Nutrition rehabilitation in eating disorder recovery

 

Eating disorders are complex mental health conditions that affect millions of people around the globe. In fact, it is estimated that around 9% of the population have been affected by an eating disorder at some point in their lives¹, whilst those with an eating disorder could be twice as likely as those without to experience anxiety or depression².

If you or someone you love has suffered from anorexia nervosa, bulimia nervosa, binge eating disorder, or any other type of eating disorder, you may be wondering which foods are safe to eat and which ones you should be avoiding.

There are several myths surrounding food safety for those experiencing eating disorders. This article will discuss eating safely while in eating disorder recovery, including tips on tackling your fear foods and freeing yourself from food restriction.

 

 

What makes something a “fear food”?

A fear food, sometimes known as a “challenge food”, is any food that makes us feel uncomfortable or afraid to eat – some common fear foods include chocolate, ice cream, pizza, pasta, and cheese.

The idea behind fear foods is the belief that they will make us lose control or overeat, which will lead to weight gain.

This can be extremely anxiety-inducing for people with eating disorders: the more fattening or calorific you perceive a food to be, the more fear you will associate with it³.

However, it’s important to remember that no food intrinsically causes weight gain – it is only if it is eaten in excess and with no body attunement that weight gain could happen.

The key to overcoming an eating disorder is acknowledging the fact that there are no “good” or “bad” foods. Once you learn to recognise and accept this, you’ll be able to enjoy eating without feeling guilty or shameful.

 

 Are “safe foods” really safe?

In eating disorder terms, a “safe food” is usually something that we feel comfortable eating because it doesn’t pose a threat to our overall goal of weight loss. These are usually very low-calorie items such as sugar-free jelly, rice cakes, diet drinks, low-calorie fibre snack bars and even sugar-free chewing gum.

If you are experiencing an eating disorder, you might think that these low-calorie options are “safer” because they are perceived as healthy. However, just because a food is low in calories, it isn’t necessarily a healthy choice – especially not when you are removing or restricting lots of other foods in your diet.

Those with eating disorders are usually trapped in the cycle of avoiding fear foods entirely and stick to strictly safe foods to avoid weight gain at all costs. The truth is these super low-calorie “safe” foods are (often) nutritionally inadequate, unfulfilling and won’t provide you with a varied, balanced diet.

 

Which foods are ACTUALLY safe for those recovering from an eating disorder?

Remember, an eating disorder can be very convincing and demonise certain foods or food groups. At the end of the day, all food is safe (unless you’ve dropped it on the floor, you’re allergic to it, or it’s past its’ expiration date!).

It’s important to include a variety of foods in our diet to challenge rigid, black and white thinking. As we like to say, our aim is to move you from black and white, to all the colours of the rainbow:

1. Carbohydrates: Not only do carbs give us fuel, but they also supply us with valuable nutrients such as folate, iodine, thiamine, and dietary fibre. Carbohydrates like whole grains will also keep you fuller for longer, so you’ll feel more satisfied after you eat them⁴.

 

2. Protein: Lean meats and fish are not only rich in protein, but provide an excellent source of essential iron, vitamin B12 and zinc. Oily fish is an excellent source of omega-three fatty acids, which help maintain our cardiovascular and brain health.

 

3. Nuts, oils & healthy fats: Nuts contain plenty of fibre and protein, on top of a multitude of essential macronutrients like zinc, magnesium, vitamin E, selenium, folate, iron, and potassium. They also provide us with healthy unsaturated fats.

 

4. Calcium: Calcium can be found in dairy products such as milk and yoghurt and is important for maintaining bone health.

 

5. Fun foods: “Fear foods” like chocolate, biscuits, burgers, cake, crisps, and pizza can also be seen as fun foods – it is important to challenge these foods and try to incorporate them into your diet, rather than cutting them out completely.

 

6. Fruit and vegetables: Leafy greens such as kale, spinach, and asparagus are rich in iron, vitamins A, C and K, B vitamins and magnesium – all of which have been shown to reduce anxiety, increase serotonin and moderate satiety⁵.

 

Fruits are high in antioxidants, chemicals which fight disease by protecting against free radicals and reducing inflammation. An apple a day might actually help keep the doctor away after all… although it is important not to fill up on too many fruits or vegetables as you may not be able to fit in other important food groups!

 

7. Fluids: To stay hydrated, it is a good idea to aim for 1 glass of fluid with every meal and snack you have.

 

How can a pattern of regular eating help eating disorder recovery?

 Maintaining a pattern of regular eating is one of the key aspects of eating disorder recovery. Research indicates that having a regular mealtime structure throughout the day with snacks in between helps people to slowly return to less disordered eating patterns and face fewer negative feelings surrounding meals⁶.

Eating every few hours throughout the day is a tried and tested method of developing a more positive relationship with food and honouring your body’s natural hunger cues, without self-judgement or restriction.

Remember, it’s difficult to work with an underfed brain and body! Your body thrives off regular nutrition to help you function at its best.

 

How long does it take to recover from an eating disorder?  

There is no single, straightforward way to recover from an eating disorder – everyone’s recovery journey is different and doesn’t have a set timeline. You may experience setbacks along the way, but it’s important to accept that recovery isn’t linear: everyone travels at their own pace and setbacks are a part of this journey.

One of the first steps to recovery is acknowledging that you want to recover, allowing yourself to accept professional help and consulting with an expert who can provide you with the advice and support you deserve.

Here at Embody Health London, we provide tailored support and coaching for those who want to reduce their food anxieties and build their body confidence.

Get in touch today to begin your recovery journey, starting with a free one-to-one discovery call with a member of our compassionate, qualified team.

 

Robin Wileman,

EHL Intern

 

References

¹ National Association of Anorexia Nervosa and Associated Disorders. (2022, June 8). Eating Disorder Statistics | General & Diversity Stats | ANAD. https://anad.org/eating-disorders-statistics/

² Patton, G. C., Coffey, C., & Sawyer, S. M. (2003). The outcome of adolescent eating disorders: findings from the Victorian Adolescent Health Cohort Study. European Child & Adolescent Psychiatry, 12(0), 1. https://doi.org/10.1007/s00787-003-1104-x

³ Gonzalez, V. M., & Vitousek, K. M. (2004). Feared food in dieting and non-dieting young women: a preliminary validation of the Food Phobia Survey. Appetite, 43(2), 155–173. 

⁴ Zong, G., Gao, A., Hu, F. B., & Sun, Q. (2016). Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer. Circulation, 133(24), 2370–2380. https://doi.org/10.1161/circulationaha.115.021101

⁵ Maqbool, M. A., Aslam, M., & Akbar, W. & Iqbal, Z. (2018). Biological importance of vitamins for human health: A review. Journal of Agriculture and Basic Science, 2. https://www.researchgate.net/publication/325359151_Biological_importance_of_vitamins_for_human_health_A_review

⁶ Hage, T. W., Rø, Y., & Moen, A. (2015). “Time’s up” – staff’s management of mealtimes on inpatient eating disorder units. Journal of Eating Disorders, 3(1). https://doi.org/10.1186/s40337-015-0052-4