Sitting down to a plate of food can be an exciting, if mundane, part of any day. Food is necessary, but it can also be enjoyable — at least for many people.
For some individuals, however, food causes a great deal of anxiety. Mealtimes may start normal, but soon, intrusive thoughts and worries may seize their brains. Tendencies towards anxiety about food is often a part of living with an eating disorder.
If you’re experiencing an eating disorder and tend to get anxious about food or eating, you’re not alone. In fact, 20 million women and 10 million men have or have had an eating disorder during their lives. Of those, research suggests nearly two-thirds also experience an anxiety disorder at some point in their lives.
Eating disorders vary, but a feature of each one is often feeling anxious at mealtimes. We’ll walk through some of the most common eating disorders.
Avoidant/restrictive food intake disorder (ARFID) is a newer eating disorder classification. It’s used to describe individuals who eat very little food or avoid eating most foods. They may become overwhelmed by anxiety and fear about food, a certain texture, or concerns about consequences that may occur.
Unlike other types of eating disorders, ARFID has nothing to do with a person’s perspective of their body or appearance. Instead, people with this eating disorder find it physically impossible to eat most foods because of anxiety, sometimes related to the sensory characteristics of food.
This is not simply picky eating either. Adults and children with ARFID often feel hungry and want to eat. However, when they sit down to a plate of food, they have a physical reaction to it. They may report feelings such as their throat closing up or an involuntary gagging reflex. Some people may report fear of aversive consequences of eating, such as nausea.
Anorexia nervosa is a common eating disorder that leads to very restricted eating patterns. People with this eating disorder typically experience intense anxiety and fear around eating. They worry about gaining weight or altering their physical appearance. Likewise, they experience additional anxiety about eating in public places or with others because they want to control their environment and food.
People with this eating disorder fall into one of two groups:
- Restricting. They may eat very little food.
- Binge eating and purging. They may eat large amounts of food and then attempt to get rid of it by vomiting, exercising, or using laxatives.
Anorexia is more common in women than men, and some people with this eating disorder may also receive diagnoses of bipolar disorder, depressive disorders, and anxiety disorders.
People with bulimia nervosa may eat large amounts of food in a short period of time. In fact, during a binge, several thousand calories can be consumed. After the binge episode, they may attempt to purge the food they ate in order to eliminate calories and relieve discomfort. Purging can include:
- excessive exercise
The binge episode may begin because of anxiety. Eating is an activity people can control when they feel powerless in other situations. However, the purging episode may also occur because of anxiety. They fear gaining weight or altering their body’s physical appearance.
Bulimia nervosa is also more common in women than men. This disorder is more likely to develop during adolescent years and early adulthood.
Individuals with binge eating disorder (BED) also eat a large amount of food, often in one sitting or in a short span of time. They’ll even eat to the point of discomfort. However, unlike people with bulimia nervosa, people with BED will not try to purge the food.
Instead, the excessive eating will cause them great emotional distress. The eating is often accompanied by feelings of:
In a vicious circle, the emotions may then drive the person to eat more.
Like bulimia nervosa, BED is more likely to begin in adolescence and early adulthood years, but it can begin at any stage in life. People with anxiety disorders may have a higher risk of developing BED than other eating disorders.
Other eating disorders may also cause anxious feelings about food:
- People with an eating disorder called purging may eat typically, but they routinely purge their food after the meal. A fixation on how they look can cause a great deal of anxiety, and it may lead to purging.
- Some individuals have disordered eating behaviors that don’t fit into another category.
Treatments for most types of eating disorders involve:
- Cognitive behavioral therapy (CBT). This highly-effective practice requires work with a therapist to discuss negative emotions and thoughts related to food and eating. The therapist works to devise coping strategies.
- Family-based therapy. For parents of children with AFRID, a family-centered program may help parents and children work through the complications of the eating disorder. Children and parents may also individually meet with a therapist.
- Medications. No medications have been proven effective for eating disorders. If a person has a co-occurring anxiety disorder, the following medications may be prescribed:
- benzodiazepines, a type of sedative, such as alprazolam (Xanax) and lorazepam (Ativan), which may carry a risk of dependence
- selective serotonin reuptake inhibitors (SSRIs), including escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft)
- Support group. Accountability is a powerful tool for individuals treating an eating disorder. Support groups help you connect with individuals who’ve been in your shoes. They can provide support and encouragement.
- In-patient facility. Some individuals may check into an in-patient facility where they can have continuous medical attention and mental health support.
- Nutritional counseling. Registered dietitians with training in eating disorder recovery can help guide you to eating plans that make you feel good and keep you healthy.
If you think you have an eating disorder, it’s important you seek treatment sooner rather than later. Likewise, if you think your child has an eating disorder, make an appointment with a doctor.
Treatment can be, and is often, very successful. But most people need professional help to overcome an eating disorder. It takes a team of experts to guide you through the process.
Likewise, if you’ve been through treatment and fear you will relapse, reach out to your therapist, support group, or an accountability partner. Stress and anxiety can come and go. These techniques can prevent the feelings from overwhelming you:
- Take deep breaths. Breathing in and exhaling air helps you collect yourself in the heat of a moment. Focus on your breathing, and talk calmly to yourself about what you need to do to get past the momentary anxiety.
- Repeat a helpful mantra. During CBT, your therapist may help you identify a phrase or word that holds meaning to you. Repeat that mantra to yourself until you feel your heart rate return to normal and feel more confident.
If your child has food-related anxiety, you can work with your child’s doctor or therapist to find ways to be supportive. This includes:
- helping them talk about their feelings
- channeling fears in productive ways
- managing expectations around social events that cause worry
Recovering from eating disorders and anxiety disorders is a process, and parents can play a big role in their child’s recovery.
If you believe you may have an eating disorder or think a loved one could, these resources may be helpful:
- The National Eating Disorders Association (NEDA) offers a helpline (800-931-2237) and screening tool that can direct you to professional help. Likewise, they can help you find free and low-cost support. NEDA can help people concerned about ARFID, too.
- The Anxiety and Depression Association of America can help connect you to a therapist or behavioral health treatment center in your area. They also provide valuable guidance on applying for assistance, including Social Security Disability.
- Your hospital’s education office is an invaluable resource for people seeking out local support groups. They can often help you find a provider in your insurance network or one that will work with financial needs.
If you have anxiety about food, you’re not alone. Eating disorders are treatable. It’s also possible to have a separate anxiety disorder. The good news is both of these conditions can be treated successfully.
The key to moving past these food-related worries and fears is to ask for help. If you think you have an anxiety or eating disorder, call a doctor today to set up an appointment. Reaching out for help is the first step to getting better.