Eating Disorder Article
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10-20-12 Category: Health and Wellness

Written By: Sarah Steinmeyer, Ph.D.
Licensed Clinical Psychologist
Director, Eating Disorders Treatment Program

Sarah Steinmeyer

Exercise can bring a level and accomplishment as well as promote health. However particularly for people who struggle with eating disorders, what begins as a desire to attain a healthy goal can become form of intense mental and physical punishment: there is an obsessive interest in weight, calories consumed, and excessive training, often to the point of physical injury. In fact, what begins as compulsive exercise may progress into a more complex eating disorder.

The 2007 guidelines from the American College of Sports Medicine and the American Heart Association recommend a healthy adult under age 65 get 30 minutes of moderately intense cardio exercise 5 days a week or 20 minutes of vigorous cardio 3 days a week and strength-training exercises twice a week. In contrast, compulsive exercisers adhere to a rigorous and inflexible training schedule, usually working toward goals that are increasingly difficult and in fact unhealthy to achieve. “Guidelines” become “rules” which must not be broken. As expectations approach the impossible, the inevitable failure to meet them prompts feelings of irritability, anger, inadequacy and guilt.

These destructive “rules” often come out of one of the thought patterns which have been characterized as cognitive distortions. They are strongly exaggerated or irrational beliefs that generate fear and other negative emotions, and which drive behaviors that are often destructive. It is always the case that these “rules” don’t lead to a sense of pride or accomplishment but rather elicit failure and despair when they are not followed exactly, as is ultimately always the case. Below are some of the most common cognitive distortions as that apply to exercise.

  • Shoulds: Perhaps the most common cognitive distortion is the belief that we must motivate ourselves with the threat of guilt or punishment in order to get anything done. “1 should add a new challenge to my workout routine every week (or else I’ll feel guilty”
  • Emotional Reasoning: We believe that our feelings are actually facts-if we feel something it is true. “1 feel so fat and disgusting! I can “t possibly be around other people- they will think I’m repulsive.
  • Jumping to Conclusions: We defeat ourselves in advance by anticipating negative outcomes. “I won’t be able to maintain this schedule every day- I’m only going to fee like a failure, again.”Polarized or “Black and White” Thinking: There is no “middle ground;” we fail if our efforts don’t achieve perfection. “If! Don’t swim for two hours every day, why bother?” Control Fallacy: When we believe that our behavior is under the control of others, we are investing in the fallacy of external control. “I couldn’t get my workout in because my boyfriend wanted me to go with him, so it’s his fault that I’m in a bad mood.”The belief that we can control others ‘ attitudes and feelings represents the fallacy of internal control. “If I work out a lot I’ll have a dynamite body and I’ll make all my friends jealous.”

While these thought patterns are common to everyone, when they are me major sources of motivation and self-esteem, particularly with reference to self-image, health, and exercise, they can become dangerous. Cognitive therapy emphasizes identifying these faulty ideas and replacing them with healthier, more reasonable and realistic alternatives. Here are some effective strategies for doing so .

  • Be aware: Learning to recognize faulty thought patterns is a first step. Usually feelings of guilt and inadequacy are a clue that we are engaged in cognitive distortions. By re-examining the thoughts that lead to those feelings we become aware of the bad press” we are giving ourselves.
  • Consider your “best friend:” Once we know what we are telling ourselves, it is often revealing to consider whether we would say the same to our best friend, or whether our best friend would judge us that harshly. Is it true, for example, that you would see her as a “failure” for not meeting her goals? Or, would your best friend tell you not to go out in public because you didn’t do enough reps and as a consequence looked fat and ugly?
  • Focus on what you do achieve: Whether it is with reference to exercise or some other activity, we can always find ways we could have done it better … faster … sooner … more completely … etc. That stream of thought only robs you of any feeling of pride or accomplishment. Replacing those negative challenges with a realistic assessment of what you did complete (perhaps with some assistance from that “best friend” you have in mind) offers a healthier and more positive point of view.
  • Stay in the present: It is always possible to see how things could have been better when we look back, but doing so only makes us feel helpless. We’re blaming ourselves for not having made changes that at that time-weren’t available or possible or an option we were aware of. If you must look back, use it as a reference for a change you want to consider in the future: “Next time I’ll arrange my schedule so that I can walk during lunch,” for example .

What are your choices? We can avoid feeling helpless when we recognize that our behavior is always under our control. If you miss a workout because you did what someone else wanted you to do, it was still your choice. You can make a different choice if the same thing happens again. Owning your power is a great way to deal with feelings of helplessness, and a major factor in building self-esteem.

Replacing cognitive distortions is not easy, nor does it happen quickly, no matter how determined we are. Be patient with yourself if you slip into old patterns, and celebrate the changes as you notice you are taking on a healthier point of view. You will find that your exercise routine becomes more effective and gratifying as a result.

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