Food Exposures in Recovery

Author: Breanna Mills R.D.

Working on exposing yourself to foods and eating situations that cause distress is an important part of working towards more freedom with food. Food exposures can help to increase overall intake through less rigidity and increased variety, which supports permission and freedom with food, as well as improved nutritional adequacy. Food exposures can also help to decrease anxiety around food and support increased flexibility.

Food exposures use Exposure and Response Prevention (ERP) principles. ERP is a type of Cognitive Behavioural Therapy (CBT). While ERP is often used in the treatment of OCD, it can also be used in eating disorder treatment. ERP involves exposing yourself to a food that makes you anxious, practicing sitting with the thoughts and feelings that arise, and working on not engaging in safety behaviours to decrease the anxiety. This helps to train the brain that these foods are safe and that you can manage eating them. As you are able to ride out the wave of anxiety, you may experience a natural decrease in anxiety over time. This is known as habituation.

It is important to remember that the goal of food exposures is not to get rid of anxiety entirely. The goal is to learn that you can experience anxiety around food without needing to act on it or allow it to dictate your choices. Anxiety may still come up, even with foods you have challenged before, and that is okay. Recovery is not about never feeling anxious around food, but about being able to make choices that support your recovery even when anxiety is present. Over time, food exposures can help you build confidence in your ability to navigate these feelings without relying on eating disorder behaviours to cope.

In Westwind’s residential program, food exposures occur on a weekly basis. This involves taking a food that the eating disorder has created a lot of rules or fear around and regularly and intentionally incorporating that food. It may seem counterintuitive to intentionally make yourself feel distressed or anxious; however, food exposures help to increase variety and overall intake, decrease anxiety around food, and support increased flexibility, freedom, and permission.

A place to start can be to create a hierarchy of foods that you may be fearful of, go through that list, and pick a specific food to challenge. It is most helpful to create a really specific plan for what the exposure is going to look like, including making a plan for how you will navigate the anxiety without using the eating disorder to cope. This can include allowing the thoughts and feelings to be present without trying to make them go away or engaging in behaviours to reduce the distress.

Food exposures are an important part of ED treatment, and doing them regularly and consistently can support you in learning to tolerate anxiety and experiencing the natural decrease in anxiety that may occur over time. Ultimately, the goal is to build confidence in your ability to challenge the eating disorder and continue making recovery-oriented choices, even when anxiety is present.