The Thin Commandments

One of the things that is so difficult to understand is the dedication to thinness beyond a reasonable doubt. I know it is hard to comprehend how someone could relentlessly pursue something that is killing her/him and ruining the family, etc. Who or what is telling her to do these things? Where did she come up with some of these behaviors? After working with several patients and thinking back on my own experience I began to see that one of the things that goes on inside is the formulation and adherence to self-imposed rules. I have formulated these rules into what I call the Thin Commandments. I use these to expose my patient's rules to themselves (many of them are unaware that they have certain rules). We go over the "Thin Commandments" and try to extract any other rules they might be living by. Below are the ten most common eating disorder "commandments" I came up with out of countless interviews with patients. In treatment these cognitive distortions are confronted and the ! meaning behind them uncovered in a slow and careful process.

The Thin Commandments

1. If you aren't thin you aren't attractive.
2. Being thin is more important than being healthy.
3. You must buy clothes, cut your hair, take laxatives, starve yourself, do anything to make yourself look thinner.
4. Thou shall not eat without feeling guilty.
5. Thou shall not eat fattening food without punishing oneself afterwards.
6. Thou shall count calories and restrict intake accordingly.
7. What the scale says is the most important thing.
8. Losing weight is good/gaining weight is bad.
9. You can never be too thin.
10. Being thin and not eating are signs of true will power and success.