3 Benefits of Gratitude in Eating Disorder Recovery

By Kamila Cass, PhD, CEDS-C

Gratitude is a useful tool in eating disorder recovery. It helps shift focus from what’s lacking to what’s present, fostering a greater sense of contentment and well-being. Regularly practicing gratitude can improve mental health and has been shown to reduce stress, depression and loneliness.

How can gratitude be used to help with an eating disorder?

Gratitude helps individuals with eating disorders recognize and value small moments of positivity, kindness or support instead of only focusing on their perceived flaws or difficulties.

Eating disorders are complex mental health conditions that go beyond food or weight. They often reflect deeper struggles with emotions, self-worth and control. Beneath the restrictive eating, bingeing and purging are intense feelings that can seem overwhelming or unbearable.

This is where gratitude can help shift perspective. By intentionally focusing on things to appreciate, gratitude supports the cultivation of self-connection and balance, reducing the intensity of negative thinking and promoting resilience in recovery.

Why is Gratitude Important?

Gratitude is important because it promotes positive recall, the intentional recall of positive memories. Focusing on negative areas of life or what one lacks can lead to stress, anxiety and depression. Those with eating disorders are more inclined to think about their hardships or the ways they’ve failed, rather than their successes, but gratitude can be a powerful tool in reframing the recovery process.

Gratitude helps to disrupt negative thinking patterns by redirecting thoughts toward positive experiences. Gratitude fosters emotional resilience and positive coping mechanisms that can help patients cope with the difficulties that come with eating disorder treatment and recovery.

Benefits of Gratitude

Reduced anxiety & stress

Practicing gratitude can lower feelings of anxiety and repetitive negative thinking. Gratitude interventions – like daily journaling, appreciating the little things, gratitude letters and benefit-finding techniques – have been shown to reduce worry, rumination and anxiety symptoms.1

Techniques like these, especially when initially taught through a structured program, can help patients fundamentally shift their thought patterns for the better.

Reduced depression

A gratitude mindset can help to reduce depression symptoms, a common co-occurring condition with eating disorders. A few studies have shown an association between higher levels of gratitude and lower levels of depression.2

Practicing gratitude can help individuals recognize the positive forces in their lives, which ultimately can boost life satisfaction, support strong social relationships and contribute to higher self-esteem.

Less loneliness

Practicing gratitude can help lower feelings of loneliness. Research suggests that those who reported higher levels of gratitude experience significantly lower levels of loneliness.3

Gratitude can help individuals recognize and value positive social interactions, which in turn can reinforce relationships and reduce feelings of social isolation, which individuals with eating disorders often struggle with.

Gratitude in Psychological Care for Eating Disorders

Acceptance & commitment therapy

Acceptance and commitment therapy (ACT) is an evidence-based form of psychotherapy that aims to develop psychological flexibility instead of avoiding, eliminating or suppressing negative experience. ACT encourages increased commitment to healthy, constructive activities – like gratitude exercise – that uphold your values or goals.

Positive psychology interventions

Positive psychology interventions (PPIs) are a set of scientific tools and strategies focusing on happiness, wellbeing, positive cognitions and positive emotions. PPIs enhance wellbeing by focusing on cultivating strengths, positive emotions and relationships.

Rather than focusing on diagnosis or treatment, positive psychology practices, such as strength-based exercises and gratitude exercises, can be used alongside psychotherapy to improve mental health and personal fulfillment.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a first-line treatment for eating disorders. CBT is a form of psychotherapy that focuses on challenging and changing cognitive distortions and their associated behaviors.

Providers can encourage patients to use gratitude exercises to help them reframe negative thought patterns and challenge cognitive distortions.

Ways to Practice Gratitude

Gratitude lists

A gratitude list includes good things that happened today or things you’re thankful for. Gratitude lists are helpful to stay focused on the positive during tough times or challenging feelings. Gratitude lists help refocus your attention away from what you lack to what you have, which can help shift your mindset in a positive direction.

Gratitude journaling

A gratitude journal is a physical or digital journal where you can write down what you feel thankful for on a weekly or daily basis. Gratitude journaling allows you to take time to pause and reflect on the small pleasures of life. Gratitude journaling is a consistent way to nurture your mental and emotional health.

Gratitude letters

Gratitude letters are a perfect way to show appreciation to those around you. Gratitude letters express deep thankfulness to someone who has impacted your life and highlight the specific actions, qualities and positive effects they have had on you.

This meaningful gesture reminds you of the power of your support system and helps strengthen your relationships.

Small practices of gratitude

There are also many small ways to practice gratitude:

  • Taking a moment to appreciate one thing around you
  • Sending a quick thank you text to a loved one
  • Picking up something small, like a person’s favorite candy, to give to someone as a thank-you gift

References

  1. Heckendorf, H., Lehr, D., Ebert, D. D., & Freund, H. (2019). Efficacy of an internet and app-based gratitude intervention in reducing repetitive negative thinking and mechanisms of change in the intervention’s effect on anxiety and depression: Results from a randomized controlled trial. Behaviour Research and Therapy, 119, 103415. https://doi.org/10.1016/j.brat.2019.103415
  2. A, I. J., M, M. J., & S, S. N. (2021). The Association between Gratitude and Depression: A Meta-Analysis. International Journal of Depression and Anxiety, 4(1). https://doi.org/10.23937/2643-4059/1710024
  3. Hittner, J. B., & Widholm, C. D. (2024). Meta‐analysis of the association between gratitude and loneliness. Applied Psychology Health and Well-Being, 16(4), 2520–2535. https://doi.org/10.1111/aphw.12549
Written by

Kamila Cass, PhD, CEDS-C

Kamila Cass, PhD, CEDS-C, is a Licensed Clinical Psychologist at the ACUTE Center for Eating Disorders and Severe Malnutrition, where she has worked with patients with eating disorders since 2021. She…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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