In my last article, I discussed the role of fear in disordered eating attitudes. I have more thoughts on fear that I’d like to share.
Fear is future-oriented. It involves thinking about what might happen a decade from now or five minutes from now. With respect to disordered eating, the process is this: thinking about what might happen, focusing on a possible negative outcome, believing that this is what will happen, feeling afraid of this outcome, and then deciding which course of action to take based on this fear—a course of action that contains the greatest likelihood of this feared possibility not coming to pass, and thus feeling less afraid. I find that this process often becomes so automatic that we don’t realize we’re doing it.
One big problem with this is that, of course, there’s no way to know for sure what the outcome will be. We’re focusing on one possible outcome, believing, as though we can predict the future, that this is THE certain outcome, and reacting to the emotion (fear) we feel when we think about this outcome.
When we make decisions in the present based on fear of what will happen in the future, the fear clouds our judgment. We are less likely to be able to make a decision based on what is in our best interests and what supports our well-being when we are afraid of a hypothetical. Instead, the motivating factor is reducing the fear and avoiding the hypothetical negative outcome. This shows up in small but very consequential ways, and contributes to perpetuating disordered attitudes about food and body.
One common example of this that I encounter with people is the skipping of afternoon snacks. Many of the people with whom I work on eating- and food-related issues have difficulty with between-meal snacks. Often, they are working with a dietician who has prescribed an afternoon snack between lunch and dinner. People will tell me that they didn’t eat that snack, or that they ate less for that snack than their dietician had outlined. When I ask why, I’m often told, “I thought that if I ate it, I wouldn’t be hungry for dinner.”
This may seem innocuous, but this thought is enfolded within the context of fear of eating too much and all the perceived risks that involves. I have heard this from people who—in the face of their physicians, dieticians, and me telling them that their nutrient intake is dangerously low and must be increased, or that their binge eating is in part a reaction to deprivation and thus they must eat at well-spaced intervals throughout the day—nonetheless find the thought that they should not eat the snack sensible.
For many disordered eaters, hunger is reassurance that they aren’t overeating, and snacks are seen as “indulgent” or “extra” rather than an important part of balanced eating. They fear that if they aren’t hungry for dinner, they will have to forgo a planned dinner with their partner and feel sad and deprived, or that they will eat anyway, believe they’ve overeaten, and feel tremendous guilt and anxiety. They often habitually under-eat during the day, saving up calories for the evening, when they can eat with more ease and enjoyment, because their fear of exceeding a self-determined number of calories is not so great. So they decide to skip the snack, the fear of the negative outcome disappears, and they experience a sense of relief and strength that they call feeling “in control.”
What’s ironic about this is that in reality, the person is not at all in control—fear is. Fear is driving the decision-making process. And the first step in overcoming fear is being aware of it.
Many years ago, I was told that FEAR is an acronym for “False Evidence Appearing Real.” I share this with people to keep in mind when they are afraid. And I say to them, “Imagine that, today, you eat your afternoon snack. What happens right now when you do this?” And they notice the fear, and we name it and work with it. Then I say, “Why don’t you test your theory and see what happens? Find out if you’re truly not hungry at dinner time after you eat your snack. If you are hungry for dinner, then you’ll find out that you were operating under an incorrect assumption. If you’re not, then it’s not a catastrophe, you can learn to figure out what your options are.”
I don’t think I’ve ever had a person report that, when they take the plunge and eat the snack, they’re not hungry for dinner. This experience helps to build trust in their bodies, diminishes the grip fear has on them, and gives them hope in the possibility of wellness.
The afternoon snack is one of many small but significant examples of the ways in which fear pervades disordered-eating beliefs and attitudes. Overcoming this fear is a huge piece of healing a disordered relationship with food and body. In general, it means learning to feel and acknowledge the fear, but make decisions about a course of action based on what supports healing and well-being.
For people who are in therapy for their eating issues, it means relinquishing control to their treatment providers, whose wisdom and knowledge and experience can guide them in learning to identify fear, identify fear-based predictions, identify what they truly need in order to get well, and take the action, no matter how scary, that will meet those needs. Willingness to face fear and do the right thing is a force much more powerful than fear.
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