Do eating disorder voice characteristics predict treatment outcomes in anorexia nervosa? A pilot study.

Eating disorder cognitions are frequently reported as a symptom of the condition. Individuals often go further in their descriptions and commonly report something more than simply cognitions, but rather describe the phenomenon of an ‘eating disorder voice’. This voice is much like a commentator accompanying one through their day-today experience, except this commentator might have specific characteristic, such as being benign and supportive or antagonistic and controlling. This pseudo-hallucinatory voice tends to focus on the individual’s eating, weight, shape and/or exercise. The commentary of an ‘eating disorder voice’ would vary from person to person, but for example something like ‘if you skip lunch you will be doing really well’ or ‘you are fat and out of control’, or ‘you must do better’, might not be uncommon.

We know ambivalence about change and recovery in people with an eating disorder can be high, and treatment outcomes for anorexia nervosa are limited. Thus, the more we can discover and understand about the complexity of an eating disorder the better equipped clinicians can be at treating it. At present, existing treatment protocols do not directly focus on tackling the eating disorder voice.

The present study measured the characteristics of the eating disorder voice at the start of therapy to ascertain whether these characteristics could help to predict changes in the disordered eating over the course of treatment. Interesting, it was found that certain voice characteristics (voices experienced as powerful, omnipotent and benevolent) at the start of therapy seemed to be linked with better outcomes. Read the full article to find out more.

Read the full paper: Hormoz, E., Pugh, M., & Waller, G. (in press). Do eating disorder voice characteristics predict treatment outcomes in anorexia nervosa? A pilot study. Cognitive Behaviour Therapy. doi:10.1080/16506073.2018.1476581

Emma Hormoz


Photo by: Daniel Lobo

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