions were present prior to the onset of anorexia (or other eating disorder), and which ones are the result of semi-starvation.

As part of my treatments for anorexia, I was told that starvation can lead to actual cognitive changes.

These might be demonstrated in such areas as trouble concentrating, difficulty understanding, and poor judgment.

“ED” The Eating Disorder Voice - More Cognitive Distortions

In anorexia, the monster of all cognitive distortions is the Eating Disorder Voice. It's also referred to as a "negative voice", or never-ending dialogue playing inside your head.

It goes constantly, from the minute you wake up until the minute you fall asleep.

You may or may not have even heard of this "Eating Disorder Voice", commonly referred to as "ED", but it is all too familiar for those who suffer from eating disorders.

ED is a cruel, accusatory, lying trickster who convinces you that you're worthless, undeserving and responsible for everything that goes wrong.

The subject of ED is extremely difficult to bring up with your therapist. I thought for sure she'd think I was a lunatic! As it turns out, she'd heard it all before :)

And to be clear, this is NOT the same thing as "hearing voices" like what has been reported in some cases of schizophrenia. The Eating Disorder Voice can be equated to the same 'voice' you have when you think to yourself, "Gee, I must remember to take out the garbage in the morning".

The difference is that ours, as a result of the cognitive distortions, is wicked, nasty and cruel - and it's always there, ready to criticize our every move and contradict every thought.

Examples Of Cognitive Distortions - Black And White Thinking

These are some examples of irrational thinking (cognitive distortions).

Although they can be both causes of eating disorders as well as effects, I think everyone experiences these kinds of thoughts from time to time:

• Extreme, black and white thinking; all-or-nothing thinking:


• "If I'm not perfect, I must be evil"
• "I'll lose my mind if I don't count every calorie"
• "I will only feel good when I consume low-fat, diet foods"


• Interpreting others' behavior as directly related to yourself:
• "Those people over there are whispering. It's got to be about me."
• "As soon as I started talking to those girls, they said they had to go. They think I'm dumb."
• "My teacher didn't smile at me today. I must have failed the test."


• Trying to casually relate two un-related events:
• "If I eat that cake, it's going to turn to fat instantly."
• "If if allow myself to get excited that I passed the test, I will surely fail the next one."
• "If I follow my Dietitian's meal plan, she is going to make me fat."


• Catastrophizing - magnifying and making a catastrophe out of situations:
• "If I gain any more weight, I am going to explode."
• "He hasn't called me in two days. I bet the relationship is over."
• "If I am not perfect, everyone will hate me."

It's easy to see how some of these examples could easily overlap, but I hope it gives you a very basic idea as to what's going on inside the mind of a person dealing with an eating disorder. Cognitive restructuring is usually part of the required treatment.

You can also read more about cognitive disorders that are related to a distorted body image.

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