Put simply, the eating disorder voice is a negative form of self-talk, or a person’s inner critic that is a part of the eating disorder. It refers to specific thoughts that are driven by, and can maintain, the eating disorder. The voice is problematic, distressing and disruptive. It creates a feeling of helplessness, undermines a person’s confidence and makes it difficult for them to trust their own decisions and abilities. [i]

What does it do?

• It creates and sets certain rules in relation to food, weight, body behaviours, and how the person interacts with other
• It creates a distorted logic that conflicts with a person’s rational thoughts and this in turn contributes to emotional distress.
• It may make promises, threats and feel as though life without it is not possible.
• It may reinterpret comments made by others and undermine a person’s confidence.
• It may demand an exclusive relationship with the individual.
• The negative, controlling and belittling tone of the voice may attempt to discourage a person from using their personal support network.
• The voice may be rigid, rule-orientated, harsh, loud, critical and demanding

Initially, the voice may be experienced as a source of comfort, however it may rapidly push a person’s body and self-control to the extreme.

Aspects of the voice often emerge when individuals contact Bodywhys by phone, email and during support groups. For some people, it can feel as though they ‘must’ or ‘should’ do certain things as part of their eating disorder.

Dealing with the voice

Counteracting the voice can be a significant challenge. Professional support can be effective by developing a positive rapport to help to deal with the eating disorder voice mindset. Friends and family can also play a role. The voice may be present in the background, ready to jeopardise the progress an individual has made. Becoming free of the voice can feel stressful as a person may have previously experienced it as source of guidance. Moving forward may involve trying to separate out the person’s individual beliefs from those that are primarily driven by the eating disorder voice.

[i] Tierney, S. and Fox, J.R.E. (2011) Trapped in a toxic relationship: comparing the views of women living with anorexia nervosa to those experiencing domestic violence. Journal of Gender Studies, 20(1), 31-41.

[ii] Scott, N., Hanstock, T.L. & Thornton, C. (2014) Dysfunctional self-talk associated with eating disorder severity and symptomatology. Journal of Eating Disorders, 2(14).

Further reading:

Bruch, H. (1978) The Golden Cage: The Enigma of Anorexia Nervosa. Cambridge, Harvard University Press.

Higbed, L. & Fox. J.R.E. (2010) Illness perceptions in anorexia nervosa: A qualitative investigation. British Journal of Clinical Psychology, 49, 307-325.

Noordenbos, G., Aliakbari, N. & Campbell, R. (2014) The relationship among critical inner voices, low self-esteem, and self-criticism in eating disorders. Eating Disorders: The Journal of Treatment & Prevention, 22(4), 337-51.

Pugh, M. & Waller, G. (2016) The anorexic voice and severity of eating pathology in anorexia nervosa.
International Journal of Eating Disorders, 49(6), 622-5.

Pugh, M. & Waller, G. (2017) Understanding the ‘anorexic voice’ in anorexia nervosa. Clinical Psychology and Psychotherapy, 24(3), 670-676.

Tierney, S. and Fox, J.R.E. (2011) Living with the anorexic voice: A thematic analysis. Psychology and Psychotherapy, Theory and Research, 83, 243-254.

Williams, S. & Reid, M. (2012) ‘It’s like there are two people in my head’: A phenomenological exploration of anorexia nervosa and its relationship to the self. Psychology & Health, 27(7), 798-815.