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Kari Anderson DBH, CEDS-S

When Your Guests Don't Eat Your Food

Can picky eating go too far?

Did you have friends or family show up for Thanksgiving or some other dinner party with their own Tupperware containers of food? And it was not a potluck! “Dietary restrictions” are a trend on the rise. Whether a true allergy or an intolerance, many people find themselves falling into a category once known as a “picky eater.” Is this behavior something to be concerned about? Can someone be too healthy or rigid when it comes to eating?

When inviting guests, we now inquire about food restrictions out of consideration. Food allergies aside, most people can navigate around their food preferences at social events. Food intolerances, however, can be frustrating for a hungry guest who finds no gluten-free or dairy-free options available. How often does a vegetarian try to get by without too much fuss, doubling up on deviled eggs? How many times has a gluten or lactose intolerant person had to go along with the food at hand only to experience severe gas, bloating, or diarrhea a short time later? Just as people in larger bodies are unfairly judged when choosing to indulge in dessert, people with food restrictions are also judged when passing up foods unproblematic to others. Yet, at what point does restrictive food behavior become a red flag for a developing eating disorder?

Eating behavior lies on a continuum from restrictive to excess in volume, food choice, and frequency. On both ends of the continuum, extreme behaviors are dangerous.

Chizhevskaya Ekaterina/Shutterstock
Source: Chizhevskaya Ekaterina/Shutterstock

With extreme restrictive eating, body weight can drop quickly, or go very low. The person may reduce eating to such a degree that hunger signals diminish, and the simple act of eating creates anxiety.

The more extreme the behavior, the more problematic. The longer one engages in the behavior, the more likely it will develop into a fixed habit. Healthy eating may not start out tied to perpetual thoughts and fears concerning health or an obsessive drive for thinness, but it can go that way in susceptible individuals.

Many eating disorders originate as a subconscious coping strategy to manage anxious or depressive states, or to avoid painful or uncomfortable memories, social, or familial situations. Eating behavior is an effective, yet dysfunctional, distraction or numbing agent. And yet, food is necessary for our survival. This is quite possibly why it evokes powerful physical and emotional responses when we perceive a threat to our well-being or existence.

Eating and feeding disorders have a set of diagnostic criteria evaluating disordered behaviors with food and in response to food. Vomiting or excessive exercise are two common examples. Too often, those displaying disordered eating are never diagnosed. Flying below the radar, their lives and health are compromised by their behaviors. Many clients have shared with me the mental and physical torment caused by their restrictive approach to eating.

There is a name for such a disorder, although it has not quite gone mainstream. It is called orthorexia: an unhealthy obsession with healthy eating. Not yet recognized as an “official” condition, those like myself treating eating disorders absolutely consider it a real thing.

Due to my familial propensity for heart disease and diabetes, and my personal experience with melanoma, I began researching the relationship between eating and health years ago. I came upon the work of Dr. Michael Gregor, M.D., and his book How Not To Die. In it, he emphasizes:

What we do “most of the time” has far more influence on our health than what we do “some of the time."

Being a bit of a perfectionist, I know firsthand the dangers of all-or-nothing thinking, and I use the “mostly” and “sometimes” language in my treatment approach to eating disorders. Clients get it!

So, what is normal eating? Ellen Satter writes, “Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it—not just stop eating because you think you should.” Her definition goes on to include eating for nourishment, pleasure, and connection. Even “emotional eating” is normal on some level.

In the "Am I Hungry? Mindful Eating for Binge Eating" program workbook, co-authored by Michelle May, M.D., and myself, we refer to eating being influenced by two major factors: self-care and flexibility. Combined and balanced, these factors create the “sweet spot” for normal eating. Rigidity and neglect, on the other hand, are the manufacturers of disordered eating.

Self-care means making mostly mindful decisions supporting the care of the self, both physically and emotionally; things that make us feel good in the long run like clarity of mind, energy, and health. Add the flexibility piece and you’re on your way to a successful relationship with food. Inflexibility lends itself to obsessive thinking. I’ve seen people have complete melt downs over the ingredients on a food label. This type of rigidity often characterizes an anxiety disorder or obsessive-compulsive type personality.

The opposite is also true. Great flexibility at the expense of self-care, or “anything goes,” can be physically and emotionally destructive as well. This brings us back to the question of how eating behavior goes off the rails. It basically comes down to moderation being replaced by behavioral extremes.

Orthorexia was initially coined by Steven Bratman in a 1997 article in the Yoga Journal. It was defined as an unhealthy obsession with healthy eating interfering with one’s physical, mental, and social wellbeing. “Ortho” is Latin for “straight” or “correct.” A play on the term anorexia, orthorexia is often a gateway to the former.

Dr. Gregor contends healthy eating can be lifesaving and says he’d rather see someone obsessive with food than have their chest cracked open for triple bypass surgery.

Healthy eating centering around self-care and flexibility translates to common-sense moderation. An obsessive focus on healthy eating crosses a line, one in which concerns become fears, and fears turn into phobias.

So, when someone brings their Tupperware containers to your party, I wouldn’t get too concerned unless they exhibit additional behaviors. For example, excessive rigidity about their schedule or exercise routine, having difficulty with change. Also, have they eliminated too much, gotten too thin, and seem to have difficulty coping? If so, I recommend getting them some professional resources, even if initially unwelcome.

References

Dunn, T. & Bratman, S. On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors Vol 21, April 2016, p11-17.

Ellyn Satter, R.D., A.C.S.W. From Radiance Summer 1991. radiancemagazine.com/issues/1992/normal.html

May, M. & Anderson, K. Am I Hungry? Mindful Eating for Binge Eating. Companion Workbook and Awareness Journal for Eat What You Love, Love What You Eat for Binge Eating. MMXIX

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