Denial and Avoidance May Result in Bad Food Choices

We hadn’t seen our cousin for almost a decade when he appeared for a family celebration. No one recognized him, or more precisely, he was only recognized because his voice remained the same. His former rather unfit, chubby body was now trim, and his food choices at the dinner seemed to be made by a stranger.

The first course, a creamy clam chowder, was left untasted, he choose the broiled fish rather than the steak, asked for a salad without any dressing, and wondered if he could get an extra serving of the vegetables rather than the cheesed potato dish. Being family, no one was polite enough to ignore his new eating persona and so, many questions later, we learned that he had had some heart problems and might be pre-diabetic.

“You know, I was in a complete state of denial about what I was eating,” he told us as he ate his fresh fruit dessert while the rest of us went back and forth to the dessert buffet table. He said,

I assumed I was eating alright and fooled myself into thinking that I ate enough low-fat dairy, vegetables, and fiber, and I avoided red meat. But anyone who knows me knows that I never ate that way. If the food wasn’t fried, or sauced, or a piece of red meat wasn’t big enough for a family of four, then I wouldn’t eat it. And of course, I avoided all the healthy foods as if they were toxic.

The relative, let’s call him Ronald, is not atypical in his dual attitude of denial and avoidance toward what he ate and what he avoided eating. Indeed, many of us use these two mechanisms to rationalize our food choices. “Of course I am eating five daily servings of vegetables,” we tell ourselves, even though we can’t remember when we last ate a more nutritionally serious vegetable than a cucumber. Or, “I eat plenty of calcium-rich foods, even though I avoid all dairy and hate kale.”

Denial may also affect food choices by making it possible to not think about the high calorie, or heart-clogging, or insulin-requiring ingredients in foods we choose to eat. Like Ronald, before he changed, the denier will choose the chowder made with cream, eat the fried dough or deep-fried candy bars at a state fair, slather multiple pats of butter on several rolls, or dig into a massive piece of cheesecake. The attitude seems to be that the less one knows about the ingredients in foods, the less caloric and nutritional harm they can do.

Some of us deliberately avoid eating certain foods, regardless of their nutritional importance, because of aversions to their texture, taste, smell, and appearance. A nephew ate only white foods (bread, chicken, soft cheese) for years despite the efforts of his family to vary his diet. Children sometimes manage to avoid eating what they experience as aversive or disgusting by finding ways of hiding the offensive food, or they enter adulthood determined never (ever) to put the offending food(s) in their mouths.

Vegetables seem to be the class of foods most deliberately avoided, so much so that restaurants stopped serving vegetables along with an entrée due to their lack of consumption. We have a frequent guest at dinner who rarely eats vegetables or salad, despite my efforts to make such foods as palatable as the main course. I am not sure he even tastes them before pushing them to the side of his plate.

Mental health specialists understand denial as a way we have of defending ourselves against thinking unpleasant thoughts or dwelling on events that have caused or will cause emotional distress, such as a death or diagnosis of a terminal illness. According to the APA Dictionary of Psychology, “Denial is an unconscious process that functions to resolve emotional conflict or reduce anxiety.” Denying the reality of a traumatic event gives an individual time to develop coping strategies and absorb the shock of grief or other devastating news.

According to writer Jill Gallagher, being in denial indicates a struggle to accept something that seems overwhelming or stressful. Could one apply this definition to those who struggle with the knowledge that they are making bad food choices, but feel helpless to do anything about it? By denying to themselves that what they are eating may affect their health, they don’t have to confront their inability/unwillingness to change. So denial protects them against guilt and maybe feeling helpless or even hopeless.

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Avoidance behavior as a psychological term describes an attempt by an individual to avoid situations that are stressful. People afraid of public speaking or social interactions, for example, will go to great lengths to avoid those situations.

Difficulty in escaping such situations may be very hard but the alternative, being faced with the stress of giving a thank-you speech or going to a reception, is so great it is worth the effort not to do so.

I have a friend, not young, who has told me how her grandmother who brought her up punished her for not eating everything on her plate by giving her the leftover dinner food for breakfast the next day. My friend hates dining situations in which she has no choice over how much food is served or, in some cases, what is served. She really doesn’t like eating in restaurants and tries to avoid catered affairs like weddings where the food, plated in the kitchen, gives her little choice over what is on the plate. She hasn’t had anyone tell her what to eat for decades, but the avoidant behavior is still there.

It shouldn’t take a potential medical problem to motivate an individual to change his or her eating behavior. The end of denial should not await a lab report, chest pain, or a bone fracture. Similarly, food habits established in the high chair should not influence what is eaten or rejected decades later. Years of avoiding nutrient-rich foods such as those high in calcium, Vitamin C, or iron may affect the health of various organs like bone or immune response.

Ceasing to use denial or avoidant behavior to make food choices may require the help of a health professional. Giving someone a diet plan or chart of recommended foods is only the first step in the process. People should be helped to understand why they were unable or unwilling to make good food choices in the past in order to do so in the present.