What Are Fear Foods? (And Why It's Important to Face them In Recovery)
Caroline Young
An overhead shot of freshly baked chocolate chip cookies

If you’ve been through eating disorder treatment or know someone who has, chances are high that you’ve encountered the term “fear food.” But now—due in large part to social media—the phrase has begun to enter the mainstream, and with that shift, the definition of fear foods has become a bit hazy. Read on to learn what exactly fear foods are, who is affected by them, what the most current research says about them, and how fear foods fit into eating disorder treatment.

What are fear foods?

“Fear food” is an age-old term used by us eating disorder dietitians to help clients progress in recovery and find lasting food freedom. But what does it mean?
According to Equip Nutrition Director and dietitian Erin Reeves, RD, fear foods are foods that feel unsafe, triggering, and emotionally charged. She explains that for people with fear foods, consuming those foods—or even thinking about them—can increase negative thoughts or feelings. “This might feel like ‘fear’ or being ‘afraid’ to eat the food, but people could experience a variety of negative emotions or thoughts associated with it,”she says.

Any food could theoretically be a fear food, but certain specific items or types of food are more likely than others to fall under this designation. In my practice, my patients’ and clients’ most common fear foods are carbohydrate-based foods (like bagels, pizza, pasta, and bread), desserts (like ice cream, cookies, brownies, and cakes), and fried foods (like potato chips, French fries, chicken nuggets, or other fast food). Typically, fear foods tend to be those that diet culture deems “unhealthy” (and that I call “fun foods”).

However, some clients may struggle with other, less expected foods, even those that diet culture praises. This could be for a variety of reasons, including past trauma (like choking on a certain food or getting ill after eating it), emotional associations, childhood conditioning, or arbitrary eating disorder rules.

Others may not be afraid of certain foods, per se, but instead have conditions and rules they need to follow to make it “okay” to eat them. “There might be foods that people feel they have to do some sort of compensatory behavior after eating in order to ‘feel better.’ That could be increased exercise, restriction, or vomiting,” Reeves explains. “They’re afraid of eating the food and not doing the compensatory behavior.” Such conditional fear foods are typically higher in fat, carbohydrates, and sugar.

Who has fear foods?

In general, the term “fear food” is associated with eating disorders, and fear foods tend to show up more frequently in people with eating disorders than in people without eating disorders. To take one data point: a study of women with bulimia and women without eating disorders showed that for those with an eating disorder, exposure to “highly palatable” foods (aka delicious foods that diet culture tends to demonize, like cookies and candy), elicited more negative responses, including fear, than they did for those without eating disorders.

But while it’s true that people without eating disorders feel generally safer around food, it’s possible for them to have fear foods for multiple reasons, too. “Our society has an irrational relationship with disordered thoughts and ideas about food, and people who repeatedly hear negative messages develop a cognitive response, which makes them fearful of the food,” explains dietitian Amy Goldsmith, RD.

Among people who do have eating disorders, fear foods are common, but they’re not always present, or may only show up in certain contexts, like when there’s “too much” of a specific food. For example, someone may be afraid of ordering a serving of French fries to themselves at a restaurant, but be okay with having a few fries from a shared plate. Or, someone may fear having a sandwich with two pieces of bread, but can have a piece of toast with little struggle.

How fear foods present can also vary across different eating disorder diagnoses. With avoidant restrictive intake disorder (ARFID), for instance, fear foods typically have different roots than fear foods in bulimia or anorexia. “People with ARFID might not identify with being ‘fearful’ of a food, but perhaps find that certain textures, smells, or flavors create anxiety or feel overwhelming. Other people with ARFID have diagnosable phobias related to certain foods, if perhaps there's a fear of choking or a food making them sick,” Reeves says. “Two people might have a fear of pizza, but one has ARFID and doesn't like the melted cheese texture and mixing with tomato sauce and another person with bulimia is fearful of the fat content.” Research also shows those with binge eating disorder are more fearful around foods than those without an eating disorder, but they may have less fear around foods than people with other diagnoses like anorexia or bulimia.

Do you have to face fear foods in eating disorder recovery?

As both a dietitian and a person living in recovery, I believe that facing fear foods is an imperative part of reaching full recovery. That’s because without complete food freedom, the eating disorder still has power over your life and room to live, and can potentially take control again. In fact, one study of people recently discharged from inpatient treatment showed that lingering food fears predicted increased eating disorder symptoms, like drive for thinness, just a month after discharge.

“Sometimes the eating disorder likes to create logic around why someone would exclude a food, such as ‘I just don't like it’ or ‘I never ate that food growing up,’ when it's perhaps the eating disorder’s judgments preventing them from experiencing the food,” Reeves explains. “The eating disorder loves to hide in rules that haven’t yet been addressed. And the best way to address fear foods is through exposure, or incorporating the food at regular intervals to allow fears and anxiety to decrease over time.”

Research shows a connection between fear food exposure work and recovery progress. One small study of patients with anorexia found that anxiety, restriction, and eating concerns reduced after eight 60-minute sessions of fear food exposure work. In another study, inpatients with eating disorders of various types were guided through challenging and eating fear foods, and prevented from engaging in compensatory behaviors like purging. After completing this exposure process, the patients experienced significant reductions in “eating-related fears and avoidant behaviors.”

With each of my clients, I typically start by creating a fear food pyramid together, with three sections: the lowest part of the pyramid is for the least challenging foods, the middle is for moderately challenging foods, and the top is for the hardest ones. We explore beliefs, thoughts, and feelings around each food, and work on incorporating it into their intake on a regular basis. Their fears associated with each food typically decrease a little bit every time they eat it, and it gets a little easier and feels a little safer each time. Eventually, fear foods become neutral and even enjoyable. As Reeves explains, this continued exposure is essential, as simply eating a fear food once or twice isn’t sufficient to help someone feel comfortable or make peace with that food.“It often takes 15 or more times to really allow for reincorporation and decreased negative feelings,” she says.

There’s no doubt that facing fear foods in eating disorder treatment is mentally and emotionally difficult—It's hard to continue to do something that doesn't feel great over and over,” Reeves says—however, with the support and guidance of a treatment team you trust, it’s completely possible. I overcame a laundry list of fear foods in my own recovery, and have watched countless patients and clients do the same. Plus, the payoff is massive: by facing fear foods, you earn a life of feeling empowered and at peace around all foods, and greater resilience to other life fears. “It does get better,” Reeves says, “and you get better in how you react to something hard, priming you to tackle other hard things.”

References
  1. Melles, H., & Jansen, A. (2023). Transdiagnostic fears and avoidance behaviors in self-reported eating disorders. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00745-8
  2. ‌Christensen, K. A., French, M. N., & Chen, E. Y. (2020). Multi‐method assessment of palatable food exposure in women with and without eating disorders. European Eating Disorders Review, 28(5), 594–602. https://doi.org/10.1002/erv.2746
  3. Levinson, C. A., Brosof, L. C., Ma, J., Fewell, L., & Lenze, E. J. (2017). Fear of food prospectively predicts drive for thinness in an eating disorder sample recently discharged from intensive treatment. Eating Behaviors, 27, 45–51. https://doi.org/10.1016/j.eatbeh.2017.11.004
  4. Cardi, V., Leppanen, J., Mataix-Cols, D., Campbell, I. C., & Treasure, J. (2018). A case series to investigate food-related fear learning and extinction using in vivo food exposure in anorexia nervosa: A clinical application of the inhibitory learning framework. European Eating Disorders Review, 27(2), 173–181. https://doi.org/10.1002/erv.2639
  5. ‌Farrell, N. R., Bowie, O. R., Cimperman, M. M., Smith, B. E. R., Riemann, B. C., & Levinson, C. A. (2019). Exploring the preliminary effectiveness and acceptability of food-based exposure therapy for eating disorders: A case series of adult inpatients. Journal of Experimental Psychopathology, 10(1), 204380871882488. https://doi.org/10.1177/2043808718824886
Caroline Young
Contributing Writer, RD
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