fear of food

A clinician friend emailed me yesterday with concern about the impact of the most recent meat recall on eating disorder patients and their families.

One of the classic early signs of an eating disorder is a false vegetarianism -- where foods are cut out but no compensatory foods are added in. It is often followed by more restriction, always accompanied by ethical concern.

During eating disorder recovery it is very important to return to the normal eating patterns and preferences of life before the illness: to rejoin the culture of the family and society around food. That goal is made harder if the society in which we live is irrational and fear-based about eating.

But we still have the power, as loving family, to create an environment around the dinner table of pleasure, nourishment, and confidence.

Comments

  1. All of these food fears are why it's so important to teach good science and critical thinking; otherwise kids and adults get sucked into being frightened by all of these scares for which there is nothing to be afraid of. Activists and quacks prey on fear and those who don't understand good science -- which anymore, seems to be a lot of the population. And it hurts children and adults who've needlessly become afraid of food and life.

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  2. Whilst I agree that activists and quacks prey on fear, I disagree that we need to teach our kids the science of food. In fact I think that it is since we have brought science into our eating that we have become more unhealthy. It is very important that children aren't bombarded with healthy/unhealthy food information. These ideas become hardwired in the brain, which can lead to under and overeating (there is science to back up this idea!) We need to be able to sit down at the dinner table and enjoy what has been prepared, with our families without being concerned whether the food is good or bad for us.

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  3. Food and the eating thereof is a celebration, uniting family members at the end of the day, to share nourishment and enjoy each others company.
    In a world which is fast tracked, obsessed with diets, convenience meals and take aways, I believe it's time to light a candle, say a blessing for the wholesome food we are given by the earth, sun, wind and rain.
    CG

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  4. Wow Laura -
    Thanks for that clarification of "false vegetarianism". While I try very hard not to talk to ANA, d hit me with "You were a vege for 7yrs...". To d, I said simply let's not talk about this now, but I really struggled with that one internally. But it's the compensitory foods that are the difference that make the difference! When I was vege, I ate a TON of legumes, butter, oils, cheeses etc to replace the animal foods I wasnt having. I usually gave a lot of thought to how to replace necessary fats, protiens and micronutrients - calcium being key for me. In my case, I eventually had to add meats back in b/c I couldn't stay healthy and vege. I became very anemic and even though I ate lots of iron-rich foods, I just couldn't eat enough of them to keep up. I also couldn't - and really didn't want to - do ovo/lacto vegetarianism. We have a familial neuropathy, and I find if I don't maintain at least 1200-1500mg of calcium most days of the week, I get severe leg cramps and restless-leg symptoms. When I was pregnant I needed 1800mg/d! That would have been IMPOSSIBLE without dairy.

    Anyway, the Aha! moment in reading your post is that in unhealthy eating, there is no balance. Whenever something is subtracted, and unequal amount is added - if anything is added at all!

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  5. Laura I love what you wrote:

    "To rejoin the culture of the family and society around food"

    that's so very important!

    On the flip side of the "false vegetarianism" issue, our d wasn't a proclaimed vegetarian prior to her AN dx- we eat predominantely Indian since my husband is from India, and eating Indian didn't = zero protein- we also have plenty of fish in curries, chicken- and we did eat other cuisine.

    Indian food is FILLED with protein/nutrition sources (legumes, beans, etc.) fresh homemade yogurt, wonderful spices, and so many other delicious menus- we were pelted with a LOT of heat and judgment regarding this, and some clinicians treated us very disdainfully and were not culturally sensitive in the least, which was very difficult to deal with.

    Now we're watching our d regulate herself from residential protocol with foods that are sometimes considerably rigid (she ironically stated some time back when being challenged to push her food choices in IP that Indian food made her "fat"- so talk about a distorted twist!)

    And at the majority of meals at the center there is no expectation to having BOTH fruits and vegetables (it's usually one- a fruit, so imagine when trying to serve salad, and other vegetables at meals when at home- this is usually easier with Indian since it's cooked/incorporated in the entrees) with the reason being many residents were afraid of the margarine on the veggies, or would otherwise only eat a plateful/fill up of vegetatablea at their meals.

    So striking this "balance" and reconnectig to the "pleasure" of nourishment, one bite at a time is so vital for our loved ones!

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  6. Our D had talked about becoming a vegetarian for several years, but it was always the family joke that this would be a big problem for her because she hated most vegetables. That is, until last September when, after viewing a science museum incubator with cute just-hatched chicks, she declared that she would no longer eat meat. We went along with the idea on condition that she would compensate by eating lots of fish and eggs...and vegetables. In fact, suddenly she was eating everything we suggested, even eggplant and mushrooms--foods that she had always refused to even try. But little by little, the portions became smaller. Two months later, our D entered a freefall, shedding 2 pounds/week.
    Now, 7 weeks into IP refeeding, she is being forced to reintroduce meat into her diet. Yes, she still clings to the "moral" issues behind her vegetarianism, but the therapist pointed out that while she may have legitimate moral concerns, it was not morality that got her to take this step, but rather her AN. Not only did the disease make her cut out a major food group, but it forced her to accept, with pleasure, the vegetables that she had always refused. Very clever disease!

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  7. Belinda, I said teach science and critical thinking -- I did NOT say "teach" nutrition or good-bad foods and certainly not to children, concepts even adults don't understand. But children can be encouraged to understand science and critical thinking and not fall prey to all of these bogus food fears and myths.

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  8. I am sensitive to the fact that people reading this blog probably have personal experience with eating disorders and that impacts almost everything related to food. But I'd just like to add that it IS possible to be concerned about the poor state of American foods (industrial feed lots, chemicals, over-processed etc.) WITHOUT having irrational responses. I think we all should be concerned about the safety of our food supply, but that doesn't mean we stop eating. It means we make the safest choices we can and try to support sustainable agriculture. We can't create an environment where food is about nourishment and community if we aren't concerned about how the food reaches our table.

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  9. Anonymous,

    I don't think we disagree. There are extremes in thinking even among healthy people that food can be BAD or THE ONLY HEALTHY OPTION. That sort of black/white thinking isn't good for anyone. I don't think the only way to reject ED thinking is to lose all critical thinking about food - I'm a fan of wholesome, varied, truly satisfying food.

    But we have to keep in mind that some people have a mental illness that USES those ideas in the service of the illness. They are in the grip of a compulsion, not a choice. People with EDs respond to public food fears like people with schizophrenia might respond to a Star Magazine headline about alien invasion.

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  10. I am only on day 2 of refeeding and I have a question regarding the vegetarian issue. At what point should I make the first attempt to put meat in front of her again? I feel like every bite she consumes at this point is a major victory and I hate to push too much too fast. I'm afraid that trying to get her to eat meat is going to be an argument I'm not ready to take on yet. I know that it can be a real convenience for people with ED to eliminate a huge portion of their diet by proclaiming to become a vegetarian but I am wondering if something about the disease creates a real repulsion in them against eating animals, different from that of a "normal" vegetarian. Is there a special approach that I should be taking to help reintroduce meat to her? I feel like her recovery will be much harder in the long run without meat in her diet. Any ideas on this would be greatly appreciated.

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  11. Julie,

    Sending cheers on your refeeding work!

    Two things: one is I hope you join the wonderful families at www.aroundthedinnertable.org who will certainly have suggestions for you.

    On when to introduce foods, I believe the key is for you, as parent, to be very clear what is rational and what is not and to act accordingly. If you buy into the fear as rational, your child will sense that. If you don't, ditto.

    A lot of ED programs are really clear on this: if they were a vegetarian since long before the ED, or the family is vegetarian, then respecting that boundary is good. If not, it is an irrational fear and needs to be treated that way: as if the patient has a conviction that foods that are blue or must be 75 degrees or can't be eaten on odd numbered days.

    Have confidence in whatever you decide.

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  12. Thank you Laura for clearing that up a bit for me. The line between what's rational and irrational seems so blurred to me these days. I know that adding meat is going to one of our biggest arguments so it helps to know that I'm not being irrational on this one. I am so thankful for your book and all of the wonderful support and suggestions on your website. I am off right now to join aroundthedinnetable.org
    Thanks!

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