Eating disorder thoughts can be defined as distorted thoughts about food, nutrition, and your body. This twisted thinking can damage your self-esteem, and make you want to act out in your old, disordered eating ways. They might be triggered by certain people or events, or might pop into your head at random.

You probably experienced such thoughts a lot in the past and may have hoped that you wouldn’t in an eating disorder (ED) recovery. But they don’t automatically stop. They do disappear for some people but for others, they just don’t. The difference now is in how you deal with them.

First, recognise and name the thoughts

Take a moment to acknowledge that the thoughts are intrusive. Remind yourself that they are disordered and untrue. Articulate exactly what you’re thinking, as much as you can. If you can describe something in detail, you’ll be able to deal with it better.

In these situations, it can be helpful to write or talk things out. Grab a pen and paper, or call a trusted friend. Try to understand what brought the thoughts on, but don’t worry too much if you can’t. Sometimes it’s impossible to say, and your top priority now is dealing with the thought.

A toolbox of responses

Over time in ED recovery, you’ll learn various new ways of responding to situations. These are drawn from several types of therapy. A good way of thinking of them is as the contents in a toolbox, which are all available to you. When an eating disorder thought pops up, consider your tools and decide which one (or ones) to use.

Some of the most useful responses to ED thoughts are:

• Practising grounding exercises
• Challenging your thinking
• Externalising your thoughts

Grounding exercises

Do some simple physical exercises that ground and calm you. This could be focusing on deep breathing, noticing the sensations around you, splashing cool water on your face, listening to some soothing music, or anything else that relaxes you.

Challenge your thinking

Challenging the validity of your thoughts is a useful Cognitive Behavioural Therapy (CBT) technique. Ask yourself if there is any evidence for the thought (if I eat that meal, will I really gain weight?) or check by asking someone else.

Then try and formulate an alternative, valid thought. Replace “I will gain weight if I eat that meal” with something like “my body will be nourished when I eat that meal. You could even try writing your eating disorder thoughts on one half of a piece of paper, and your replacement thoughts on the other.

Externalise Your Thoughts

Externalising is used in Acceptance and Commitment Therapy (ACT). Don’t let your ED be your identity. When you experience this twisted thinking, distance yourself from it. Instead of saying “I think that …” say “my ED head is telling me that …”. This way, you take the power away from that damaging voice and give it back to yourself. Remember, you are so much more than your eating disorder. Always.

Practice STOP-ping and ACCEPTS-ance

In Dialectical Behavioural Therapy (DBT), you learn STOP ACCEPTS skills sets, as part of increasing your distress tolerance. They bring the techniques described above together in one convenient package. You could say that these skills are a kind of Swiss Army knife for ED recovery.

STOP

STOP stands for:

• S – Stop: Freeze and stop what you’re doing.
• T – Take a step back: Take a minute and just breathe.
• O – Observe: Notice the situation, including what others are doing and what you’re feeling.
• P – Proceed: Think about how you want to handle the situation.

ACCEPTS

ACCEPTS stands for:

• A – Activities: Do simple, distracting activities. Take a walk, colour a picture, or do the dishes.
• C – Contributing: Do something for others. This could be as small as giving someone a hug, or as large as volunteering
• C – Comparison: Compare yourself now, to before you entered recovery. Take a moment to appreciate how far you’ve come.
• E – Emotions: Elicit a new emotion for yourself by listening to a happy song or watching a funny movie.
• P – Pushing Away: Set the intrusive thought aside for now. Some people visualise putting it into a box. This doesn’t mean you won’t deal with it; it just means you want to be calmer when you do.
• T – Thoughts: Like activities, thoughts can help distract you. Redirect yours away from disordered eating; count something, talk to someone, or sing a song.
• S – Sensations: Let your physical body feel something good. Have a warm bath, smell some lavender, or walk barefoot on grass.

Be kind and patient with yourself

Eating disorder recovery is not linear, and takes time. You didn’t develop the illness overnight, so you won’t heal from it that way either. Be patient and gentle with yourself. Practice kindness and self-compassion. The fact that you are trying to deal with these thoughts shows how brave and determined you are. Don’t forget to recognise that.