Eating disorders

Eating disorders and thought patterns

This section includes people describing their experiences of negative thoughts at the time when they were ill. Some people might find reading about these experiences distressing. All the material on this website is intended to support a better understanding of why these unhelpful thoughts in eating disorders happen, how to get help for them and to support genuine recovery from eating disorders.
“Eating disorders are serious emotional and physical illnesses in which sufferers use food and sometimes exercise in different ways to manage difficult circumstances in their lives and the feelings that come with them. It is important to remember that food and weight is not necessarily the problem, it is embedded in the underlying factors which can be low self-esteem and lack of self-worth.” Men Get Eating Disorders Too - 2018. 
From the outside, eating disorders may not appear to make sense but for those with an eating disorder, there is an “inner logic”. The psychological problems that people can experience include: negative thinking, low self-esteem, perfectionism and obsessions. Despite the difficulties eating disorders cause, it can be difficult for someone to want to get better. People can feel that obsessive behaviour, for example, helps them to cope with anxiety.
Here young people we spoke with describe their thought patterns and their state of mind when they were ill. They explain the impact that these negative habits had on their lives and why it could be so difficult to want to get better. (For more see ‘Obsessions and rituals around eating’.)
Negative thought patterns

Many of the people we talked with described being taken over by constant negative thoughts, particularly about themselves. Some people referred to this as the “eating disorder voice”; a “supercritical”, “relentless” and “intrusive” voice. They said that voice makes them feel low and ’not good enough’, pushing them to restrict (severely limit eating), binge (eat excessively) or purge (rid the body of food).
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“It’s like having somebody in your head telling you that everything you do is wrong, like you can’t please it no matter what you do. If you go for a walk, you’ve not walked far enough. If you eat a lettuce leaf you still should have not had it. It’s like nothing you can do is good enough for it.” -Eva
Andrew described how the voice was “shouting and calling me a disgrace”. A few people commented that they felt like the voice belonged to a different person, compelling them to behave in harmful ways.

If bad things happened in life, people often felt it was their fault. They were first to blame themselves if anything went wrong at home. Such feelings could delay the initial contact with their GP as they didn’t want to feel like “a burden”.

Young people often described themselves as “worriers”. Their minds were filled up by “worst case scenarios”, worry about failure or what other people thought of them or even “the world ending tomorrow”. Some even worried about other people being worried about them. Fiona-Grace said her challenge was to learn to live in the moment, rather than worry about the future and “endless what ifs”.

People talked about different ways they coped with negative thoughts. These included getting the thoughts out into journals or blogs, having positive walls and compliments books and doing things that made them feel good about themselves. Distractions and mindfulness or relaxation techniques worked too. (For more see Coping with an eating disorder and self-help.)


Young people we spoke with often described an eating disorder as a form of control they could have over their own lives. People could feel out of control because of things happening around them such as:

• Unsettled home lives 
• Parents’ divorce
• Witnessing domestic violence
• Death of a loved one
• Changing schools 
• Bullying
• Personal factors (such as puberty, changing body, loneliness, a feeling of ‘not fitting in’)

Often the eating disorder was described as the only thing they could “control”. Some called it “my thing” that they “didn’t want to let others in on”. An eating disorder was something that was just for them and not for others to decide. Sometimes people felt that it was an “escape” and helped them cope.

A lot of people had experienced more than one type of eating disorder (often anorexia nervosa and bulimia nervosa) and said that one of the differences between them was the amount of control they felt they had.


People we talked with commonly described themselves as having “perfectionist” tendencies, being “driven” and “hard-working”. Desire to “do things right” and to achieve the highest possible goals could extend into many areas in life such as school or exercise. At the same time people often struggled with low self-esteem and could lack self-confidence even when they were in recovery.
For some, the eating disorder itself became a project in which they “excelled”. It provided a source of “achievement” and self-worth. In particular, people with anorexia nervosa described restricting food as a form of achievement. Felicity said that through therapy she learnt to understand how being ‘successful’ at weight loss was a “marker of achievement” for her and made her feel good about herself.
People’s perfectionism wasn’t necessarily driven by wanting to be the best, or even comparing oneself to others, but instead by a fear of failure or not feeling “good enough”.
“It’s a race that you’re just never gonna win. It’s always going to end badly if you just keep going.” -Hannah O
“It’s definitely not pleasant and it’s not sustainable for me personally. I have an element of that and I guess I consider myself quite driven but I think I’ve tried to because I’ve worked on coming to terms with the fact that nothing I ever do will ever be perfect because perfection is, by definition, impossible.” Rob
It was important for young people to find other areas in life they could be good at, and not value themselves for their eating disorder. When recovering, people also started to learn to accept themselves for who they were, not try and be different or "better".

Throughout their illness, people developed complicated emotional relationships with food, bingeing, eating and not eating. As part of the negative mindset, people could feel that they didn’t deserve enjoyment or pleasure. The eating disorder could become a form of self-harm. People with anorexia nervosa sometimes described restricting their food intake as a way of punishing themselves. Elizabeth used to think that “pleasure meant failure” and that by restricting her food intake she was also restricting the fun she didn’t feel she deserved. Rob felt “he had no right to have fun” in life, either through food or in other areas of life. Georgia even said that she felt she didn’t “deserve to eat”.
People could also feel the need to make up for the times when they thought they had overeaten. They could restrict their food intake further, do exercise or household work, purge or cause themselves pain, for example by sleeping on the floor instead of the bed.
Talking therapies were often useful in helping young people break the negative cycle of self-punishment. They found more positive outlets for their anger or frustration but also, over time, were able to address the underlying reasons behind the negative emotions and let go of them. 
Dealing with emotions

“My reaction to that unhappiness of feeling really dissimilar to all of these people around me was to kind of hold back and eat bean salad and go to the gym loads. And so I got into a very punishing cycle of working really hard, obsessively and exercising obsessively. And feeling like I didn’t have the right to have any fun.” -Elizabeth
Restricting food, or bingeing and purging could also be a way of dealing with emotions; feeling upset, guilty, anxious, lonely or embarrassed. Particularly people with bulimia nervosa often described, bingeing and/or purging as a release of negative emotions. Bingeing and purging was described as a continuing cycle of emotions where people would overeat if feeling upset, then make themselves sick to stop the feelings of guilt that came from overeating. Weight loss or “being skinny” could also be associated with being happy and successful. Jasmin said she’d never liked herself and she thought that she could “fix” this by losing weight.
People with bulimia nervosa often described their illness as “dirty” and “disgusting”. Emily said bingeing made her feel “greedy and overindulgent” and people could feel that purging would help undo those feelings. Charlotte said she used to “stuff food” to numb the feelings of anxiety. For Jasmin, bingeing could help “cover up” negative feelings. Craig said that rather than express his emotions, like anger or sadness, he tended keep them inside and restrict his food intake.

Last reviewed October 2018.


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