Selective Eating May Be Food Phobia in Disguise

February 6, 2003

Ashley Lord, <i>Hullabaloo</i> Assistant News Editor

Tulane University Medical School staff, led by eating disorder specialist Deborah Marcontell Michel, Ph.D., have recently discovered a food phobia that explains a wide variety of social anxieties. Multiple case studies have shown that a mental condition exists which causes individuals to fear the consumption of certain food products ranging from meat to certain types of vegetables.

The inability to consume these foods stems from the psychological compulsion that convinces victims that the food is going to either taste bad or actually be spoiled. Individuals suffering from this phobic disorder find themselves only able to consume the same food products daily. Eventually the ailment becomes hazardous not only to their health, through malnutrition, but it also damages them psychologically.

These people can have an inability to function in society normally, and they may refuse to go places where they might have to eat strange foods. Most phobia-sufferers are unable to eat in public, attend business functions that involve food, order from menus, and some are unable to have successful personal relationships due to their embarrassment of their condition.

Last year Dr. Michel, co-author of the scientific report on these phobias, reviewed several cases involving phobias of food consumption. At first it was thought that these individuals were suffering from known psychologically influenced eating disorders, and thus the cases seemed quite relevant for Dr. Michel to examine.

Soon after reviewing the cases individually, though, it was apparent that there were innate differences between the food phobias displayed in their cases and more common eating disorder examples involving anorexia or bulimia. Most of the time those individuals that suffer from anorexia nervosa or bulimia suffer from a fear of fat content in foods, not of the foods themselves, Dr. Michel said. These food phobics, though, were not afraid of gaining or losing weight.

In fact, some of the cases involved slightly larger individuals. These were examples of people who had innate fears of the food itself. These differences led Dr. Michel and her colleagues to classify these conditions not as eating disorders but as a type of anxiety disorder. With a new condition on their hands, Dr. Michel and her colleagues researched for similar cases of this type of condition. The researchers were able to trace the disorder back to the toddler years, where children are naturally inclined to be food phobic.

In most instances, the children were treated on an inpatient basis for the malnutrition the disorder caused. Almost none allowed the ailment to follow them into adulthood, but for some the condition not only carried on -- it grew. For some reason the individuals we were seeing never made it through this stage of childhood food phobia, Dr. Michel said. Therefore, all through the growing up years, this problem continued. There are no medical reasons for this, but we knew that there was obviously some sort of psychological component involved.

From this information, the researchers were then able to begin a series of treatments for the ailed individuals. This treatment involved a two-part process using both a cognitive behavior approach, attempting to change the way the person thinks, and a psychodynamic approach, pinpointing the why and the how of the problem. Patients met with Dr. Michel for psychological counseling and a dietician for the introduction of new foods.

The treatment was centered around systematic desensitization, which is a very effective treatment for phobias, Dr. Michel said. Food was introduced within a controlled environment. Some of these individuals were only able to eat bread and French fries for three meals a day. They had to learn how to relax and not panic while trying new foods. I met with them to discuss why they feared the foods, and taught them ways to relax while the foods were in front of them. We started with the ones that produced the smallest reaction.

Directly after meeting with me they went to the dietician and tried the foods for which we had prepared them. In addition, the treatment Dr. Michel and her colleagues administered involved eating the new foods at home, and in public. The patients were required to eat at restaurants and order new things off of the menus.

A year later, Dr. Michel and staff have found their processes to work very well. Most of the individuals they treated have found normalcy within their diet, and lives. We have not done any psychological follow-ups, which is our next step, but we have done patient follow-up, Dr. Michel said. One patient has moved out of state successfully and feels no fear for foods any longer, and another has even become engaged, fearing no social repercussions of his past disorder.

With the report published on their findings and treatment methods, Dr. Michel, a member of the Association of Eating Disorders, has been inundated with multiple requests for case study follow-ups and more information from all over the world, the most recent from Yugoslavia and Spain. Dr. Michel and her colleagues believe that this is further proof of the success their studies have become. We will continue to study these cases, Dr. Michel said. We want these people to know that they are not alone, and that, yes, they can be treated.

Tulane University, New Orleans, LA 70118 504-865-5000