Exploring new ways of thinking about dieting, body image, fear foods, and more.
Cognitive Behavior Therapy & Nutrition.
In a previous discussion, I introduced the concept of the Second Arrow, which metaphorically represents our reaction to negative thoughts or experiences, often amplifying our pain and suffering in those moments. These reactions, or behaviors, are influenced by our feelings about the situation, which in turn are preceded by our thoughts and beliefs. This interconnectedness is central to the therapeutic model known as Cognitive Behavioral Therapy (CBT), illustrated in Figure 1. CBT is a versatile approach used to address various psychological issues ranging from anxiety to PTSD, but at Second Arrow we find it can also be beneficial for individuals seeking to improve their relationship with body image and food.
Figure 1. - Interconnectedness of thoughts, feelings, and action.
CBT is grounded in three core principles (American Psychology Association):
Psychological problems often stem from faulty or unhelpful ways of thinking.
Psychological problems are reinforced by learned patterns of unhelpful behavior.
Individuals can learn more adaptive coping strategies to alleviate symptoms and enhance their overall functioning.
Example
Meet Sarah, a former D-1 soccer player now age 33, and becoming more serious into CrossFit. She has been diligently following a strict diet plan, motivated by her gym environment and the prevailing notion that thinness equates to health, superiority, and is standard if she's to be a serious athlete. Sarah often finds herself reminiscing about her slimmer physique in college while observing other athletes with learner builds and six-packs at her gym.
One day at work, a coworker brings in cake to celebrate a birthday. Initially, Sarah thinks, "I don't eat that processed junk; I can’t believe people put that in their body." Despite her initial resolve to resist, she later indulges in a small slice. Instantly, she is overwhelmed with guilt and frustration, especially after adhering to her meal plan diligently all week. Her negative self-talk intensifies: “I can’t believe I ate that garbage; I’m going to gain weight if I don't burn this off.” Consequently, later that day she restricts her dinner, only eating a small salad, and she extends her gym session an extra 30 minutes. The next morning, still plagued by guilt, she skips breakfast, opting for coffee to ”get back on track.”
Diet Cycle
The scenario above exemplifies a cycle of restriction or a restrict-binge cycle, fueled by misconceptions and unhelpful beliefs. Once entrenched in this cycle, negativity compounds, trapping individuals in a spiral. We can notice here in Figure 2, what the cycle of thoughts, feelings, and behaviors may look like for those constantly trying to diet.
Breaking Down the Cycle
In a CBT model we could break this example down into our categories of thought, feeling, and actions to better objectively understand this negative cycle.
Beliefs: All processed food is inherently unhealthy. I must be thin to be valued.
(Black and white thinking. Rarely are things either A or B only).
Thoughts: Initially: "I can't believe others would eat that; how could they? Gross." After indulging: “I’m such a failure; why can't I keep it together? I ate so unhealthily. I'm going to gain weight.”
Over-Generalization - Believing other always eat this way or are unhealthy based on limited evidence.
Mislabeling - Calling yourself “a failure,” in life because you ate a small piece of cake.
Feelings/Emotions: Initially, Sarah feels restricted as sticking to the meal plan proves challenging, especially without dessert. After indulging, she experiences guilt, shame, and a sense of failure, accompanied by thoughts of compensatory actions.
Food restriction breeds food fixation. Cutting out food groups forever based on black and white thinking, scare-tactic information from social media, fad diets, or misinformation leads to reinforcing the diet cycle and preventing us from enjoying food, finding balance, and becoming intuitive eaters.
Actions/Behaviors: She feels compelled to compensate by burning off calories through additional exercise and imposing dietary restrictions, reinforcing negative body image and self-belief.
You never need to earn your calories. Working with an RD to find a way to incorporate fun foods keeps us from feeling the need to compensate when we “eat bad.” Cake might not be the most nutritionally dense food, but NO bad is BAD food unless you're allergic or it's expired.
How we use CBT
With CBT-informed nutrition care, you and your dietitian can collaborate to:
Identify specific issues and pinpoint where in the cycle of thought, feeling, and action you reinforce the problem.
Define achievable and meaningful goals aligned with your values, steering clear of diet culture influences.
Learn about emotional cycles, influences of social media on self-beliefs, and explore individual challenges
Restructure cognitive and behavioral patterns hindering progress towards your goals.
Acquire additional coping skills to navigate life's challenges more effectively
Engage in homework assignments and review progress with your dietitian to sustain growth outside of sessions.
Through CBT-informed nutrition care, you can develop a healthier relationship with food and your body, fostering long-lasting positive change.
Message us today if you want to start working towards an improved relationship with your mind, body, and food.
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