How to Improve Self-Esteem: The Rules You Live By, and How to Loosen Them

Everybody lives by rules. Most were never written down, and some you'd never say out loud. "I must never let anyone down." "If people saw the real me, they'd leave." "If I eat after 8pm, I've failed." "I have to be slim to be liked."

Rules like these usually start out as protection. Keep them, and you're safe from a harsher thought underneath, something like "I'm not good enough" or "I'm unlovable". The catch is that the rigid ones can't be kept all the time. And while you're busy keeping them, you never get to find out whether you needed them in the first place.

That idea sits at the centre of cognitive behavioural therapy (CBT) for low self-esteem, and it comes from a model Melanie Fennell published in 1997. This piece walks through how rules and assumptions keep self-esteem low, why the ones about food and bodies are so stubborn, and how people learn to loosen them, one rule at a time. There's a free two-page worksheet to go with it.

It started with a module from the free Improving Self-Esteem workbook published by the Centre for Clinical Interventions (CCI), part of the Department of Health in Western Australia (CCI). We've written our own version for Healthcount readers, many of whom have a long history with dieting, and some of whom are on or coming off weight-loss medication. Where the research is solid, we'll say so. Where it's thin, we'll say that too.

What rules and assumptions are

CBT has pictured thinking in layers since Aaron Beck's early work on depression. At the surface are the quick, automatic thoughts that run through your day. Underneath are deeper beliefs about yourself, often formed early in life and set off later by stressful events (Beck, 2008). In between sit rules and assumptions, which tie the deep beliefs to what you think and do from one day to the next (Rimes, Smith and Bridge, 2023).

A rule tells you what you must or mustn't do: "I must always look put together." An assumption is its "if... then" partner: "If people see me looking a mess, they'll think less of me." The two often travel together, and therapists sometimes call both of them rules for living.

Having rules isn't the problem. You need plenty of them to get through a day. "If the roads are icy, I'll drive slower" is a rule, and a good one. It fits the facts, it bends when the facts change, and nobody hates themselves for breaking it.

The unhelpful ones are built differently. They tend to be:

• absolute, full of must, should, always and never
• impossible to keep every day, in every situation
• tied to your worth, so breaking one feels like proof of something bad about you
• quietly expensive, in time, food, sleep, friendships or fun

That last one is easy to miss, because the cost builds up slowly. The rule feels as though it's keeping you safe. The bill arrives later.

How a rule keeps self-esteem low

In 1997 Melanie Fennell, then at the Warneford Hospital in Oxford, set out a cognitive model of low self-esteem built on Beck's (Fennell, 1997). It has shaped individual and group CBT for low self-esteem ever since, and a 2023 paper from King's College London sums it up clearly (Rimes, Smith and Bridge, 2023). Put simply, it goes like this.

Experiences, often early ones, combine with temperament to leave some people with a harsh bottom line about themselves: "I'm not good enough", "I'm unlovable", "I don't matter". Living with that belief out in the open would hurt, so rules grow up to keep it covered. "If I'm always helpful, nobody will notice." "If I stay slim, I'll be accepted."

For as long as the rules can be kept, life feels manageable. Then something tests one. A friend invites you to a pool party. A photo goes up. You eat something the rule says you shouldn't. The bottom line flares up and brings anxious predictions with it: "They'll all be looking at me." "Everyone will see I've let myself go."

So you do something to stay safe. You say you're busy. You wear the baggy top. You skip lunch tomorrow to make up for it. In one sense it works, because the thing you feared doesn't happen. But you never get to find out whether it would have. And when a rule does break, as rigid rules do, the bottom line feels confirmed, the self-criticism starts, and low mood follows. Low mood makes the bottom line feel even truer, and the loop goes round again (Rimes, Smith and Bridge, 2023).

The link to low mood isn't only theory. Across 77 long-term studies, low self-esteem predicted later depression more strongly than depression predicted later low self-esteem (Sowislo and Orth, 2013). The authors are careful to say that fits the idea that low self-esteem feeds depression, without proving it.

The 2023 update to Fennell's model adds something that matters for anyone who has lived in a larger body. Self-esteem, it argues, is closely tied to how you think other people value you: whether you feel good enough, and whether you feel accepted. People whose characteristics are less valued in their culture, and appearance is one the authors name, meet more criticism and exclusion, and those experiences go with lower self-esteem (Rimes, Smith and Bridge, 2023).

Rules about food and your body

Of all the rules people carry, the ones about food and bodies are some of the loudest. See if any of these sound familiar.

• "If I eat after 8pm, I've failed."
• "I must be slim to be liked."
• "I have to earn my food."
• "If I start eating, I won't stop, so I mustn't start."
• "If my weight goes up, it proves I have no willpower."
• "I can't let anyone see me eat."
• "Once I've blown it, the whole day's ruined, so I might as well keep going."

Eating disorder researchers have a name for the deepest version of this: the overevaluation of shape and weight. Most people judge themselves on lots of things at once, such as their relationships, their work and what they're good at. For people with eating disorders, self-worth comes to depend largely, or even entirely, on shape, weight and the ability to control them. The Oxford team behind CBT-E, the form of CBT they built for eating disorders, calls this the core of the problem (Murphy et al., 2010).

You don't need an eating disorder for some of that to ring true, and it isn't about body size. In a Yale study of people with binge eating disorder, all of them carrying extra weight, the ones who judged themselves most by their shape and weight had more eating problems and lower mood than those who did so less, even though their bodies were much the same size (Grilo et al., 2008).

Therapists who treat this use a simple exercise. You draw a pie chart of the things you judge yourself on, with each slice sized by how much it counts. For most people with an eating disorder, one slice, covering shape, weight and control of eating, takes up most of the pie. That causes three problems. The rest of life gets squeezed out. Controlling shape and weight is an area where success is hard to hold on to, so self-esteem keeps taking hits. And the bigger that slice, the more it drives dieting and bingeing. Part of treatment is growing the other slices, so that friends, work, interests and everything else you are start to count again (Murphy et al., 2010).

Food rules also backfire in a particular way. The CBT account of binge eating says binges are largely the result of trying to stick to lots of strict, specific rules about eating. Breaking one now and then is almost inevitable. When it happens, people tend to read the slip as proof they have no self-control, give up for the moment, and binge. That makes the worry about control worse, and the next set of rules stricter (Murphy et al., 2010). Our piece on the all-or-nothing guilt cycle goes into that loop in detail.

How rigid the rules are seems to matter more than wanting to eat well. In a German study of more than 54,000 people on a weight-loss programme, rigid, all-or-nothing control of eating went with more frequent and more severe binges, while flexible control went with fewer (Westenhoefer, Stunkard and Pudel, 1999). A survey like that shows a link rather than a cause, but it's the pattern CBT is built around.

Perfectionism adds a twist. Oxford researchers describe clinical perfectionism as judging yourself mostly by whether you hit demanding standards you've set yourself, and chasing them even when it costs you. Miss the standard and the self-criticism starts. Meet it and the standard often gets raised, as if it must have been too easy (Shafran, Cooper and Fairburn, 2002). If you've ever reached a goal and felt nothing but the next goal, you'll recognise it.

It works the other way round too. In a study that followed girls and young women aged 12 to 21 in Navarre, Spain, for 18 months, those with high self-esteem were much less likely to develop an eating disorder, though a personality trait called neuroticism predicted it more strongly (Cervera et al., 2003). In CBT-E, core low self-esteem is one of four extra problems that can keep an eating disorder going and get in the way of change (Fairburn, Cooper and Shafran, 2003). And in a trial of 154 patients, those with marked low self-esteem, perfectionism, difficulty tolerating their moods, or relationship problems appeared to do better with the broader version of CBT-E, which tackles those problems as well (Fairburn et al., 2009).

None of this means a food rule makes you ill, or that having one means you have an eating disorder. It means rules about food and bodies are often doing a job for your self-esteem, which is exactly why they're so hard to put down.

Where rules come from

Nobody sits down and chooses a rule like "I must be slim to be liked". Rules are learned, usually without anyone meaning to teach them. In Fennell's model, experience and temperament shape the beliefs underneath, and the rules grow out of those beliefs (Rimes, Smith and Bridge, 2023). Some of the usual sources are easy to spot:

• things said at home, such as "you'd be so pretty if..."
• teasing at school, or one comment you still remember word for word
• what you were praised for, and what got you criticised or ignored
• the culture around you, which has plenty to say about bodies
• years of diets, each with its own list of rules

The culture part is real, and it's been measured. When people absorb the negative stereotypes about weight and turn them on themselves, researchers call it weight bias internalisation. A review of 74 studies found strong links between it and poorer mental health (Pearl and Puhl, 2018).

Here's the part that helps. Most rules made sense when you made them. A child who learned "if I'm good, nobody will shout" was being clever. A teenager who decided "if I'm thin, they'll stop teasing me" was trying to stay safe. So the useful question is whether the rule still fits the life you have now.

On a GLP-1, or coming off one

If you're taking a GLP-1 medicine for weight, food may be taking up much less room in your head than it used to. For a lot of people that's a relief. It can also make an old rule very easy to keep. A rule like "less is always better" can feel as though it's finally working, when the medicine is doing much of the work.

Eating disorder specialists have raised this worry directly. A 2026 paper in the International Journal of Eating Disorders warns that the same effects that quiet appetite and food preoccupation may, in vulnerable people, reinforce restriction, avoidance of regular eating and compulsive weight control (Škudar, 2026). A 2026 review of 25 trials, led from University College London, found the medicines reduced binge eating on average, which is good news for many people, while dietary restraint went up. The authors say it isn't clear yet whether that extra restraint is the healthy kind or the rigid kind, and every trial they found had some risk of bias (Emptage et al., 2026).

Coming off can wake rules up. In the STEP 1 trial extension, people who stopped semaglutide, along with the trial's lifestyle support, had regained on average about two-thirds of the weight they'd lost within a year (Wilding et al., 2022). If one of your rules says "if my weight goes up, I've failed", that's a collision waiting to happen. It's worth doing the worksheet before your last dose rather than after, and talking your plans through with your prescriber. If you've ever had an eating disorder, tell them. Screening before and during treatment is what specialists are asking for (Škudar, 2026). Our piece on set point theory explains why weight tends to come back after stopping, and why that's biology rather than a verdict on you.

How to spot your own rules

Rules are hard to see because they feel like facts. A few ways to catch one in the act:

• Listen for must, should, have to, always and never.
• Finish the sentence "If I..., then...". The end of it is often an assumption.
• Notice when a small slip brings a flood of guilt, panic or shame. That's usually a rule being broken.
• Look at what you do so you don't break it: the cancelled plans, the skipped meals, the photos you won't be in.
• Check what you criticise yourself for. Self-criticism tends to point straight at a rule.
• Think back to family sayings, and to what earned you praise or trouble.

If you keep a food diary, the notes you write beside a meal can show a rule at work: "good until 4pm", "ruined it", "won't eat tomorrow to make up". That's worth noticing, gently. The same 2023 paper points out that low self-esteem can show up as checking your worth over and over, and that for some people this means monitoring weight or shape in spreadsheets or apps (Rimes, Smith and Bridge, 2023). If tracking has started to feel like a test you keep failing, that's a rule too, and a good one to put on the worksheet.

How to loosen a rule, step by step

The method works the same way whether the rule is about food, work or friendship. Take one rule at a time, and start with one that's causing you trouble now rather than the oldest or biggest you've got. The Centre for Clinical Interventions module that inspired this piece walks through the same basic process (CCI), and the worksheet further down is our own take on it.

1. Write the rule down in the words it uses in your head, even if it looks harsh on paper. Seeing it written down is often the first surprise.
2. Notice when it switches on. What's happening, what do you feel, and what do you do, or avoid doing, because of it?
3. Ask where it came from. When did you first learn it? Did it help back then? Does the situation it was built for still exist?
4. Be fair about what it does for you. Rules hang around because they pay off somehow. Maybe it makes you feel in control, or spares you a moment you dread. Write that down too.
5. Count the cost: time, food, sleep, money, friendships, fun, peace of mind. What has the rule stopped you doing?
6. Write a roomier version. Swap the absolutes for words that leave space, such as "I'd like", "usually", "most of the time" and "it's OK if". Keep what the old rule was trying to protect, and cut its link to your worth. One test: would you say the new version to a friend you love?
7. Try it out with a small experiment. Pick one thing the old rule forbids, write down what you predict will happen, do it, and then write down what actually happened.
8. Keep the new version where you'll see it, on a card in your wallet or as your phone's lock screen. Expect the old rule to get loud again sometimes, especially when you're tired or stressed. Old rules do that, and it doesn't mean the work has failed.

Why an experiment, rather than more thinking? Because rules are held in place by never being tested. In a study of 91 volunteers, a single session of writing out and questioning a troubling thought and a single behavioural experiment both helped shift a negative belief. After the experiment, though, the belief changed sooner, and the change spread further, to beliefs about other people as well as the self (McManus, Van Doorn and Yiend, 2012). It was a small study in people without a diagnosis, so take it as a pointer rather than proof.

A word of caution before you start. If you're in treatment, check experiments with your therapist first. If you're underweight, or you've been eating very little for a while, don't use food experiments to change how much you eat on your own. That needs medical support.

One rule, worked through

Here's how that might look for one common food rule. It's an example, not anyone's real story.

Whatever happens is useful. If it went the way the rule predicted, that's worth knowing too, and it's something to take to a therapist rather than a reason to tighten the rule. The evening snack isn't a random choice, either. The regular eating pattern used in CBT for eating disorders is three planned meals and two or three planned snacks a day, so there's rarely more than about four hours between them (Murphy et al., 2010). Our piece on why regular eating works explains the thinking.

A rule about your body works the same way. Take "I must be slim to be liked". A roomier version might be: "I'd like to feel at home in my body. The people who matter to me like me for a lot more than my size." And the experiment might be going to the thing you'd normally skip until you've lost weight, whether that's a friend's birthday, a day at the beach or a group photo. Write down what you predict beforehand. Afterwards, write down what happened, and how people actually treated you.

Rigid rules, and roomier versions

A few more examples. Yours will be in your own words, and they'll probably come out longer, because a roomier rule has to leave space for real life.

What the research shows, and what it doesn't

Low self-esteem has been treated as part of other problems far more often than as the main target, so the direct evidence is smaller than you might expect (Waite, McManus and Shafran, 2012).

One randomised trial, run in UK primary care, took 22 adults and allocated them either to start CBT straight away or to wait. Treatment was ten one-to-one sessions with workbooks, based on Fennell's approach. By the end, the people treated first had better self-esteem, better day-to-day functioning, less depression and fewer psychiatric diagnoses than the people still waiting, and when the waiting group had their turn, they improved in the same way. The gains held at a follow-up 11 weeks later (Waite, McManus and Shafran, 2012). The authors point out the limits themselves: the trial was small, most of the participants were highly educated women, and the follow-up was short.

A 2018 review pulled together studies of CBT based on Fennell's model and found eight that fitted, seven of which could be combined. Weekly individual or group sessions produced large improvements in self-esteem, one-day workshops smaller ones, and depression improved in a similar way (Kolubinski et al., 2018). The studies were all from the UK, several lost a lot of participants along the way, and few followed people up for long (Rimes, Smith and Bridge, 2023). The review's authors also say it's unclear how different these treatments really are from ones aimed at depression.

What nobody has tested is whether reading an article like this one, or filling in a worksheet on your own, raises self-esteem. We think it's a reasonable place to start. It isn't treatment, though. CBT for low self-esteem, like CBT for anything else, is delivered by trained therapists.

If this is hard, talk to someone

Looking closely at an old rule can stir up a lot, especially one about your body. You don't have to work through it alone, and you don't need to be in crisis, or to have a diagnosis, to ask for help.

If low self-esteem comes with low mood that won't lift, anxiety, or eating that feels out of control, a CBT therapist is worth seeking out. The details above include a route to one for your country.

Questions people ask

This is information, not medical advice or therapy, and it can't diagnose or treat low self-esteem, an eating disorder or any other condition. If you're in treatment, your care team's plan comes first.