Fairburn, Cooper & Shafran (2003) · Eating disorders
Fairburn, Cooper & Shafran (2003)
Over-Evaluation of Shape, Weight & Control
The core mechanism: judging self-worth largely or entirely in terms of shape, weight, eating and the ability to control them — rather than across the range of areas most people use. Everything else in the model flows from, and feeds back into, this over-evaluation.
Strict Dieting / Dietary Restraint
Strict, rigid and extreme dietary rules — restricting the amount, type or timing of food, fasting, calorie limits. Driven by the over-evaluation and itself reinforcing it; the rigidity sets up the conditions for binge eating.
Binge Eating
Binge eating — episodes of eating experienced as out of control — often triggered by breaking a rigid food rule, or by difficult events and moods. (Present in bulimic and binge-type presentations; in pure restriction this step may be absent.)
Compensatory Behaviours
Compensatory behaviours intended to undo eating or control shape and weight — self-induced vomiting, laxative or diuretic misuse, and driven exercise. These maintain both dietary restraint and the over-evaluation, completing the cycle.
The published model, shown for reference. Switch to “Blank” to see the empty template you complete with a client.
Eating problems can look very different from person to person, but they often share the same engine. This model — the transdiagnostic CBT-E model — shows what tends to keep them going.
At the centre is how someone judges their own worth. Most people judge themselves on a range of things — relationships, work, interests. In eating disorders, self-worth comes to rest mainly, or only, on shape, weight, eating, and the sense of controlling them. This is called over-evaluation.
Because so much rides on it, people often follow strict, rigid food rules. Dieting this tightly is hard to keep up, and breaking a rule — or a stressful day — can tip into a binge, which feels out of control. That can be followed by trying to undo it: making yourself sick, using laxatives, or driven exercise.
Each of these — the dieting, the bingeing, the compensating — feeds back and strengthens the belief that shape and weight are what matter most, so the whole pattern keeps itself going. For some people, perfectionism, low self-esteem or difficulty coping with feelings add further fuel.
How to introduce the model, guided-discovery questions, treatment targets and a behavioural experiment are available to signed-in therapists.
This diagram is a reconstruction of the published model for clinical and educational use, grounded in the sources above.
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