What’s your favorite food?
We commonly pose this question to kids we meet through our community outreach initiatives, and it’s fun to hear their not-so-wide-ranging responses: pizza, candy, ice cream, French fries… But ask a group of adults the same question, and their answers will be much more variable. Age, gender, cultural background, body weight, and socioeconomic status all influence food preferences, as do positive and negative associations with foods or tastes, beliefs and attitudes about body weight and “healthy eating,” and contextual variables ranging from current season to current mood.
Among individuals with eating disorders, food preference seems to be less dependent on taste, texture, and presentation – all factors that strongly influence food choice in healthy adults – and more determined by beliefs about the degree to which particular foods are “nutritious,” “healthy,” or “non-fattening.” As one early study showed, the caloric content and perceived nutritional value of foods do impact food preference ratings in healthy adults, but the correlation between preferences and perceived calories was much stronger among individuals with anorexia and bulimia. Similarly, another study found that patients with eating disorders rated their desire to eat high-calorie foods significantly lower than their desire for low-calorie foods, while the ratings of individuals without eating disorders were independent of the caloric content of the foods. Interestingly, in a third study, restrained eaters (i.e., people who are “watching what they eat” but do not have an eating disorder) reported that they would choose to eat high-calorie foods more often if the foods did not contain calories; individuals with anorexia nervosa, on the other hand, did not endorse a desire to eat high-calorie foods more frequently, even in the absence of calories.
While there is no evidence that people with eating disorders have altered perception of taste for fat or sweet solutions, they predictably rate sweet, high-fat foods as less preferred and tend not to choose energy-dense foods. Individuals with anorexia nervosa also report eating a narrow range of foods, and both aspects of restrictive eating have been linked to poorer long-term outcome.
What might this mean for those with eating disorders and those who treat and care for them?
- Recognize that high-calorie foods may actually not taste as good to those with eating disorders as those without an eating disorder. This can help friends, family members, and treatment providers who share meals with someone struggling with an eating disorder to support the person’s efforts to try new foods and can help replace frustration or confusion with empathy.
- Recovery might mean eating foods you don’t like. For someone with an eating disorder, eating a balanced diet at regular intervals is a lot like taking medicine for a physical ailment. Sometimes medicine doesn’t taste good, but that doesn’t make it any less essential to regaining health and wellness.
- Taste preferences can change over time. Little longitudinal research has been done to track changes in food preference before, during, and after having an eating disorder, but research in the general population supports the idea that taste preferences change over the lifespan. So there’s reason to believe that maintaining a pattern of regular eating that includes a wide range of foods (high- and low-calorie) will lead to the cultivation of food preferences that are unlinked to nutritional content.
- Try it and see! Try not to assume you (or your loved one with an eating disorder) won’t like a food just because of how it makes you/him/her feel. Many patients receiving treatment on our inpatient unit express that during treatment they discover that they like many more foods than they had previously thought. Approach new foods with an open mind, and be willing to be pleasantly surprised.