Cognitive theory in anorexia nervosa and bulimia nervosa: A review

This paper reviews cognitive theories of eating disorders as they are usually applied in treatment. More recent theoretical contributions and theory that is not widely applied are also reviewed. A set of hypotheses is derived from these theories and evidence for the validity of each hypothesis is discussed: this includes evidence from treatment studies, questionnaire studies and from experimental psychology. Following review of existing evidence, the paper summarizes the current status of cognitive theory in eating disorders. It then considers ways in which theory and research could be developed in order to improve and extend our understanding of cognitive content and processes in eating disorders. Limitations of existing models are highlighted and gaps in our knowledge, including knowledge of variables that typically have a central role in cognitive theory, are identified. Further strategies to test the validity of hypotheses derived from cognitive theory are suggested, together with strategies that might extend existing theory. It is concluded that much further research is needed, both to test the validity of existing theoretical contributions and to extend theory so that it will be more useful in clinical practice.