In June’s blog post, “When Food Hurts,” I wrote about how we might consider feeding ourselves when food causes digestive distress - because of an untreated chronic gastrointestinal condition, for instance. But I thought it would be interesting to explore the flip side of that: What happens when the digestive condition is effectively treated or managed and food that was once “off limits” can now be eaten freely? Is it the relief we might expect? Or are there other feelings that might surface in response to such “food freedom”?
When I work with clients who have been suffering for an extended period of time with undiagnosed, untreated digestive distress, the focus is so often on what cannot be eaten - what must be avoided to prevent exacerbating the symptoms and how the client can structure their life around these limitations. But when foods that historically caused pain no longer have the same effect, I have seen a sort of “phantom limb” effect: There is an expectation of distress and pain, but none exists. And as relieving as this may be on the one hand, it can feel disorienting and frankly, a little disturbing, to live in the absence of the expected reactions. It’s like a familiar structure is no longer present; something that governed nearly every aspect of meals is no longer there to provide a sense of stability and direction when it comes to feeding.
So now there is the opportunity for clients to create a new frame and set of guidelines around how they choose food, but it can feel overwhelming at first and stimulate new, unfamiliar feelings of being nourished, of feeling a different kind of fullness and satisfaction, and of being deserving of this kind of food. And these feelings, while perhaps “good” may also feel overwhelming, scary, and unwelcome. There might be complicated feelings about a food that once felt so bad suddenly feeling and tasting really good. And perhaps even fear about new potential repercussions, like weight gain.
And while it might make practical sense to start incorporating all the once-unsafe foods back into the diet once it is physically possible, it may not be emotionally possible or tolerable right away. The same can be said for “fear foods” with clients have who have suffered from eating disorders. Just because they come to nutrition therapy for help with the eating disorder doesn’t not necessarily mean they are emotionally prepared to introduce these fear foods; they may introduce them more slowly, on their own terms, even when they are physically capable of handling more. And this process might take longer than a regularly scheduled introduction of fear foods, but in my experience, it is also a more effective, long-lasting result.
The same can be true for re-introducing foods that once caused physical pain. This is not to say that we don’t also find ways to make sure the client is properly nourished with energy and nutrients in the interim; it might just be with a more limited spectrum of foods right off the bat. It might also take many introductions of the same food before there is trust that this food is safe. Just like a young child learning to eat solid foods: There are multiple studies suggesting that it can take up to 20 times of introducing a food before a child accepts it as part of their regular food repertoire. Some of the clients with whom I’ve worked have carried digestive distress with them since early childhood, so in some ways, eating without pain and introducing foods really might feel like the first time. And so we proceed accordingly.
A final note about foods that have caused pain in the past: Let’s take something like ice cream. There may be a lingering sense of waiting for the other shoe to drop. So ice cream hasn’t caused pain for the first 10 introductions, but what about the 11th? And the 12th? There can be a sense of foreboding around a food that one has had to avoid for so long. And keep in mind, there is no requirement that any particular food be re-introduced, despite its safety, as long as energy and nutrient needs are being met with other comparable foods. Yes, it can be something to work through and explore, but I have found that making any food a requirement tends to have the opposite effect and lacks true, meaningful integration.