The Struggle with Perfectionism and Eating Disorders

Perfectionism is often a driving thought belief for patients struggling with disordered eating — and it’s something that must be overcome for recovery. Ultimately, it is a self-protective mechanism that proposes, “If I do everything perfectly — if I eat perfect, look perfect, and act perfect — then it will help me escape shame, blame, judgment, and so on.” The idea is, if you can control everything, you can also control how others perceive you. It becomes a way to protect yourself from pain. 

Perfectionism shows up in eating disorders by a belief system that focuses on the perfect foods, portions, and exercise.

This combination, then, helps you achieve the perfect body, health, and life. The problem is, perfectionism requires that you control your thoughts, your feelings, your environment — the list goes on. It all must be manipulated so your routine is never disturbed. 

In the case of disordered eating, perfectionism usually looks like a funnel. The foods and activities that you allow yourself to enjoy become smaller and smaller as your beliefs become more specific and your need for control becomes stronger. Your regimen eventually becomes so extreme that you can no longer maintain it. At this point, perfectionism has taken over your life. For those struggling with disordered eating, it makes it impossible for you to healthfully engage with food and exercise in a way that allows you to take care of yourself. After all, you need food to survive!

Of all belief systems, perfectionism can be the most damaging and the hardest for clients to overcome. 

With that thought in mind, let’s discuss four ways to confront perfectionist thoughts.

1. Identify and challenge thought distortions.

For instance, if you’re sitting at the dinner table thinking, “I absolutely cannot eat this meal,” it’s time to step back and troubleshoot that thought. Ask yourself what is triggering you and how it’s making you feel. Then, challenge that thought and question why it has to be a certain way. Give yourself the opportunity to be more flexible and allow your meal to look a bit differently. If needed, a dietitian and therapist can help you as you rediscover a regular relationship with food.

2. Transition from product thinking to process thinking.

Perfectionism is all about the outcome: x + y = z. When you believe that every decision directly impacts your outcome, it’s easy to obsess over every bite or movement. Instead, think about each choice as part of a process of growth and learning, experimentation and curiosity. This shift may lead you to think something like, “This meal feels challenging and doesn’t really fit with what I want for myself, but let me just eat it and see how it goes.” Again, a mental health professional can help you put this idea into practice.

3. Replace absolute thoughts with flexible terms. 

A huge part of perfectionism includes thinking in absolutes — thoughts like I should, I’m supposed to, and I need to. Instead, work to replace these ideas with more flexible terms, like it’s possible, I might, and it’s okay if I. This flexible thinking will help you challenge those fears as they arise and slowly relinquish your need for control. 

4. Work on distress tolerance and expanding your self-care.

Sometimes, your environment and obligations lead to feelings of discomfort, anxiety, anger, boredom, or even grief — and that’s okay. After all, we can’t fully control and manage everything. Perfectionism often kicks in as a defense mechanism to deal with the distress; your desire to control your food may increase because of your lack of control in other areas. In doing so, you miss out on the opportunity to learn and grow from these uncomfortable situations. 

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