When food fears deserve special attention

It’s common on forums discussing the painful and difficult road back from eating disorders, to hear nutritional misinformation and fears about certain foods. Many who are avoiding certain foods are convinced they are aren’t dieting or restricting their eating, but are eating healthy. While the idea of foods that are good and bad mimic what is popularly cited in mainstream media and often taught to young people in nutrition classes, recent research by Columbia University eating disorder specialists suggests that recovery from disordered eating requires getting past fears of ‘bad’ foods.

This small study in the current issue of the American Journal of Clinical Nutrition looked at two eating disorder studies on 47 women (18-45 years of age) who had been hospitalized for inpatient treatment of their eating disorders between June 2000 and July 2005 and followed for an average of 6 to 8 months after discharge. Forty one women successfully reached 90% of their ideal body weight during inpatient treatment. While there is no universally accepted definition of relapse or recovery from anorexia nervosa, they said, they used several definitions for their analysis, examining psychological, dietary and weight measures. The researchers, led by Janet E. Schebendach, MA, RD, sought to quantify the food choices made by these recovering anorexia nervosa patients to determine whether calories and diet variety predicted their recoveries.

They found that those who avoided energy-dense foods, — what many will call ‘junkfood’ — desserts and snacks, meats and milk, and added fats like salad dressings and butter, were more likely to have failed recovery from eating disorders, regardless of their BMI and regardless of their caloric intakes. All of the patients were prescribed diets with 30% of calories from fat, in accordance with the Dietary Guidelines, and 2,600 kcal/day to maintain their weight and while caloric intake didn’t differ significantly between the outcome groups, fat avoidance was significantly higher among the failure group. The researchers also found that the more the women restricted and limited the variety of foods they ate, the poorer their recovery from eating disorders.

The authors concluded that while it can be emotionally difficult for these patients to bring themselves to eat energy-dense foods and a greater variety of foods, it may be crucial for helping them prevent relapse. And this information may also help alert us to women and men at risk.