Anxiety about food may lead to eating disorders and other mental health conditions.
Food plays a crucial role in day-to-day life, and eating a healthful diet is incredibly important. However, if thoughts about food and eating become intrusive, this can develop into food anxiety.
In this article, we examine the causes of food anxiety. We also take a look at related disorders and their treatment.
Food anxiety typically arises due to individual and cultural factors. According to the Centers for Disease Control and Prevention (CDC), in 2013–2016, 49.1% of adults in the United States had tried to lose weight within the previous 12 months.
With that in mind, it is important to understand these factors so that people can effectively manage food anxiety.
Below are key factors that research has associated with food anxiety:
- Negative messages about eating or appearance: Social media contains numerous images and messages encouraging people to lose weight and shaming those who do not eat “right.”
- Negative self-talk: Some people engage in what researchers call “fat talk,” in which they assert that they are fat, even if they do not actually believe themselves to be so. This practice promotes the idea that a certain body type is wrong. A 2012 study exploring fat talk also found that it may lead to depression, anxiety, and negative body image.
- Genetics: People who share genes that scientists have linked to eating disorders may feel more anxiety about food. The same is true with people whose family members have genes associated with different types of anxiety. A 2013 review suggests that eating disorders tend to run in families and that part of this link may be genetic.
- Personality traits: Certain personality traits may increase the risk of the food anxiety that can cause eating disorders. They include perfectionism, novelty-seeking, and impulsiveness.
- Community messages: Messages about food and body image in a person’s community may increase food anxiety. People who participate in sports or other activities that value thinness may have more food anxiety.
- Cultural messages: The wider culture values thinness and may even treat it as a moral choice. This message can cause people to feel anxious about their food choices and body shape.
- Early experiences: A 2013 review found that some, but not all, studies identified a link between early experiences of abuse and food anxiety. A person who experienced childhood abuse may use food as a way to regain control, and this can nurture food anxiety.
A person can experience fleeting food anxiety without having an underlying diagnosis. Some people may also use food as a way of coping with anxiety. For example, the findings of the American Psychological Association’s Stress in America survey suggested that 38% of U.S. adults had eaten too much or chosen unhealthful foods due to stress during the past month.
However, a person may have an underlying mental health condition if their anxiety about food:
- undermines their relationships
- interferes with their daily life
- consumes their thoughts
- causes them to make unhealthful choices consistently
Some potential diagnoses include:
A person may also develop unusual rituals about food, engage in excessive exercise, or take laxatives to lose weight.
Anorexia can cause a person to become dangerously underweight, triggering heart and endocrine system problems, which can be lethal in some cases. Anorexia has the highest death rate of any eating disorder.
The hallmarks of bulimia are binge eating and purging. People may get rid of the excess food by vomiting, taking laxatives, or using enemas. Alternatively, they might compensate for binge eating by fasting or overexercising.
During a binge session, a person typically feels as though they have little or no control over their eating, leading them to eat much larger quantities of food than is healthy. They may do this in secret and then feel ashamed and embarrassed. This feeling means that they often attempt to prevent weight gain by purging.
Bulimia can cause severe health issues, such as electrolyte imbalances, tooth damage, and injuries to the esophagus (food pipe).
Binge eating disorder
Binge eating disorder is similar to bulimia in that it causes a person to eat very large quantities of food. However, unlike bulimia, a person with binge eating disorder does not purge.
This condition may cause intense shame, and a person may obsess over their food intake. This obsession causes anxiety, which can lead to more binge eating.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize orthorexia as a standalone eating disorder, but it includes it as a type of avoidant/restrictive food intake disorder (ARFID). Many clinicians treat it as a separate condition, though.
Orthorexia causes a person to become preoccupied with healthful and “clean” eating. Their fixation goes well beyond a mere attentiveness to good health. Instead, a person assigns a moral quality to foods and fears eating anything unhealthful. This condition can cause dangerous nutritional imbalances and weight loss.
Some people with orthorexia embrace fad diets or get nutritional advice from social media or discredited diet plans.
Generalized anxiety disorder causes a person to feel anxious in many situations where the anxiety is irrational. Some people channel that anxiety toward food. In severe cases, this can lead to eating disorders.
Obsessive-compulsive disorder (OCD), a type of anxiety, may also cause food anxiety. People with OCD have overwhelming anxious thoughts (obsessions), such as a fear of dying or losing someone they love.
People with OCD manage these thoughts with specific behaviors and rituals (compulsions) such as cleaning, eating only certain foods, or restricting the amount of food that they eat.
Other mental health conditions
Many people with eating disorders or food anxiety have other mental health conditions, such as depression, drug or alcohol use disorder, or schizophrenia. Some people with serious mental health conditions may use food as a way to regain a sense of control.
When a person has an eating disorder and another mental health condition, they will need treatment for both.
Although the symptoms of various forms of food anxiety are very different, the treatment is similar. It includes:
- Therapy: During therapy sessions, a person will work to identify why they feel anxious about food. They may talk about their history, relationships, and stress. The therapist can help them find safer coping mechanisms, manage their emotions better, and establish strategies for diverting obsessive thoughts about diet.
- Medication: Various medications can help a person manage the emotions that trigger food anxiety. For example, some people with OCD find relief from antidepressants.
- Nutritional counseling: When a person is outside their recommended weight range, they may need nutritional help to reach a more moderate size. People who are severely underweight may sometimes need intravenous (IV) fluids or treatment in the hospital to prevent serious health issues.
- Support groups: Support groups can help people better understand their feelings about food and get practical advice from people facing similar challenges.
- Lifestyle changes: Certain lifestyle changes may ease food anxiety. For example, a person with an eating disorder may need to limit their use of fashion magazines, social media, or other triggers for food anxiety.
A person should talk to a doctor about food anxiety if:
- it is intense and affects daily functioning or well-being
- it causes them to eat far fewer calories than is healthy
- they lose a significant amount of weight in a short period
- they throw up, use laxatives, or administer enemas to avoid gaining weight
- they frequently binge eat very large quantities of food
- they feel overwhelmed by anxiety, depression, or other negative emotions
- thoughts of food are so intense that they cannot focus or enjoy time with loved ones
Many people experience intense cultural pressure to worry about their appearance and, therefore, the food that they eat. Others use food as a way of managing trauma or feelings of anxiety.
Anxiety about food can be crippling and dangerous, but it does not have to be permanent. Seeking treatment can help a person live a longer, more healthful life free of overpowering thoughts of food.