Why Food Variety Is Important to Eating Disorder Recovery

Flexible Eating for a Healthier Start

Variety of foods on table
Davide Illini/Stocksy United

In my work with clients with eating disorders, a primary goal for any diagnosis (whether anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified eating disorder, OSFED) is to increase the range of foods eaten. Research and my own clinical experience support this goal.

There are numerous reasons to encourage consumption of a more varied diet, not only for individuals in recovery, but for eaters in general:

  1. Success in cognitive behavioral therapy for bulimia and binge eating is associated with becoming a more flexible eater. Cognitive behavioral therapy (CBT) for eating disorders is the most studied and validated treatment for bulimia nervosa and binge eating disorder. It is based on the cognitive model holding that reduced dietary restraint leads to a reduction in binge eating and purging. Therefore, an important therapeutic task is to identify the patient’s “forbidden foods” (items the patient does not allow themselves to consume or only consumes in the course of binges); then, gradually encourage and help the patient to start to consume those foods in moderation. Research shows that patients who adopt a regular pattern of flexible eating exhibit reductions in binge eating and purging.
  2. Successful treatment for anorexia nervosa is associated with a more varied diet. One symptom of anorexia nervosa is a restricted range of food choice; an important treatment goal is expansion of this range. Research by Schebendach and colleagues revealed that individuals who were successful in recovery from anorexia nervosa consumed a more varied diet.
  1. A more varied diet reduces the chance of overeating any single food that contains substances unhealthy in larger quantities. Every week it seems we are learning about the association of a new food with some negative outcome. Earlier this year it was bacon. In years past, we worried about mercury in fish or large amounts of soy. It is my personal opinion that it is best to moderate intake of any food such as bacon, fish, and soy, and balance this with a wide range of foods. This way we can reduce the risk of high exposure to any single substance deemed dangerous while maximizing the chances of getting all needed nutrients. 
  1. Flexibility is important to people who are sensitive to an energy imbalance (as many people with eating disorders are). Individuals who only eat a limited range of foods can be at a greater risk of not getting enough food in certain circumstances. For example, driving up the interstate on a road trip, where the only place to stop for food may be a fast food restaurant, could be problematic. Inability to eat enough energy dense foods could trigger an energy imbalance, which could in turn reactivate an eating disorder.
  2. A limited variety of food intake can significantly hinder social opportunities, since many activities center around food. Individuals who are not comfortable eating in different settings and consuming different cuisines may not be able to join friends in certain activities, or (as I have observed among my clients) may feel compelled to eat alone. For most people, this restriction may consequently limit their ability to have fun and connect with others.
  3. A limited range of food intake may shrink your ability to see the world. Having lived in China for almost three years, I know firsthand the difficulty of finding familiar foods in a foreign land. However, experiencing new foods is one of the most exciting aspects of travel.  My clients who travel during an early stage of recovery generally struggle with unfamiliar foods. I have had clients travel to countries known for amazing cuisines and not take a single taste — tragically lost opportunities.
  1. While eating the same foods repetitively might give a sense of security, it often leads to food “burnout.” Eating a range of foods prevents people from getting tired of foods. My clients who repeatedly eat the same food often report getting bored of that food. They also tend to report less interest in eating and less satisfaction from eating. Research also supports the proposition that most people quickly tire of even a favorite food if it is eaten to the exclusion of all others and might even reduce their intake far enough to lose weight, which could be a risk for relapse.

In summary, while a limited range of food might decrease one’s anxiety, it is not without costs. When it comes to food, variety is not only the spice of life, but may hold a key to recovery.

Sources:  

Epstein LH, Temple JL, Roemmich JN,  and Bouton ME. Habituation as a determinant of human food intake. Psychological Review. 2009. 

Latner J D, & Wilson GT. Cognitive–behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating. Eating Behaviors. 2000. 

Schebendach JE, Mayer LE, Devlin MJ, Attia E, Contento IR, Wolf RL, and Walsh BT. Dietary energy density and diet variety as predictors of outcome in anorexia nervosa. American Journal of Clinical Nutrition. 2011.

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