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Eating disorders (young people)

Obsessions and rituals around eating

This section includes people describing their experiences of obsessive behaviours and rituals at the time when they were ill. Some people might find reading about these experiences distressing. All the material on this website is intended to support a better understanding of why these unhelpful behaviours in eating disorders happen, how to get help for them and to support genuine recovery from eating disorders.
 
Most people have experienced having thoughts or images in their mind that can be hard to get rid of. When it is impossible to get rid of these thoughts and images, or when they severely affect people’s daily lives, is when it becomes a problem.
 
Many young people we talked with felt that their early issues with food started to become more serious when they grew more “obsessive” and “compulsive”. A few people had been diagnosed with OCD (Obsessive Compulsive Disorder) or had experienced general obsessions most of their life. These obsessions could be related to:
 
• Cleaning and washing, 
• Arranging things in a certain order or lined up in a particular way 
• Constant checking and other routines they felt they “needed” to repeat
• School work. 
 
Obsessions and compulsions were also linked to their eating disorder and many of the young people we spoke with discussed obsessive thoughts and compulsive rituals about eating and weighing Read more about how people overcame their obsessive thoughts and rituals; ‘Talking therapies’ and ‘Working towards recovery’.
 
The purpose of obsessions

When ill, obsessions often served a purpose which made people feel that they had to hold on them. Understanding the reasons behind obsessive habits can help people to start letting go of them. Some described how constant obsessing distracted them from negative things. Obsessive thoughts and behaviours were also linked to the habitual behaviours of eating disorders; restricting, bingeing, purging. Calorie counting and charting became something people did (and felt they had to do) routinely without thinking. Over time, obsessions could become extremely draining. People described how they felt trapped by the need to follow obsessive routines to feel safe. Emily said she was thinking, worrying and planning her routines 24/7. Some described how it felt like every minute of every day was consumed by them.
 

Eva describes how obsessions about eating and weight affected everything she did and thought.

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Age at interview: 17
Sex: Female
Age at diagnosis: 14
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The height of it for me, I would say that it was 100%, because it was everything to me, like even when I was talking to other people I’d look, I’d be looking at them, “Are they skinnier than me? Are they bigger than me? I wonder what they’ve eaten today.” And then I’d start to think about what I’d eaten that day, and then I’d start to think about, “Oh well maybe I should be exercising now.” And everything I did it had to, I’d even be thinking, “How many calories does this burn, what I’m doing?” 
 
And it was like really obsessive and even when I was in hospital if I’d have a meal, and then I would supervision and spend the whole, which is when you’re like you weren’t allowed to go to the toilet or anything for like an hour after your meal. And all I’d be thinking for the whole of supervision was, “I need to pace. I need to go in my room and walk around until I feel happy.” But that would be until the next meal and then I’d spend the whole meal panicking about what I was eating.
 
And then if my parents came to visit, I can’t believe how horrible this thought was I had at the time, but all I could think about was, “I want,” I wanted to go out, but it wasn’t, it was nice to see them, but I wasn’t thinking about spending time with them, all I was thinking about was using the time to burn as many calories as possible. Like if we went to the park we’d have to walk around it, and if my Mum had had a long day at work, and she was like, “Oh we’ll go slowly. We might have a sit down on the bench or something and get a coffee.” I’d be like, I’d get really annoyed and be like “No I want to, come on let’s go,” and if they were ever late, which because the hospital was like an hour or so away from where I lived, they’d, you know they would get stuck in traffic and stuff because it was rush hour when they came to see me. And I’d, if they ever came late I’d be horrible to them. I’d be in a bad mood with them for the rest of the visit, like, “Why are you late? I’ve been waiting for you.” And because I wanted as long visiting time as I could, so when they took me out I’d have time to get rid of as many as possible.
 
Elene described how the eating disorder became the only priority in life and James said how “nothing or nobody else matters to you”;
 
“If you’re watching like a film, you might not remember what you’re watching but you’ll remember every single moment if there’s a meal in the film.” -James
 
“I’d just [have] glazed eyes, brain would be thinking, ‘Food, food, food.’” -Andrew
 
Obsessive habits and rituals could take over a person’s life. It was difficult to understand what a negative impact the rituals had on their quality of life until later on, when looking back on the experiences. Different forms of talking therapies could help people to make sense of their obsessions and learn to live without them. 
 
Calorie counting and recording weight

A common obsession, particularly for people with anorexia nervosa, was the need to count and control calories. Eva said she recorded everything she consumed – even the water she drank. Annabelle described how calorie-counting became so automatic she could quote calories in any food item by heart. People recorded calories by writing them down or kept “a mental tally”. When ill, food became almost meaningless because eating was “a numbers game” and all that mattered was “input and output”, as Ewan put it. Often hand-in-hand with calorie counting went the need to constantly weigh oneself. A “bad number” in the morning could push people to restrict severely for the rest of the day.
 
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Annabelle was counting calories obsessively. She would never eat food if she didn't know how many...

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Age at interview: 22
Sex: Female
Age at diagnosis: 14
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I do write things down, not a lot actually because well I’m a Maths student, and I quite like numbers, so I did it all in my head and I was, and that was another thing that was going on in my head, it was the constant calculating, and also going over it twice just to double check that I’d got the right amount, because it would just be so awful if I’d got it wrong.
 
So I’d always work out things, and estimate calories, and I’d read all these books that had amounts of calories in. I wouldn’t eat a food unless I knew what calories it had in it. Yeah I mean from the age of 10 I’ve known about calories and started counting them now and again. Yeah and it, it’s really hard once you know all there is to know about calories, to forget it. Like I wished that I could but even now I still, I, of course I know what calories are in things.
 
Do you still find yourself counting them?
 
I try not to, but I do, sometimes I just can’t help it, it’s a very automatic thing like, it will be like a subconscious thing that I know how many calories I’m eating.
 
People spent hours finding the foods with the lowest calories possible. Some people said this resulted in trips to the supermarket that could take hours' checking all the labels for different brands to find the one with the least calories but often leaving the shop not having bought anything. Andrew said he would always go down the same aisles and go round the supermarket in the same order. Fiona-Grace said she became obsessed by finding the ingredients with the least calories for a Bolognese sauce.
 
Once in treatment, people we spoke with were often given meal plans to follow, in order to gain weight safely. As many people said they had lost a sense of “normal” eating or portion sizes, meal plans helped them learn to eat well again. For some, following fixed meal plans and being weighed regularly could cause problems because it fed their obsessive tendencies. For them a less structured eating plan worked better. 
 
Eating rituals

Many of those we talked to ate at set times every day. They often organised their days around set meal or snack times and followed a certain ritual every time they ate something. They often ate very slowly and so a meal could take hours. Some would cut their foods into small pieces or did not want different foods touching each other on the plate. Others had to use specific cutlery and plates or set the meal table in a particular order. People could feel highly anxious unless they knew the full nutritional and calorie content of a meal, and to do this many people weighed all their foods. Elizabeth always had to leave half of her plate unfinished. These routines and rituals could help people feel in control.
 

Annabelle used to have food and eating rituals which made her feel safer.

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Age at interview: 22
Sex: Female
Age at diagnosis: 14
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Yeah. I, well, I ate very like slowly and methodically. I’d eat everything separately, I’d cut it up into little pieces which I’d get, always get told off in hospital for doing. I’d have to eat at certain times. I’d have to what else did I do? I liked eating with certain cutlery and bowls. I’d have to, well I’d have to weigh things out, I don’t know if that’s a ritual, or just something that I was doing to count calories. But I can’t remember what else I did. Yeah I think that was it.
 
Okay. Do you remember for why you did that?
 
I don’t know, I think it was like, I think I started off because I thought if ate slower I’d feel like I was eating more. And I’d feel less hungry. And kind of make it last longer. But then it just became a kind of like, I just felt safe doing it. I just felt like I’d rather do it this way, I don’t really want to, this is how I do it, and I’m a creature of habit and I like doing it this way. And that applied to everything, like the bowls, the forks, like, I don’t know, yeah, strange.
 
So it just became your thing that you just did then?
 
Yeah. And another thing I used to do is I used to hoard food. I didn’t used to eat it; I just used to keep it in a drawer in my room. Like anything, like if I went to somewhere and there were like little mini pots of jam or, sachets of sugar, or pots of milk, or biscuits that you get in a hotel I’d take them. And I’d put them into a drawer and hoard it all. I think maybe my thinking was that at a later date when I could allow myself this food, it would be there. So I wouldn’t have missed out on an opportunity. But I never got to that stage, and they just went off. But I just used to hoard food.
People often described themselves as being “obsessed with food”. Some of those had anorexia nervosa and didn’t even enjoy eating food. As they denied their bodies of their natural need for food, it became all they could think about. Reading recipes and cookbooks, watching cookery programmes, cooking for and “feeding” others could become a “substitute for eating”, as Katherine described.
 

Lauren had to watch every food programme on TV, go around the supermarket looking at all the...

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Age at interview: 23
Sex: Female
Age at diagnosis: 20
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I think like when you have an eating disorder you think you’re the only weird person like you and the only one that’s doing all this weird stuff but just like becoming obsessed with like food programmes, for example. I had to watch every food programme that was on TV. Going round supermarkets for like hours and just like looking at all the food that was there but not actually buying or finding it hard to buy it. You know, shopping, the, the day I would go and do my food shop was equally, one of my highlights of the week but also the worst part of my week. And I used to love going round looking at food but then I’d hate having to decide what one I was going to have and I found it very stressful. Just having like my strict timetables. I had to write everything down that, you know, when I was going to get up. What I was going to do. What I was going to eat. Making menu plans, buying recipe books and then using like, there were strange things like I had to use a certain bowl to eat out of. And like for cereal or soups and things like that I had to like use a teaspoon to eat with because in my mind it made it last longer and made me think I was eating more and things like that.

As part of the illness, people could develop unhelpful thoughts and beliefs about food, eating and weight gain. People commonly developed ‘fear foods’ that they thought would cause immediate weight gain. Some described believing that they could gain weight just by thinking of or smelling food.
 
"A form of my compensatory behaviour was I had this notion to punish myself. I remember once I dreamt about eating food, because I was so underweight and I actually punished myself by exercising pretty frequently that morning because I actually dreamt about food. I actually believed in my head that I was going to gain weight from thinking about it.” Lauren
 
Different therapies helped people to make sense of these rituals and thoughts. Therapy helped people to understand that they were irrational, and had a very negative impact on their life and restricted what they could do. See ‘Talking therapies’.
 
Those who had bulimia nervosa said they used to hoard food in their bedrooms but not necessarily eat it. Annabelle had a collection of mini pots of jam, milk and sugar from hotels that she never ate and it would all go out of date. People often developed a compulsive need to do more exercise alongside an unhealthy relationship with food. People felt the need to exercise excessively to make up or punish themselves for eating. This behaviour was linked to having poor self-esteem and low confidence and got better once people’s view of themselves improved. For more information on improving self-esteem see Talking therapies’, ‘Self-help’ and ‘Working towards recovery’ see also ‘Exercise’
 
Recovering from obsessive habits
When people were recovering and began to understand and tackle some of the underlying reasons for their obsessive habits, these patterns began to ease off. They started to feel less need to keep to routines. Looking back, people saw how much time and energy the routines took up. Emily wishes she would’ve “thrown my energies into” other things.
 

Eva explains how Cognitive Behavioural Therapy helped her see that her thoughts about eating and...

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Age at interview: 17
Sex: Female
Age at diagnosis: 14
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In CBT they asked me things like is there anything that’s upset you, and I’d say yeah and then explain it. And they’d be like, “Why did it upset you? What?” And then you’d sort of break the thought down like, say you think, “Oh I can’t wear those jeans today, I look really fat.” And then they’d be like, “What,” like you’d break it down into like thoughts of why you think you look fat. And you’d be like, “Oh because I ate such and such yesterday.” Or, “I just do.” And then you’d realise, “I just do” isn’t really, you know like a valid explanation for it. And you’d think well why, because I’m exactly the same weight as I was yesterday, I can’t possibly have gained a stone in a day, sort of thing, and you think, “Oh maybe I am being irrational.” And it helped in that way to see it laid out like in three parts. Like the thought before, thought afterwards and sort of the rationale behind it. That did help seeing like logical, illogical conclusion sort of thing. It did help doing that.

People found many ways of getting over obsessions and routines through different behavioural, psychological and practical approaches covered in ‘Talking therapies’ and 'Working towards recovery’.

Last reviewed October 2018.
 
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