Living in a bubble? How reality is altered in people with eating problems

Second-year Psychology students participating in the University Honours College or in the Departmental Excellence Program complete a Research Seminar in which they learn to communicate science to various audiences, including the general public. For one assignment, the students write a popular science paper. This year a selection of these papers is published on Mindwise. Today’s piece is by Solveigh Lingens.


Imagine you see the world around you through a bubble. You will probably see everything around you in altered colours and shapes. Now imagine such a bubble surrounds you. The curved and coloured bubble walls will now not just influence your vision but also your other senses. The bubble changes the reflection of the world into a new reality. After some time you might start believing that the world actually looks like it.

What sounds like an imaginary fantasy for us, is known to be the sad truth for people diagnosed with eating disorders. Everything they perceive is distorted. They see themselves as too fat or the food portions as too large. Thus, the objective reality is converted into a subjective reality comprised of eating behaviour, body shape and weight-related thinking.

An important question is, how does this bubble come into existence? Researchers have found that one of the essential factors in the development of an eating disorder is low self-esteem (Fairburn, Cooper & Shafran, 2003). People with low self-esteem see themselves as less worthy and feel less appreciated by others. They doubt themselves in various ways, which in people with eating disorders mainly means they doubt their body shape and weight. To cover their insecurity and increase their self-esteem, people with an eating disorder may develop maladaptive patterns of behavior such as under eating or vomiting.

Eating disorders are considered among the most severe and resistant disorders of our society. An effective treatment has not yet been found, at least not one with long-lasting benefit. Relapse rates remain high and patients may eventually starve to death. Doctors, psychologists, and scientists are desperately trying to find a way to treat people effectively and prevent relapse, but until now these attempts have had limited success.

What makes it so difficult to burst the bubble and free patients from their disorder, so to speak?

The major difficulty basically lies within crossing the bubble wall to convince the person inside that they have lived with a subjective and distorted reality. The mind-set of people with an eating disorder became so strong about their body and shape that although one tells them or provides obvious proof about their disorder, they would not take you serious. Simply put, their thinking, feeling and reasoning has markedly changed and became biased.

Fortunately, there is hope. To date some research in the field of eating disorders has tried to cross the bubble from the outside, by developing strategies that would get people with eating problems to eat normally. However, an increasing number of researchers are of the opinion that one has to additionally understand the inner processes of the patients rather than solely trying to find strategies to convince them of their disorder externally. Once the internal cognitive malfunctioning is also fully understood one could focus on the restoral of healthy functioning. For instance, by improving the understanding of how low self-esteem might contribute to the maintenance of eating disorder problems, researchers might be more likely to develop a successful treatment.

Obviously, it is still a long way to get anywhere near to a promising solution but in my opinion it is always helpful to change perspectives or approaches whenever a problem seems to be unsolvable. As Albert Einstein, the master of finding solutions to seemingly unsolvable problems, put it: “The formulation of the problem is often more essential than its solution, which may be merely a matter of mathematical or experimental skill.”


Fairburn, C.G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509-528.


Solveigh Lingens

Bio: Solveigh is an international psychology student starting her third year of the English Bachelor Program this fall. She is also part of the Excellence Program, which prepares her for an academic research career. Her main interests regarding psychology lie within the fields of clinical and neuropsychology. As part of the Excellence Program, Solveigh was involved in a one-year research project that investigated cognitive problems in people with eating problems. In the upcoming semester she will be studying at Uppsala University in Sweden and assisting in a research project on epilepsy.


NOTE: Image by Hartwig HKD, licenced under CC BY 2.0

Dr. aan het Rot completed her doctoral degree at McGill University (Montreal, Canada) and was a postdoctoral fellow at the Mount Sinai School of Medicine (New York, USA). She works at the University of Groningen since 2009 and is affiliated with the Heymans Institute for Psychological Research and with the Groningen School of Behavioral and Cognitive Neuroscience (BCN). Her research interests concern the role of interpersonal and biological factors in the development and maintenance of psychological problems. More specifically, Dr. aan het Rot is interested in (1) the role of interpersonal factors in the development and maintenance of psychological problems, and (2) the biological factors that underlie poor interpersonal functioning. Dr. aan het Rot teaches in the Dutch and English Bachelor and Master programs of Psychology. For more information, you can visit her website.

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