Beck-Institute-Eating Disorder Presentation

A Cognitive-Behavioral Model
for Eating Disorders
DR. JENNA DILOSSI, PSY.D.

Licensed Psychologist & Diplomate CBT-Certified Therapist
Co-Founder & Clinical Director
Center for Hope & Health, LLC.
January 14, 2022
beckinstitute.org
©2022 Beck Institute for Cognitive Behavior Therapy
Dr. Aaron T. Beck developed CBT at the

University of Pennsylvania in the 1960s.
In 1994, Dr. Beck and his daughter, Dr.
Judith Beck, established Beck Institute.
Beck Institute is a leading international
source for training, therapy, and
resources in Cognitive Behavior Therapy
(CBT) and Recovery Oriented Cognitive
Therapy (CT-R).
beckinstitute.org
©2022 Beck Institute for Cognitive Behavior Therapy 1
© 2022 Beck Institute for Cognitive Behavior Therapy
Permission required for reproduction of these materials www.beckinstitute.org 1
About Beck Institute
Our mission is to improve lives worldwide

through excellence and innovation in
Cognitive Behavior Therapy (CBT) Training,
Practice and Research.
beckinstitute.org
Objectives
• Identify and interpret specific measures used to assess vital elements
related to eating pathology and treatment (i.e., symptom severity, level
of risk, level of care, maintenance variables).
• Classify and differentiate between specific eating disorder diagnoses
and sub-clinical disordered eating presentations.
• Formulate individualized, transdiagnostic case conceptualizations
rooted in a cognitive-behavioral framework.
• Design collaborative, behaviorally driven treatment plans aimed
towards immediate symptom reduction, effective relapse prevention,
and long-term maintenance of progress.
• Recognize when and how treatment plans ought to be modified (e.g.,
incorporating additional treatment providers or referring to a higher
level of care) to optimize outcomes.
beckinstitute.org
Agenda
A Cognitive-Behavioral Model for Eating Disorders:
• Eating Disorders (EDs)
o Identification
o Diagnosis
o Assessment
o Vignette
• Cognitive Behavioral Treatment (CBT) for EDs

o Origin and Efficacy
o Conceptualization Models
o Key Tenants
o Core Interventions
beckinstitute.org
EATING DISORDER
IDENTIFICATION
beckinstitute.org
ED Identification
Prevalence Statistics:
• In the U.S., 20 million women and 10 million men will suffer from a clinically
significant ED at some point in their life
• 95% of those who have EDs are between the ages of 12 and 25.8
• 91% of women surveyed on a college campus had attempted to control
their weight through dieting. 22% dieted “often” or “always”
• 35% of “normal dieters” progress to pathological dieting. Of those, 20-25%
progress to partial or full-diagnosis for EDs
• 25% of college-aged women engage in bingeing and purging as a
weight-management technique
• Over one-half of teenage girls and nearly one-third of teenage boys use
unhealthy weight control behaviors such as skipping meals, fasting,
smoking cigarettes, vomiting, and taking laxatives
• 47% of girls in 5th-12th grade reported wanting to lose weight because of
magazine pictures.
National Association of Anorexia Nervosa And Associated Disorders
beckinstitute.org
ED Identification
Risk Factors:
• Demographics
o Female, adolescence, Western beauty ideals, LGBTQI, athletes
• Personality
o Perfectionism, “people pleasing,” passivity, rigidity, impulsivity
• Comorbidity
o Major Depressive Disorder, Anxiety Disorders, Obsessive–Compulsive Disorder
• Coping Style
o Active vs. passive (avoidant)
• Life Events
o Trauma, bullying, parenting issues, onset of certain physical illnesses
• Genetics
o Metabolism/weight history and predisposition
Rohde, P., Stice, E., & Marti, C. N. (2014). Development and predictive effects of eating disorder risk factors during adolescence:
Implications for prevention efforts. International Journal of Eating Disorders, 48(2), 187-198.
beckinstitute.org
ED Identification
Disordered Eating vs. ED Diagnosis:
• Disordered Eating
o Refers to non-normative eating habits that do not cause psychological or
physical distress and/or are below the the diagnostic threshold for intensity,
frequency, and duration of symptoms
• ED Diagnosis
o Refer to maladaptive eating patterns consistent with the diagnostic criteria
listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th
Edition (DSM-5), implying that such patterns cause clinically significant
psychological distress and/or impairment in functioning
beckinstitute.org
EATING DISORDER
DIAGNOSIS
beckinstitute.org
ED Diagnosis
Diagnostic Classification:
• Anorexia Nervosa (AN)
o Restricting Type (R)
o Binge/ Purge Type (B/P)
• Bulimia Nervosa (BN)
• Binge-Eating Disorder (BED)
• Other Specified Feeding and Eating Disorder (OSFED)
• Unspecified Feeding and Eating Disorder (USFED)
beckinstitute.org
10
ED Diagnosis
Accurate Diagnosis Note:
• ED diagnosis can (and often does) change over time, but one cannot
be diagnosed with more than one ED at the same time.
o AN trumps BN
o BN trumps BED
o BED trumps OSFED
o OSFED trumps USFED
beckinstitute.org
11
ED Diagnosis
Diagnosing AN:
• Restriction of energy intake leading to low body weight within context of
age, sex, developmental stage
o Significantly low weight: less than minimally normal/expected
• Intense fear of weight gain/ becoming fat, even though underweight or
persistent behavior that interferes with weight gain, even though at a
significantly low body weight
• Disturbance in the way body weight, shape, or size is experienced;
undue influence on self-evaluation; denial of the intensity of low body
weight
o Specify:
 Subtype: R or B/P (3 months)
 Status: In Partial Remission or In Full Remission
 Severity: BMI (>17- <15)
Criteria Listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)
beckinstitute.org
12
ED Diagnosis
Diagnosing BN:
• Recurrent binge-eating episodes
o Excessive quantity, within 2-hour period
o Perceived lack of control
• Recurrent compensatory behavior to prevent weight gain
• Binge & compensatory behavior occur at least 1x per week for 3
months
• Self-evaluation is unduly influenced by body weight, shape, & size
• Not occurring during AN
o Specify:
 Status: In Partial Remission or n Full Remission
 Severity: Frequency per week (1-14/+ episodes)
beckinstitute.org
13
ED Diagnosis
Diagnosing BED:
• Recurrent binge-eating episodes
o Excessive quantity, within 2-hour period
o Perceived lack of control
• Binge-eating episodes associated with 3/+ features
o Features: Rapid, uncomfortably full, no physical hunger, alone, negative
emotion)
• Marked distress regarding binge-eating
• Binge-eating occurs at least 1x per week for 3 months
• No compensatory strategy; Not occurring during AN or BN
o Specify:
 Status: In Partial Remission or In Full Remission
 Severity: Frequency per week (1-14/+ episodes)
beckinstitute.org
14
ED Diagnosis
Diagnosing OSFED:
• ED symptoms present with clinical impairment in functioning but does
not meet full criteria
o Specified:
 Atypical AN: body weight above or within normal range
 Sub-threshold BN: Recurrent episodes < 1x per week and/or < 3 months
 Sub-threshold BED: Recurrent episodes < 1x per week and/or < 3 months
 Purging Disorder: Recurrent purging behavior to influence body weight,
shape, or size w/o binge episode
 Night Eating Syndrome: Recurrent episodes of night eating upon awakening
and/or after evening meal; Awareness of the eating
beckinstitute.org
15
ED Diagnosis
Diagnosing USFED:
• ED symptoms present with clinical impairment in functioning but does
not meet full criteria
o Unspecified:
 Clinician chooses not to specify
 Insufficient information needed to specify
beckinstitute.org
16
EATING DISORDER
ASSESSMENT
beckinstitute.org
17
ED Assessment
General Variables:
• Medical Information/clearances
• DSM-5 criteria
• EDE/EDQ
• BDI/BAI
• Suicide and/ or abuse risk
• Motivation level
• Treatment history and expectations
beckinstitute.org
18
ED Assessment
Initial Evaluation Interview:
• What the patient would like to be different
• Current problems with eating (as perceived by the patient or by
others), including
o Eating Habits
o Methods of shape and weight control
o Views on shape and weight
• Impairment resulting from the eating problem
o Psychosocial impairment
o Physical impairment
From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

beckinstitute.org
19
ED Assessment
Initial Evaluation Interview Con’t:
• Development and evolution of the eating problem (including the
patient’s weight history and prior experience of treatment)
• Co-existing psychiatric and general medical problem (including any
current treatment)
• Brief personal history
• Family psychiatric and general medical history
• Personal psychiatric and general medical history
• Current circumstances and plans
• Attitude to attendance and treatment (and any ongoing treatment)

beckinstitute.org
20
EATING DISORDER
VIGNETTE
beckinstitute.org
21
ED Vignette: ”T"
T is a 28-year-old white, single, female working as an insurance policy analyst who
presents for a consultation regarding eating problems. She is third of four children from a
wealthy midwestern family. No one in her family presents with food or weight problems,
but she recalls a strong value on being fit and in shape. As a child T was an athlete and
good student, she developed an interest in figure skating.
At age 15 she was transferred into a boarding school where her parents felt like would
give her an edge to get into an Ivy League school. She described herself as well
adjusted, with friends, coping well and doing well in school. She was still figure skating
and recalls her coach at the time mentioned that she may do better competitively if she
lost a couple pounds. She was 5’7 and 128 pounds.
T began dieting and increased her exercise on top of her skating practice. She would
work out 6 days per week in addition to her exercise demands for her sport. She
eliminated desserts and red meat from her diet. Her rigid schedule and new diet
demands caused her to grow distant from her new friend group. During this year, her
weight dropped from 128 to 100 and her menstruating ceased. After the school year was
over, her dieting eased up and she started eating more over the summer.
beckinstitute.org
22
ED Vignette: “T”
She then found herself struggling to control her appetite and portions. Eventually, she
began bingeing on forbidden foods like cookies and ice cream after her family went to
bed. When she returned to school, she started a chaotic dieting pattern of restricting and
overeating and then bingeing approximately 1-2x a week. Her exercise decreased and
her eating increased causing her to gain weight throughout this year. She went back to
125 pounds and resumed her menses.
This chaotic eating remained until college and her weight climbed to the 150s. After one
bad binge over a holiday break, T tried and successfully purged. Over the last 10 years
she has been bingeing and purging while failing dieting multiple times a week. She is very
ashamed of her eating patterns, struggles with body image, has obsessions about food
and weight loss, and overall feels like a failure.
T presents as motivated for change to improve her health and to rid herself of the shame
and control that food has over her. However, she also acknowledges the ambivalence
she is feeling at the idea of change due to fears of weight gain and self-doubt about her
ability to successfully break this pattern of behavior after several failed attempts.
beckinstitute.org
23
ORIGIN AND EFFICACY OF
COGNITIVE BEHAVIORAL TREATMENT
FOR EATING DISORDERS
beckinstitute.org
24
Origin and Efficacy of CBT for EDs

CBT-BN:
• Original model
• Christopher Fairburn
• Developed in late 1970s and refined throughout the 1980s and 1990s
• Theory-driven based on the core maintenance variables of BN
• Designed for adults in outpatient settings
• Successful randomized controlled trials
o Roughly 50-60% of patients with BN who receive manual-based CBT achieve
either near or full recovery that appears well maintained over time
Fairburn, C. G. (1981). A cognitive behravioural approach to the treatment of bulimia. Psychological Medicine, 11, 707-711;
Fairburn, C. G., Marcus, M. D., & Wilson, G. T. (1993). Cognitive-behavioral therapy for binge eating and bulimia
beckinstitute.org nervosa: A comprehensive treatment manual. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature,
©2022 Beck Institute for Cognitive Behavior Therapy assessment, and treatment (pp.361-404), New York: Guildford Press, 25
25
Origin and Efficacy of CBT for EDs
CBT-E:
• Enhanced model
• Christopher Fairburn, Zafra Cooper, Roz Shafran
• Modified in early 2000s
• CBT-BN model enhanced to further address obstacles to successful
outcomes and be “transdiagnostic” to all EDs with two forms (i.e., focused
form vs. broad form)
• Adapted versions for adolescents and higher levels of care
• Successful randomized controlled trials
o 65% efficacy
o Gold Standard for BN and BED; suitable for AN
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.;
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A
beckinstitute.org “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
26
CONCEPTUALIZATION MODELS OF
beckinstitute.org
27
Conceptualization Model of CBT for EDs
Core Psychopathology of EDs:
• Over-evaluation of body weight, shape, and size
o Overvalued and dysfunctional concerns drive extreme dieting/restriction
and weight loss behavior
o Extreme dieting/restriction leads to binge-eating
o Binge-eating leads to purging and extreme dieting/restriction
o Purging and extreme dieting/restriction reinforces over-evaluation
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
beckinstitute.org
28

AN Model:
Over-evaluation of shape and
weight and their control
Strict dieting:
Non compensatory
Weight control behavior
Significantly low weight
• Preoccupation with eating

• Social withdrawal
• Heightened fullness
• Heightened obsessionality

beckinstitute.org
29
BN Model:
Strict dieting; non-compensatory

weight-control behavior
Events and associated

mood change
Binge eating
Compensatory vomiting/
laxative misuse

beckinstitute.org
30

Transdiagnostic Model:
Strict dieting:
Non compensatory
Weight control behavior
Events and associated Significantly low weight

mood change
Binge eating
Compensatory vomiting/
laxative misuse

beckinstitute.org
31
Problem-Focused Cognitive Conceptualization
RELEVANT LIFE HISTORY: Family value of being fit and in shape; aesthetically-focused
sport; coach encouraged weight loss
CORE BELIEFS: I am a failure. I am unworthy.
CONDITIONAL ASSUMPTIONS/ BELIEFS/ RULES: If I eat a ”bad” food, then I messed up

the day. If I gain weight, then I won’t be attractive
COPING STRATEGIES: Repeated attempts at dieting; binge-eating; self-induced vomiting;

self-criticism; body avoidance
SITUATION #1: SITUATION #2: SITUATION #3:

Jeans are too tight. Ate 2 cookies at work Compliment about outfit
AUTOMATIC THOUGHT: AUTOMATIC THOUGHT: AUTOMATIC THOUGHT:

I have let myself go. I already screwed up. I must have lost weight.
MEANING OF AT: MEANING OF AF: MEANING OF AF:

I am disgusting. I have no self-control. I am more worthy.
EMOTION: EMOTION: EMOTION:

Frustration; shame Embarrassment; hopeless Happy; proud
BEHAVIOR: Restricts BEHAVIOR: Binge-eat BEHAVIOR: Weighs self
© 2018. Adapted from J. Beck (2020) Cognitive Behavior Therapy: Basics and Beyond, 3rd edition.
beckinstitute.org
32
Strength-Based Cognitive Conceptualization

RELEVANT LIFE HISTORY: Loving family; did well in school; social with lots of friends; has dated
ADAPTIVE CORE BELIEFS: I am generally loveable and well-liked. I am competent.
ADAPTIVE ASSUMPTIONS/ BELIEFS/ RULES: My family and friend love me regardless of my

body. Some men prefer more weight.
ADAPTIVE COPING STRATEGIES: Hang out with friends; do improv comedy; assert my needs
to friends and colleagues
SITUATION #1: SITUATION #2: SITUATION #3:

Jeans are too tight. Ate 2 cookies at work Compliment about outfit
AUTOMATIC THOUGHT: AUTOMATIC THOUGHT: AUTOMATIC THOUGHT:

This happens sometimes. I gave myself a treat! People think I look good.
MEANING OF AT: MEANING OF AF: MEANING OF AF:

Not the end of the world. I can maintain balance. I am attractive.
EMOTION: EMOTION: EMOTION:

Slightly bummed out Neutral Happy
BEHAVIOR: Eats next meal BEHAVIOR: Conversation BEHAVIOR: Cooks dinner
© 2018. Adapted from J. Beck (2020) Cognitive Behavior Therapy: Basics and Beyond, 3rd edition.
beckinstitute.org
33
KEY TENANTS OF
beckinstitute.org
34
Key Tenants of CBT for EDs

Treatment Expectations:
• Systematically addresses each of the primary and secondary
(maintenance) components of the ED cycle
• Directive, active, problem-oriented, collaborative approach, focused
on the here and now
o Structure:
 Focused Form: Generally provided in 16 to 20 50-minute sessions over a 4-
month period, roughly 40 sessions with BMI <16
 Broad Form: Extended to 30 sessions or 80-minute sessions to more
adequately address one or more of the following: clinical perfectionism,
core low self-esteem, interpersonal problems
beckinstitute.org
35
Primary Treatment Goals for AN:
• Assisting client to acknowledge the severity of the problem and
motivating them to stay engaged in treatment
• Weight gain and re-establishment of eating are non-negotiable
o Based on life-threatening weight loss/low weight
o Improvement in patient’s overall mental status
o Outcomes linked to the time frame between start of treatment and weight
gain
• Improve one’s ability to experience body weight, shape, and size more
accurately
• Reduce over-evaluation of body weight, shape, and size
beckinstitute.org
36

Primary Treatment Goals for BN/BED/OSFED:
• Return to normal eating pattern throughout the day
o Frequency of eating episodes
o Diet includes a variety of foods
• Remit binge-eating episodes
• Remit compensatory behaviors
• Reduce over-evaluation of body weight, shape, and size
• Weight goals are usually not part of treatment plan
o May lose, gain, or maintain depending on presenting behavior and degree
of change made
beckinstitute.org
37
Therapeutic Relationship:
• Engage the patient in treatment and change from the start
o Be empathic and conversational in manner
o Ask about their preferred name
o Convery understanding of eating problems and expertise in their
assessment and treatment
o Empathize with the ambivalence involved in seeking treatment
o Actively involve patient in the assessment process and in personalized
formulation
o Instill hope
o Avoid being controlling
o Repeatedly invite questions and check ins about patient being “on board”
o Enquire about concerns patient may have
beckinstitute.org
38
CORE INTERVENTIONS IN
beckinstitute.org
39
Core Interventions in CBT for EDs
Beginning of Treatment:
• Symptom reduction  stabilizing eating behaviors
o Psychoeducation
 Share case conceptualization per symptom presentation
 Describe treatment sequence and tenants
 Impact of malnutrition and hunger
 Explain weight trends/differentiating between fluid shifts vs. change in body mass
o Collaborative weighing
 In-session weighing 1x/week only, plot trends on graph, corrective learning,
outcome measure in AN
o Self-monitoring
o Regulated eating
beckinstitute.org
40

Self-Monitoring Record:
Time Food/Drink Place * V/L Context/Comments

11:30am Turkey and cheese Dining hall Usual lunch. Felt hungry and enjoyed
sandwich in wheat this.
bread with mayo;
yogurt; diet coke
7:00-9:00pm Slices of lunch Kitchen * V I am so mad at myself. I ate like a fat
meat, bag of pig when I got home, and now I am
pretzels, 3 string disgusted with myself and don’t want
cheese, bunch of to go to the party tomorrow night
walnuts, 2 granola because I am going to look fat. Ugh
bars, apple and what is wrong with me?!
peanut butter,
more spoonful's of
peanut butter, 2
glasses of oat milk
12:30pm Half of banana My room Still feel gross, but I was somehow still
hungry and wanted something
sweet. Wouldn’t let myself have more
peanut butter because of earlier 
Monitoring Record From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.
beckinstitute.org
41
Establishing Regulated Eating:
• Two primary components to form new eating pattern
o 3 planned meals plus 2-3 planned snacks
o Eating should be confined to these meals and snacks
• Guidance and collaboration is key to success
o Patient chooses foods at first
o Rarely allow more than 4-hour interval between meals and snacks
o New eating pattern needs to be prioritized
o Plan ahead
o Use others as reference points
o Social eating may need more planning
o Strategize how to resist eating between planned meals and snacks
beckinstitute.org
42

Middle of Treatment:
• Core psychopathology  removing maintenance variables
o Body image
 Feeling fat
 Social comparison
 Body checking and body avoidance
 Pie chart for self-evaluation
o Dietary restraint
o Fear food hierarchy
o Events, moods, and eating
 Identify high-risk situations
 Binge analysis
 Appropriate coping
beckinstitute.org
43
Addressing Body Checking:
• Psychoeducation about the impact of checking (spider phobia
metaphor)
• Adapt self-monitoring record to include body checking
o Collaboratively decide which checking behaviors need to be adjusted
versus completely ceased
• Questions to ask:
o How often do you look in mirror?
o How long do you take?
o What exactly do you do?
o What are you trying to find?
o Does this seem to improve or worsen your mood?
o If you are looking for fat, you are going to find it!
beckinstitute.org
44

Self-Monitoring Record with Body Checking:
Time Food/ Place * V/L Checking Place Context/
Drink (behavior, Comments
time)
6:30am Water Kitchen Looked at reflection (2 Kitchen My face looks really
mins) fat.
7:00am Looked in mirror while Bedroom Ugh my stomach is so
getting dressed-stood gross!
sideways (2 mins)
Pinched my fat rolls (5
mins)
7:10am Banana, bowl Kitchen Feel fine.
of cheerios
8:30am Checked mirror to see Bathroo How can I be so fat
if my butt looks big in m at already? I have only
this skirt (5 mins) work eaten breakfast!
10:00am Cereal bar Desk * Looked down at Desk Cannot believe that
stomach while having my stomach is so big.
a snack It is making me
grossed out. Want to
be skinny!
Monitoring Record From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.
beckinstitute.org
45
Addressing Social Comparison:
• Psychoeducation about cognitive appraisals and biases in comparisons
• Identify when and how the patient makes comparisons
• Encourage patient to consider whether comparisons were inherently
biased in any way
• Explore the implications of any detected biases
o Comparison on a single domain
• Make comparisons more scientific!
o Compare to every third person of same gender and approximate age
o Purposefully scrutinize someone’s body (internally) focused on the parts in
which he/she is most self conscious
• Modify comparison-making
beckinstitute.org
46

End of Treatment:
• Relapse prevention  promoting maintaining progress
o Consolidation of progress
o Future-oriented
o Relapse prevention
o Managing lapses and set-backs
o Plan for review session
 Occurs months after treatment ends to follow up on progress)
beckinstitute.org
47
Best Practices for Relapse Prevention:
• Identify strategies and procedures to be continued
• Explain the importance of realistic expectations
• Psychoeducation setbacks
o Distinguish between a “lapse” and a “relapse”
• Identify specific variables in patient’s life that could be a trigger
o Plan for how to minimize risk of setback
• Develop plan for how to deal with setbacks
• Formulate long-term maintenance plan
o Practical for patient’s life
o Align with patient’s goals and values
beckinstitute.org
48
Summary
Important Takeaways:
• EDs
o Both disordered eating and diagnosable EDs have a growing prevalence
o Biopsychosocial in nature with known risk variables
o Accurate and thorough assessment based on many factors
• CBT for EDs

o Empirically-supported with positive outcomes
o Collaborative, time-limited, goal-focused, engaging, and empowering
o Includes diagnosis-specific and transdiagnostic conceptualizations
o Aims to target the present variables that maintain the problematic eating
behaviors
o Prioritizes behavioral symptom reduction first and core psychopathology
secondary
o Can achieve long-term change
beckinstitute.org
49
THANK YOU!
QUESTIONS?
beckinstitute.org
50
Beck Institute CBT Certification
Get Beck Certified!

Learn more at
https://beckinstitute.org/certification/
beckinstitute.org
51
Visit www.beckinstitute.org to learn
more about CBT, CT-R, and:
• View Beck Institute’s COVID-19 resources
• Download worksheets
• Read blogs and articles by Dr. Aaron Beck,
Dr. Judith Beck, and Beck Institute Faculty
• Watch free webinars and video clips
• And more
beckinstitute.org
52
CBT and CT-R Training

• Live Workshops (online, future workshops
may be held onsite in Philadelphia)
• Training for Organizations (online or at your
location)
• Supervision & Consultation
• CBT Certification
• On-Demand Courses
For more information, email education@beckinstitute.org
beckinstitute.org
53
Get social with Beck Institute on our
social channels
/beck‐institute‐for‐cognitive‐behavior‐therapy/
@beckinstitute (Facebook)
\
@BeckInstitute (Twitter)
youtube.com/BeckInstitute
beckinstitute.org
54
Join the CBT Conversation
beckinstitute.org
Sign up for the Beck Institute newsletter

beckinstitute.org/subscribe
beckinstitute.org
55

Beck-Institute-Eating Disorder Presentation

Uploaded by

Copyright:

Available Formats

Beck-Institute-Eating Disorder Presentation

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Beck-Institute-Eating Disorder Presentation

Uploaded by

Copyright:

Available Formats

A Cognitive-Behavioral Model

for Eating Disorders

DR. JENNA DILOSSI, PSY.D.

January 14, 2022

Dr. Aaron T. Beck developed CBT at the

Our mission is to improve lives worldwide

• Cognitive Behavioral Treatment (CBT) for EDs

From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

Origin and Efficacy of CBT for EDs

Conceptualization Model of CBT for EDs

Significantly low weight

• Preoccupation with eating

From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

Strict dieting; non-compensatory

Events and associated

From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

Conceptualization Model of CBT for EDs

Events and associated Significantly low weight

From Cognitive Behavior Therapy and Eating Disorders by Christopher G. Fairburn.

CORE BELIEFS: I am a failure. I am unworthy.

CONDITIONAL ASSUMPTIONS/ BELIEFS/ RULES: If I eat a ”bad” food, then I messed up

COPING STRATEGIES: Repeated attempts at dieting; binge-eating; self-induced vomiting;

SITUATION #1: SITUATION #2: SITUATION #3:

AUTOMATIC THOUGHT: AUTOMATIC THOUGHT: AUTOMATIC THOUGHT:

MEANING OF AT: MEANING OF AF: MEANING OF AF:

EMOTION: EMOTION: EMOTION:

BEHAVIOR: Restricts BEHAVIOR: Binge-eat BEHAVIOR: Weighs self

Strength-Based Cognitive Conceptualization

ADAPTIVE CORE BELIEFS: I am generally loveable and well-liked. I am competent.

ADAPTIVE ASSUMPTIONS/ BELIEFS/ RULES: My family and friend love me regardless of my

SITUATION #1: SITUATION #2: SITUATION #3:

AUTOMATIC THOUGHT: AUTOMATIC THOUGHT: AUTOMATIC THOUGHT:

MEANING OF AT: MEANING OF AF: MEANING OF AF:

EMOTION: EMOTION: EMOTION:

BEHAVIOR: Eats next meal BEHAVIOR: Conversation BEHAVIOR: Cooks dinner

Key Tenants of CBT for EDs

Key Tenants of CBT for EDs

Core Interventions in CBT for EDs

Time Food/Drink Place * V/L Context/Comments

Core Interventions in CBT for EDs

Core Interventions in CBT for EDs

Core Interventions in CBT for EDs

• CBT for EDs

Beck Institute CBT Certification

Get Beck Certified!

CBT and CT-R Training

Join the CBT Conversation

Sign up for the Beck Institute newsletter

You might also like