Food Phobias Related to Eating
Individuals fearful of foods usually fear foods due to fear of the food itself, or because of an associated situational fear (like vomiting) but not concerned with weight.
Eating Disorders or Food Phobias: Complexities
Eating disorders and food phobias are different in nature and typically are different in treatment modalities. Both can involve having foods that are avoided and restrictive food intake.
Individuals who have food phobias will generally have more symptoms that are anxiety based, and the fear centers around having to eat, cook, or be close to specific foods.
Symptoms can include dizziness, excessive sweating, nausea, feeling like you cannot breathe, heart rate increase and shaking, all similar to panic disorder symptoms.
Individuals with an eating disorder such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder (BED), Avoidant Restrict Food Intake Disorder (ARFID), Other Specified Feeding and Eating Syndrome (OSFED) and Food Phobias – can have nutritional and physical consequences. A person can become malnourished, and lack essential vitamins and nutrients due to starvation. Weak and brittle bones can also occur for individuals with and eating disorder and food phobias and when prolonged starvation occurs – anemia, low blood pressure, hair loss, kidney failure and other medical conditions are common.
Not all food phobias are the same within each individual. Some may be fearful of eating perishable foods, other individuals may have trouble with texture and taste of foods or smells. This can initiate nausea or a sensation of gagging if trying foods that fall into this category. Another food phobia can also be a fear of cooking for others, that the food may be over or under-cooked. It can also include fear of cutting yourself or burning oneself in the process of cooking.
Young children may also have a fear of trying new foods and this may never disappear and continue through adulthood.
Types of Food Phobias
Food phobias will typically involve a food aversion. This is important because it may trigger a feeling of revulsion around food rather than anxiety. Aversions can be very strong and last lifelong.
Another type of phobia is the fear of an inability to swallow or fear of choking. It has been linked to extreme sensitivity with the gag reflex. The anxiety is maintained with the thought that they will choke and so the food is avoided which releases a ‘feel good’ thought and emotion, giving the phobia more power.
Similarities and Differences
Eating Disorders and Food Phobias hare common characteristics of anxiety based thoughts and symptoms. Food phobia and eating disorders evoke avoidance of certain foods due to fear. Both can have starvation and malnutrition effects with long-term medical complications.
Differences vary in how the individual views themselves and food. Those with eating disorders see themselves as ‘fat’ or needing to lose weight. Often the weight loss is never sufficient, and the person is unhappy with the way they look and are perceived. Individuals will frequently engage in compensating behaviors in an attempt to alter body shape and size and weight.
With food phobia, individuals are fearful of certain foods due to a fear response. Some individuals may fear vomiting or textures and the smell of foods. Typically there was a precipitating event, for example, eating fast food in the car as a child and then throwing up. The individual then comes to associate all fast foods, or foods with a vague connection to throwing up – and will refuse to eat them.
There is no concern with weight, body shape, or self-esteem with those that have food phobias. Typically the individual will want to be able to gain weight and eat similarly to their social group.
Treatment Approach
Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Eating Disorders
Exposure work is essential. Being able to work up slowly from least fear-provoking to most fear-provoking is part of the process.This approach is suitable for the treatment of food phobias and ARFID (Avoidant Restrictive Food Intake Disorder). Anxiety and fears exists with food phobias and ARFID. Avoidance of particular foods may contribute to weight loss or failure to appropriately gain weight and nutritional deficiencies. Psychosocial problems that effect friendships and overall wellbeing for individuals with food phobias and ARFID can lead to withdrawal and depression. When necessary, therapy may initially aim to renourish a person through nutrition.
Individuals work with a therapist at Uniquely Human Psychology to be able to tolerate anxiety at various fear hierarchies to be able to learn distress tolerance and coping skill mastery. This enables individuals to be able to practice in and out of the therapeutic setting. Steps are typically progressive and logged. The phases are used to raise anxiety at each level and to learn what physical, emotional, and mental symptoms occur as well best practices to manage it, so the individual feels that they can stay in control. Steps become more relaxed as they are worked through, and anxiety may not be 100% reduced from level to level. It is encouraged to practicing daily food phobia exposures and keeping a written log of the process and challenges.