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The study examined whether the extent of negative body-related thoughts and emotions evoked by looking in a mirror can be changed by cognitive-behavioural body image therapy (BIT) and whether any remaining cognitive and affective responses dropped faster after the treatment. Females with eating disorders (n = 17) looked in a mirror for 40 minutes under standardised conditions before and after BIT. A control group (CG) (n = 24) was also exposed to their own bodies twice. Cognitive and affective reactions were assessed four times during the session. Hierarchical Linear Modelling revealed that among eating-disordered patients, the entrance levels of negative thoughts and feelings were lower at post compared to pre-BIT, whereas they remained stable in the CG. The extent of reduction of the remaining body image distress was not changed after the treatment. BIT seems to be a potent treatment of negative emotions and cognitions in an in vivo situation.