Does Eating Give You Pleasure, Or Make You Anxious?

Does Eating Give You Pleasure, Or Make You Anxious?

"a paradoxical response to food"

I'm so glad to see, and share, this press release and this new article. We need to understand that anorexia involves very powerful biological mechanisms that tend to be explained as other things, like "fear of being fat" or "disgust with unhealthy foods," "feeling unworthy," or "wanting to feel control in one's life. Surely, most people have reasons they might diet or avoid foods - but can those reasons alone cause an aversion to eating that overpowers the most basic of survival mechanisms and defies logical thought?

I do want to note that this release misses something important: that while this predisposition to respond to low nourishment may pre-exist, it doesn't always persist. I know lots of patients, and their families, who recover fully and lose this phobic aversion and go on to normal lives - especially when the intervention is early and thorough and involves full, optimal and sustained weight restoration - supported by others.

Comments

  1. Really interesting article - which I can identify a lot with. Thanks for posting Laura :)

    I have never enjoyed eating. Eating has always been a huge form of stress and anxiety for me. As a small child I had the typical autistic features of finding certain tastes and textures of food revolting/disgusting. I also avoided foods of certain colours because I feared they'd cause me to vomit. I found eating in company difficult because people's chewing noises and facial expressions while eating 'freaked me out'.

    When I was very stuck in AN I was told things like "anorexics really love food; they just won't allow themselves to eat it". That may be true for some people, but it wasn't so for me. I had no desire to binge-eat and never have had such a desire.

    But the unconscious 'use' of eating rituals and routines to control one's life is not inaccurate or incorrect. It can be a huge part of an ED for persons with both AN and autistic features - because people with autistic feature fear change, spontaneity and unpredictability. Eating in a very ritualised manner is a means of avoiding change and avoiding feelings of chaos - which may be translated in one's mind to feeling 'in control' of one's life. Such 'control' (albeit illusory) was a HUGE part of my AN.

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  2. I'm one of those former patients who has lost their aversion. I used to have panic attacks at the idea of drinking an extra cup of herbal tea than usual (those 5 calories would totally make a difference!), and now I eat intuitively, dessert is a daily part of my life and I maintain a healthy weight without any anxiety at all. And I was ill for more than ten years, so I am very vocal in my belief that even longer term patients can recover, although obviously early intervention would solve a lot of problems!

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  3. Katie, SO glad you said that. People tend to think that brain functions can't change - and that recovery is just living with distress quietly and out of immediate medical harm - we NEED to aim for full remission!

    Cathy, you are using the "control" word differently than others are, and it matters. I hear you describing controlling anxiety - which I believe really is the mechanism. Most people saying EDs are "about control" are talking about people wanting to control the course of their lives - in a life that is victimized and trapped. I find they're talking about wanting to control food as a proxy for controlling their sexuality, their finances, their chaotic family life, bullying, a bad job, that sort of thing.

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  4. Well said, Laura! And don't forget about option C: None of the above. This happens when the person with anorexia (or any eating disorder, for that matter) learns to numb to the anxiety, and therefore eating is entirely mechanical, neither pleasurable nor anxiety-provoking.

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  5. Laura, I agree with you about the way that 'control' has been (mis)interpreted in the context of AN. The 'control' issue does relate primarily to the control of anxiety - and not to the outmoded and inaccurate theories of (e.g.) Hilde Bruch.

    I never engaged in anorexic behaviours wilfully, to control other people. Rather, the situation was that without such behaviours, which for me formed part of a rigid routine, I felt that the world and my existence were chaos. As well as anxiety, 'order' and predictability were (still are) of importance to me.

    And I agree with you and Katie, that for some people, AN is a temporary state that is rectified by re-feeding. Other people have more complex co-morbidities.

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  6. If Walter Kaye ever sees me again he will probably run very fast in the opposite direction because he will know what I'm going to ask him - what's going on the brains of those people with AN Binge-Purge subtype. Could food give them both pleasure and anxiety - very probably, after all a lot of things do to all sorts of people.

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  7. Interesting you say that Marcella... I find it difficult that most people with AN experience anxiety with food; even some of those with restricting AN, as I have had. You only need to look at the blogs of people with AN. Many of them include loads of photos of food. It's like 'food porn'. Many people I know who have (had) AN become obsessed with food and pour over cookery books.

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  8. Cathy,

    I believe we're talking about two different things? The anxiety around EATING food seems to go together with the incredible attraction to food. Some parts of the brain is unable to let the person eat, others recognize the current famine and still seek it, yet another part rationalizes all that with "reasons" for both. The fascination with the Food Network is quite reminiscent of the Minnesota Starvation Study participants who collected recipes.

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  9. Laura, when I was very unwell I put sticky labels into my recipe books on all the pages I wanted to cook one day. It looked like a fluorescent forest when I was done. I also obsessively watched cookery programmes. But I never felt hungry, and if you had put one of those meals in front of me I would have reacted like you had put a plate of tarantulas on the table. There is definitely a big difference between being obsessed with food and being terrified of it, and I would say that they can co-exist.

    I have quite a few friends with AN binge purge subtype, and I would say that they are/were very similar, really. They are obsessed with food (the same behaviours with recipe books and cookery shops, hoarding food, walking around supermarkets for hours every day, etc), but the terror and discomfort comes from the idea of digesting it. It's kind of the same but different.

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  10. I haven't read all the comments so I might be repeating something here. :) ...and I'm kind of typing quickly, so please bear with the way this jogs around -- THANK YOU for what you posted re: pre-exist and not necessarily 'persists'. I personally never had concrete thoughts of "this food is bad", rather what I did 'feel' was a euphoria that came with avoiding foods, thus starving my body and brain. That euphoria was short-lived because the pain that my under-nourished body and brain suffered was always more prevalent than the false feeling of 'euphoria'. (By 'false feeling', I mean emotionally false euphoria. I do think that 'euphoria' became a visceral feeling very shortly into the under-nourishing of my self b/c my body & brain learned to cope/adapt to the awful pains of ED). ~ I no longer feel remotely 'good' in response to feeling hungry. I feel HUNGRY in response to feeling hungry ;-) In response, I eat :-). And eating causes me zero anxiousness. It causes me great pleasure no matter if I'm I'm just grabbing something on the go from McD's or enjoying a lovely meal after thoughtful preparation (but not raw chicken --inside joke ;-)... Food is good and simple and lovely and logical...and yummy. It is never 'bad' :)

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  11. I must have been super-weird then, because I was disgusted by everything to do with food when very sick with AN. I didn't want to eat it and certainly wasn't attracted to it. The idea of cooking or watching cookery programmes 'freaked me out'. I think that was an unusual response to what most people feel, however.

    I prefer food nowadays but I still don't find eating particularly pleasurable. That said, I didn't enjoy food pre-AN either.

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