Return of the Suppressed: Mental Control and Bulimia Nervosa

Abstract

The clinical literature has long acknowledged the paradoxical findings that deliberate attempts to suppress particular thoughts actually increase their occurrence. The unwanted, intrusive thoughts that are a major feature of obsessive disorders, depression, sleep disorders, and a range of other disturbances are of particular clinical concern. The exploration of psychological factors associated with cognitive control is, therefore, clinically relevant. The present paper considers the role of mental control and thought suppression in bulimia nervosa in explaining the occurrence of unwanted thoughts and feelings, specifically in relation to weight, shape, and food. Our fundamental argument is that suppression of thoughts of food, weight, and body shape can lead to the increased frequency of these thoughts. The increase in unwanted thoughts is likely to result in a loss of control over eating, and lead to the escalation and perpetuation of bulimia. Dietary restriction is likely to be associated with successful suppression, and binge-eating with failed suppression. Indeed, the initial success of suppression paradoxically causes its inevitable failure. We conclude that the suppression of thoughts of food and weight or shape in bulimia nervosa is maladaptive and counterproductive. In addition, the therapeutic implications of thought suppression are considered.

Thought suppression in obese and non‐obese restrained eaters: piece of cake or forbidden fruit?

“…An often reported dieting-related side effect is excessive thinking about food and eating (Bonifazi & Crowther, 1996;Ogden, 1995;Ward, Bulik, & Johnston, 1996). These preoccupations can lead to reduced levels of cognitive functioning (Jones & Rogers, 2003) and they are potential cognitive enhancers of eating behaviour since intrusive thoughts may be interpreted as cravings for a substance, thereby leading to use (Herman & Polivy, 1993;Toll, Sobell, Wagner, & Sobell, 2001).…”

“…Despite the abundant similarities between thought suppression effects and dieting failures (Ward et al, 1996;Wegner, 1989), the results of eating-related suppression studies are not straightforward. While some studies found no evidence for food-and weight-related rebound effects in normal-weight restrained eaters (Harnden et al, 1997) and high disinhibitors (Oliver & Huon, 2001), others did find an overall increase in food-related thoughts after suppression (Mann & Ward, 2001).…”

Examining the relationship between food thought suppression and binge eating disorder

“…Although Ward and colleagues posited a link between thought suppression and binge eating over 15 years ago [16], only recently has this hypothesis received empirical attention in nonclinical [17,18] and clinical [19] samples. Food thought suppression may have even greater significance for obese persons with disordered eating such as binge eating disorder (BED).…”

Effects of Thought Suppression on Subliminally and Supraliminally Presented Food-related Stimuli

“…One possible explanation for this would be the fact that the Oliver and Huon study as well as our own study involved successful dieters who did not differ in their behaviour from non-dieters. Ward, Bulik, and Johnston (1996) have already suggested that patients with eating disorders differ from normal patients because they regularly overeat in spite of their strict dieting intentions. These patients can be seen as non-successful dieters.…”