Thought Bias and Weight Shape Concerns in Women

Therapy to treat co-occuring disorders

The beliefs and thought bias that we have about ourselves, our bodies, and food begin taking shape early in life. Consider the rules you were given regarding food. What were you allowed to eat, and when was it acceptable to eat it?

What messages did your parents give you about the purpose of food and eating? How did the adults around you refer to their bodies and how their appearance related to their value?

All of these aspects, and many more, form the belief system we generate surrounding food, nourishment, worth, and our bodies. These beliefs can consciously, or unconsciously, follow us for our entire lives and often dictate how we speak to, view, or judge ourselves and others as well as how we behave and the choices that we make.

The Thought Bias-Feeling-Behavior Connection

Cognitive Behavioral Therapy (CBT) is one of the most commonly taught and used evidence-based treatments for mental illness and eating disorders. The basic idea of this treatment philosophy is that what we think creates an emotion within us, and our behaviors are dictated by that emotion.

As such, if we alter our belief systems and our thoughts, we can regain control over our feelings and, therefore, behaviors. The questions asked previously may give you insight into some of your own personal belief systems that dictate your thoughts.

If one holds the core belief that living in a larger body is somehow “bad,” future thoughts, feelings, and actions related to this are likely to be impacted by this in a maladaptive and disordered way.

A large part of eating disorder treatment involves identifying the unhelpful core beliefs that are leading to maladaptive thoughts and behaviors and replacing them with core beliefs that support helpful and recovery-focused behaviors.

Negative Interpretation Thought Bias

A recent study examined a specific thought-process that is influenced by our beliefs, known as “negative interpretation bias (1).” This bias is defined in the study as the “tendency to interpret ambiguous information about one’s body in a negative way (1).”

A “key factor in maintaining maladaptive cognitions and behaviors in eating disorders, negative interpretation bias can impact our lives and decisions in a harmful way without us even recognizing it (1). The implicit and unconscious nature of these beliefs makes them particularly challenging to treat and change.

Growing Research

Dr. doing research on Thought BiasThe study, published in the Journal of Eating Disorders, attempted to measure the effectiveness of a strategy that involved “unscrambling positively valenced, body image-related sentences” that may be able to treat negative interpretation bias. The study examined 40 women classified as being of average weight, but they reported feeling unhappy with their bodies.

The women were split into two groups of 20. Half that received the “unscrambling positively valenced, body image-related sentences” training strategy and control half did not receive any treatment. The 6-session training started with measuring negative interpretation bias by asking all participants to unscramble body-image-related sentences that could be unscrambled positively or negatively (1).”

For example, participants would be presented with a sentence such as “Be thin to healthy like I.” Participants could unscramble this as “I like to be thin,” or “I like to be healthy.” All participants also completed the Body Shape Questionnaire, the Body ImageStates Scale, and the Sociocultural Attitude Towards Appearance Questionnaire-4.

The 20 women receiving the positive training strategy used the same unscrambling method as before but only providing positive body-image related statements. For example, one could unscramble it to “my body is quite beautiful” or “my body is quite attractive (1).”

Afterward, all participants were again given the original unscrambling exercise with both a positive or negative response. Researchers measured if the women that received the positive unscrambling training strategy chose more positive responses than they had before the intervention.

Results

As promising as this method sounds, the results, unfortunately, indicated that the treatment was not as effective as hoped. A positive note is that those that received the intervention did show reduced body-image-related negative interpretation bias. However, so did those women that did not receive the intervention (1).

Researchers considered that the sample size of 40 was too small and that the number of trainings (6) was too low. Whether study results support the hypothesis being tested or not, each study is important, as it provides us with more information than we had previously and asks the questions whose answer might unlock a key aspect to eating disorder treatment.


Resources:

1. Bradatsch, S. et al. (2020). Interpretation bias modification to reduce body dissatisfaction – a randomized controlled pilot study in women with elevated weight and shape concerns. Journal of Eating Disorders.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published August 31, 2020, on EatingDisorderHope.com
Reviewed & Approved on August 31, 2020, by Jacquelyn Ekern MS, LPC