Food fear in eating disorder recovery

Food fear in eating disorder recovery

Today we’re going to hear from a parent whose child is facing food fear during eating disorder recovery. She is afraid of food and her list of safe foods is getting smaller and smaller. I’ll talk through what food fear feels like and provide some advice for the parent so that she can help her child in recovery.

The letter

Dear Ginny,

My child is in recovery from an eating disorder, and she is deathly afraid of food.

Her therapist says food fear is part of the eating disorder and not to worry. She says to just keep doing what I’m doing, but the list of safe foods keeps shrinking. It seems like every day we lose another food option. And when I try to stay firm or introduce foods she ate a few weeks ago, she has a complete meltdown. 

This fear has taken over our house. We’re all walking on eggshells, not sure how to respond when the fear comes up. What do you say to someone who is afraid of food? 

Signed, Marni

My response

Marni, this sounds so hard and I’m so sorry. Food fear is a common symptom of an eating disorder, and it can be hard for parents to handle.

So let’s talk about fear. Most people can relate to being afraid of something. So I want you to think back to a time in your life when you were intensely afraid. Ideally, I’d love it if you could think of a specific fear rather than a long-term fear.

So rather than thinking back to a time when you were worried about whether you would get a job you applied for, think of a time when you were terrified that a check you wrote would bounce or something like that.

If you wrote a bad check, I’m guessing you probably had racing thoughts, thoughts about what could go wrong, what was going to happen to you, what you had done wrong to get yourself into this situation, and what you should have done to avoid it.

Maybe you called yourself stupid for spending too much money. Maybe you declared to yourself that you would never spend any more money again. Those are some of the thoughts that might have happened.

Now, I want you to try and remember what the fear felt like in your body. We’re wired to respond to any perceived threat with physiological responses that may cause symptoms like racing, heart tingling, nausea, jitters, clumsiness, hot flashes, and other awful symptoms.

These symptoms could help us if we were trying to run away from a tiger in the wild. But in the world that we live in today, it just feels awful. Most of us, when we’re facing fear, have classic anxiety symptoms: negative thoughts, and physical symptoms.

Fear and eating disorders

And most people who have an eating disorder must live with food fear, which includes the negative thoughts and physical symptoms of anxiety. We can understand that they may try to avoid these awful symptoms by making commitments to themselves about avoiding feeling those feelings in the future.

So remember that bad check. In addition to feeling bad about having too little money, you also vowed never to spend money again. That might have been a kind of silly, fleeting thought that disappeared quickly, but it still showed up.

A person who has an eating disorder feels intense fear and then plans ways to avoid feeling that intense fear in the future. And unlike the fleeting thought of never spending money again, these thoughts for a person who has an eating disorder don’t go away.

Remember that eating disorders are not a choice. They are mental disorders characterized by distorted thoughts. So while you may have moved on from the bad check experience and even forgotten about it, someone who has an eating disorder may stay stuck in a loop of feeling intense fear and making plans to avoid it in the future.

Your child is afraid of food, and that fear is intense, both in their thoughts and in their physical reaction to that fear. Their thoughts are big, scary, and incessant.

They may say things like “sugar is bad, carbs are bad, I can’t eat that, if I don’t control my food, I’ll eat everything, I’ll never stop eating, I need to eat clean,” and stuff like that.

Then there’s the physical reaction. Her fear can create physical symptoms like a racing heartbeat that feels like a heart attack. And importantly, fear causes nausea. This makes it very hard to eat.

And in the midst of feeling this fear, she’ll be planning ahead to avoid the fear in the future.

Because the fear is awful and terrible, she doesn’t want to feel the fear again, so she makes a commitment to herself to avoid it.

An example of eating disorder and food fear

So, for example, let’s say she sits down and she’s given an avocado. She may have racing thoughts like, “I can’t eat that. It’s got too much fat, too many calories, I already had too much fat today.” Her heart rate speeds up, her chest feels tight, and she feels nauseated.

So she plans a way to get out of this fearful situation and to avoid the fear in the future. “I’ll tell my mom I can’t eat avocados ever again. I’ll tell her if she puts avocado on my plate, I’ll die.”

She thinks I must avoid avocados to stay safe from these dreaded feelings of fear. Her subconscious thought, and it’s not conscious, it’s subconscious, is “I must avoid avocados to stay safe from these dreaded feelings of fear.”

So what I’m trying to do here is help you understand what might be going on for your child.

Most people who feel a temporary fear, like writing a bad check, will keep a more careful check on their finances in the future, and the problem is solved.

But an eating disorder means chronic fear. It’s feeling as if you’re writing bad checks all day, every day.

Let’s say a person becomes very afraid of writing bad checks or spending money they don’t have. They commit to a cash-only lifestyle. In doing this extreme overcompensation for one bad check, their buying options become severely limited.

They have just shrunk their opportunities. They’ve shrunk their lives.

And while they may tell us that what they’re afraid of is writing checks, what they’re actually afraid of is feeling that fear, those negative thoughts and physical sensations that they experience when they write a check.

This is a fear of feeling fear, and that’s what anxiety is. And the proven way to treat fear is to face it.

The setup for fear

The first time a child becomes afraid of a particular food, it can seem like no big deal.

After all, it’s just one food out of thousands. What’s an avocado when you have so many choices?

So we say, “OK, I’ll give you something else instead.” But then you give them something else and they become afraid of that too.

This is what you’re seeing with the diminishing list of safe foods. What you have learned is that removing a type of food from the list doesn’t actually make things better. It just shrinks the list, just like the person who decides they’ll only pay cash.

A person who is afraid of food is going to increasingly shrink their options in the world because they think that food is the problem.

But food isn’t the actual problem. What they are afraid of is the thoughts and sensations they get when they feel anxious.

The treatment for fear

The most common treatment for anxiety like this is called exposure therapy. This is when a trained therapist exposes a person who is afraid of something to that fear, because the only way to stop fear is to face the fear and not die.

Seriously, that’s the treatment.

If I’m afraid of writing bad checks, then I need to practice writing checks. Each time I do that, I’ll learn that I’m actually OK. After I write a check, my fear will reduce and over time it’ll disappear.

If I’m afraid of eating, then I need to practice eating lots of different foods. Each time I do that, I’ll learn that I’m actually OK. After eating food, my fear will reduce and over time it will disappear.

Understanding and moving forward

So what I’ve given you here is a way to possibly understand what might be going on with your daughter, how very terrifying it is for her to face food multiple times every day. It’s a real challenge.

And I’ve briefly explained the most common treatment for fear like this, which is exposure therapy.

So I’m curious to know whether your child’s therapist is integrating exposure therapy into her treatment. I would want to understand her treatment approach and how she feels about the diminishing list of safe foods.

She may have an alternative strategy that she’s working on with your daughter. With eating disorders, it’s never one size fits all.

For example, perhaps your daughter has trauma or sensory processing issues that the therapist is trying to work on without challenging that list of safe foods. It’s possible that your child’s therapist is doing some things before getting to the exposure therapy. Or she may have another approach entirely in mind for your child.

A conversation with the therapist

What you can share with her is that your child is increasingly reducing the types of foods she will eat. That is a symptom of distress and her therapist should really be aware of that.

It sounds like you’ve already mentioned it to her. So I’m really just encouraging you to reach out to her again and ask specifically about the list of safe foods and whether she wants you to hold firm on the food you serve your daughter or continue to reduce that list of safe foods.

I hope that in explaining fear and its treatment to you, I’ve given you some confidence to communicate your concerns to your child’s therapist and open up the conversation about her treatment plan.

Marni, I know how hard it is to face eating disorder pushback and anxiety. I hope this has been helpful and I wish you all the best as you move forward. 

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Published by Ginny Jones

My mission is to help reduce body hate, disordered eating, and eating disorders.

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