This article delineates the phenomenon of "cognitive-affective division" in eating disorders, used to refer to the difficulty some patients face in translating what they "think" cognitively to what they "feel" emotionally. A clinical description of cognitive-affective division is first presented, drawing on existing research, before moving on to discuss psychological theories that might shed some light on this often-seen but seldom understood phenomenon. These include the role of emotion awareness and alexithymia, cognitive and emotional development, and neuropsychological theories. We discuss implications for treatment and further research of the cognitive-affective division in eating disorders.