Trouble Eating (Anorexia)

“Anorexia” literally means “not eating.” If someone is unable to eat, for any reason, they are said to be “anorexic.” Don’t confuse this with the eating disorder Anorexia Nervosa which is marked by a fear of gaining weight or appearing overweight, especially when one is already skinny like a zipper. Many emetophobics are misdiagnosed as having Anorexia Nervosa because they are terrified of eating. However, body image is not involved. They’re anorexic because they fear food, or some foods, or too much food, will make them sick.

ADULTS

Here are some foods that adult emetophobics are often afraid to eat:

  1. Chicken (lest it is undercooked)
  2. Beef, undercooked
  3. Shellfish, particularly oysters, clams, mussels (as raw oysters in particular carry Norovirus)
  4. Any food past its “best before” or “expiration” date
  5. Leftovers

STEP ONE – buy a digital thermometer. They’re pretty cheap (under $10). It will make you rest at ease, while not serving up charred rubber meat!

The easiest thing to remember is that the magic number is 74C (165F) except for whole birds such as turkeys, chickens, water fowl which need to be cooked to 82C (180F). Make sure your STUFFING reaches 74C in the centre.

Some meats can be cooked to lower temperatures, so check this HANDY POSTER CHART from the Canadian Government Health Authority. Don’t look up the American one. Trust me on this.

Best Before Dates are just that – the product is “best” before the date. It’s not poisonous after the date. Normally the only way to tell if it’s still ok is to look at it, smell it and taste it. One little sip or baby-spoon-sized taste will not hurt you, even if the yogurt or whatever tastes mouldy and vile. You will not be sick, guaranteed 100%. Well, not from that, anyway.

I served my family an (unopened) ham last week that was a whole month past its “best” date. I took it out of its package and it wasn’t slimy or green or shiny. I cooked it to 74C. We all enjoyed it and were fine. Not that “being fine” is a good enough test on its own. My sister was “fine” after regularly eating raw hamburger but you can also play Russian Roulette several times without blowing your head off.

How to Eat Again When You’re Terrified

I have no evidence as to this “method” – I can only tell you what worked for me, and for a little girl I counselled named Emma. Emma got down to 50 pounds at 12 years of age and had to be hospitalized and tube-fed. She never wanted to go through that again. As for me, I was a teenager in university, 90 miles away from home. I decided that I could only eat Bananas, Digestive® Cookies (because of the name, I suppose) and Milk. I took a multi-vitamin. Long story short, I knew I was going to die if I kept that up. So I made a conscious decision: eat, no matter what. So did Emma.

The first meal I was served in the cafeteria I will never forget, even though it was in 1977: poached filet of sole, Tater Tots® and broccoli with a cheese sauce. I sat and looked at the plate and cried. My friends cheered me on. I took one bite of fish and chewed it about a thousand times, then swallowed and cried some more. I managed two Tater Tots, and one bite of the broccoli florets. Four friends softly applauded. It was before the days of high-fives and thumbs up. But I forced myself to eat one bite more than what I thought I could do. One more bite of fish. Stretch the stomach out. I drank my milk and had a banana and Digestive cookie for dessert.

Gradual Exposure – I’d never heard of it in 1977: no internet, no social media, no cell phones. Libraries as big as city blocks. But somehow I managed to figure it out intuitively. The next morning I got a plate of eggs, sausage and toast and managed about three more bites than the night before. It took me a year to get back to eating normally. And ya, I ate that ham last week without a second thought so I’m cured of that particular fear for sure. Emma did the same thing. Choked down Hagen Das® Ice Cream bars to bump up her calories and weight. I know, right? She did gain weight and is well on her way to overcoming the emetophobia entirely.

KIDS

If your child is not eating, or restricting the foods or amount they eat and is losing weight, this is a medical emergency. Take your child to a family doctor or paediatrician immediately for monitoring and assessment of their BMI (Body Mass Index).

Sometimes you won’t notice that your child is not eating. My own daughter suffered from anorexia nervosa for a short time during which she skipped breakfast, threw out her lunch and ate dinner in her room allegedly doing homework but all the while feeding it to the dog. But I assume since you’re reading this that you have noticed.

Younger kids seem to restrict (or even count) their treats and “junk food.” They hear in health class that eating such things can lower your immune system leaving you vulnerable to sickness. They can also restrict the amount of food they eat. Others freak out about how their parents are cooking the food or washing their hands and the dishes. One thing they all seem to share is the need for reassurance from a parent that they won’t throw up. This need for reassurance is actually a symptom of the anxiety. Being caring, compassionate and comforting by telling them they won’t throw up is thus contraindicative. In other words, don’t do it. Your answer to “will it make me sick?” must always be a calm, cool, collected “I don’t know.”

Caring, Compassionate, Comforting. Calm, Cool, Collected.

Emphasis on the calm. If your child has your worry about them to add to their problems, how will they ever cope? I have three kids so I know it’s easier said than done. But I also know that a kid getting upset or anxious won’t hurt them. And yes, it will have to get a lot worse before it gets better. So make dinner the way you always do, empty the dishwasher the way you always have and … um … ya, they’re right about washing your hands first.