Dichotomous thinking about food as an understudied subclinical disordered eating cognition

Abstract Dichotomous thinking about food involves sorting foods into strict categories such as “good” and “bad” or “healthy” and “unhealthy,” and is an understudied cognition in the context of disordered eating. Although this way of thinking is an established symptom in orthorexia nervosa, there is a dearth of research on dichotomous thinking about food and its correlates and consequences. The purpose of this paper is to discuss the lack of research on dichotomous thinking about food, as well as to understand previously unknown associations between dichotomous thinking about food and other subclinical disordered eating behaviors and cognitions. In a racially diverse sample of 630 women ages 18–44, dichotomous thinking about food was positively and significantly (at p < .01) associated with body dissatisfaction, binge eating, cognitive restraint, restriction, excessive exercise, purging, drive for thinness, and anti-fat attitudes. Results suggest that dichotomous thinking about food warrants further inclusion in research on eating disorder pathology. Future studies should examine the prevalence of dichotomous thinking across ages, gender and racial/ethnic groups, consequences of this cognitive pattern, and whether dichotomous thinking about food precedes eating disorder diagnoses.