“I’m following the Paleo diet.” “Sugar is bad for you.” “Gluten makes me bloated.” “I only eat foods that have ingredients I can pronounce.”
To most of us, conversations about food and diet goes in one ear and out the other. We might participate by asking a few questions or by adding our own beliefs about healthfulness, however at the end of the day, we are unlikely to make long lasting changes based on these conversation tidbits. Most of us will talk about wanting to decrease belly fat and, 1 hour later, munch on a cookie or walk through Costco sampling the food.
Unfortunately for those struggling with eating disorders, discussing or even overhearing diet advice is completely different. When a person struggling with eating disorders hears “I only eat whole grain pasta,” they think “Wow, I’m not eating healthy enough. I need to switch to whole grain pasta.” This modification begins innocuously as requesting the family to buy whole grain pasta, but may quickly progress to refusing to eat pasta unless it is whole grains, and eventually eliminating pasta completely. Remember, persons with eating disorders have temperaments that include perfectionism and obsessiveness. Their brains get stuck on ‘whole grains’ so if the only option is white pasta, they may be inflexible to the point of not eating. Eating a serving of white pasta one time is too risky for the rigid ED brain. Their thinking may sound like this: “Should I eat this? Will I be bloated if I eat this? Will my stomach hurt? If I eat this, should I change my eating later? Will this cause my weight to change? What if my clothes feel tighter? What is the calorie, carbohydrate, fiber, fat, protein difference? I’m trying to eat healthy and this white pasta will ruin it.”
Eating disorder treatment includes working on rigid thinking, filtering unhelpful information, normalizing eating and food exposures, however, every statement that the person with an eating disorder hears requires them to deliberately decide if the information is helpful for them. It is not easy for them!
Of course, we don’t live in a bubble! We all hear conversations that we don’t want to. However, if you know someone with an eating disorder be mindful that idle chit chat about food and dieting may unintentionally cause stress.
Pam Chin-Lai, MS, RD, LD, CEDRD specializes in the nutritional rehabilitation of eating disorders in children, adolescents and adults.