Function of ED Behaviors
Name one emotional function of restriction.
Avoidance/numbing of emotions, sense of control, reducing anxiety
What emotions do I tend to avoid or numb through my eating behaviors?
Name one biological factor contributing to eating disorders.
Genetics, temperament, neurotransmitters
Are there traits I’ve had since childhood (e.g., anxiety, sensitivity)? How might these play a role in my relationship with food?
What does “cognitive defusion” mean?
Separating from thoughts instead of believing them
What is a recurring thought I tend to believe automatically? What happens when I treat it as “just a thought”?
“I ate one ‘bad’ food, so the whole day is ruined.”
All-or-nothing thinking
Where do I see “all or nothing” thinking in my eating or body image? What would a more flexible thought sound like?
Name one distress tolerance skill.
Grounding, paced breathing, temperature change
Which coping skills have I tried before?
Why might binge eating temporarily reduce distress?
Activates reward system, distracts from emotions, provides comfort
What feelings show up before and after?
What psychological trait is strongly linked to EDs?
Perfectionism, rigidity, low self-worth
How do I respond when I feel like I’ve “failed”?
Give an example of defusing from the thought: “I can’t eat this.”
“I’m having the thought that I can’t eat this.”
Try this: What changes when I say, “I’m having the thought that ___”? Does it feel less powerful or still convincing?
“Everyone is judging my body.”
Mind reading
When do I assume others are judging me? What evidence do I actually have?
What is “urge surfing”?
Riding out urges without acting on them
What does an urge feel like in my body? How long does it usually last if I don’t act on it?
A patient says, “Purging helps me feel in control after eating.” What function is this serving?
Regaining perceived control, reducing guilt/shame
How does my ED try to “fix” that feeling?
Give an example of a social/cultural influence.
Diet culture, media, weight stigma
How have external messages influenced beliefs about myself?
What is “experiential avoidance,” and how does it relate to EDs?
Avoiding internal experiences; ED behaviors reduce discomfort short-term
What do I usually do to avoid internal experiences?
“If I gain weight, everything will fall apart.”
Catastrophizing
What’s a “worst-case scenario” I often jump to? How likely is that outcome realistically?
Why is distraction sometimes helpful but not always enough?
Short-term relief but doesn’t address underlying emotions
When do I rely on distraction vs actually processing emotions? What might “processing” look like for me?
How can over-exercise function as both avoidance and reinforcement?
Avoids emotions while reinforcing identity/self-worth or reducing anxiety
In what ways do my behaviors both help me cope AND keep me stuck?
Why is it inaccurate to say EDs are “just about food”?
They are coping mechanisms influenced by multiple interacting factors
If my ED isn’t about food, what is it about for me?
How does values-based action differ from emotion-based action?
Acting on what matters vs. what feels comfortable
How do my current behaviors align—or not—with my values?
How do cognitive distortions reinforce ED behaviors?
Increase distress → drive urges → justify behaviors
What thought tends to trigger my urges most strongly? What happens if I challenge or step back from it?
Give an example of replacing restriction with a value-based behavior.
Eating regularly to support health/connection
What is one small action I could take this week that aligns with recovery? What makes that action hard?
Identify two different functions the same ED behavior (e.g., restriction) can serve.
Control, emotional numbing, identity, communication of distress, safety, etc.
Which of these needs could be met in a healthier way?
Case: Someone with anxiety, family emphasis on appearance, and dieting history develops an ED. Identify at least 3 interacting factors.
Biological vulnerability (anxiety), psychological traits, environmental/cultural influences
What are 1–2 factors in each category (bio/psycho/social) that apply to me?
A patient feels intense anxiety at a meal but eats anyway because recovery matters. Which ACT process is this?
Willingness + committed action + values
When have I acted in line with my values despite discomfort?
Reframe: “My worth depends on my weight.”
Worth is multifaceted; weight ≠ value as a person
If my worth isn’t based on my body, what does define me? What qualities do I value in others that have nothing to do with appearance?
A patient feels the urge to binge. List 3 alternative responses.
Delay, reach out, grounding, self-talk, opposite action
Which 2–3 alternatives feel most realistic for me to try?