Over‐evaluation of thoughts about food: Differences across eating‐disorder subtypes and a preliminary examination of treatment effects

Abstract

Objective: Over-evaluation of food, shape and weight is a multi-faceted component of cognitive-behavioral models of eating disorders. One specific aspect of over-evaluation of food is a cognitive distortion known as thought-shape fusion (TSF). TSF is purported to be specific to eating pathology; however, research has not yet elucidated whether individuals across the subtypes of eating disorders are differentially susceptible to this phenomenon. Furthermore, it remains unclear whether susceptibility to TSF decreases over the course of treatment.Method: TSF, eating pathology, and generalized psychopathology were assessed in 76 individuals with eating disorders. Changes in TSF from pre-to posttreatment were assessed in a subset of participants (n 5 24).Results: Individuals with the binge/ purge subtype of anorexia nervosa were more susceptible to TSF than were individuals with bulimia nervosa or the restrictive subtype of anorexia nervosa. Increased TSF corresponded with higher levels of eating pathology, depression, and impulsivity. In addition, there were decreases in TSF over the course of treatment.Discussion: The observed differences in TSF susceptibility across eating disorder subtypes suggests that subtypes may be differentially prone to overevaluation of thoughts about food, which represents a facet of one of the core maintenance mechanisms in cognitive-behavioral models of eating disorders. V C 2013 Wiley Periodicals, Inc.

Thought-shape fusion in young healthy females appears after vivid imagination of thin ideals

“…Repeated exposure to thin ideals as it happens in daily life (Hargreaves & Tiggemann, 2003) together with a susceptibility to body-related cognitive distortions may be relevant factors in predicting long-term negative effects. Future longitudinal and intervention studies should investigate whether the susceptibility to TSF-B represents a potential risk factor for later ED development and whether TSF-B can be modified (Coelho et al, 2014).…”

Shared Concerns and Opportunity for Joint Action in Creating a Food Environment That Supports Health

“…Many individuals with eating disorders assign “good” or ”bad” labels to foods or have “forbidden foods” that they avoid eating out of fear or guilt. Learning to eat these in moderation has been shown to be a key element of successful treatment [76]. As such, eating disorders prevention messaging often adopts a “no good/bad foods” mantra.…”

Susceptibility to cognitive distortions: the role of eating pathology

“…Interpretation of the current results is limited by the inclusion of a transdiagnostic sample of individuals with eating disorders. Some recent findings suggest potential differences in TSF across eating disorder subtypes in TSF [ 32 ], such that those with a diagnosis of AN-BP report higher levels of TSF than other groups. Future research would benefit from examining predictors of state TSF susceptibility across eating disorder subtypes.…”