Food + Anxiety

How can experiences of those with food anxieties be used to improve treatment for eating disorders? What types of creative activities, or without food, can help to reduce food anxieties?

The project came about when Sabrina Shirazi was told by diners from Cuisine+Colour that her creative dining experiences helped them to overcome anxieties about eating. She initiated interviews with people in recovery from treatments for their eating disorder and consulted with Bristol based GPs and Wellsprings Healthy Living Centre.

These consultations showed that, by failing to address food anxieties, the current provision for eating disorders has several limitations. Patients can only be referred for hospital treatment if they have reached a specific BMI. This means that, even if patients are underweight and require support, GP’s cannot help unless they lose further weight. There is also little outpatient support for patients once discharged from hospitals, which contribute to a high relapse rate.

Studies show that anxiety disorders are intimately connected with eating disorders yet the co-morbidity of eating disorders and anxiety is not yet fully understood (Swinbourne and Touyz, 2007). According to the charity BEAT 725,000 people in the UK are diagnosed eating disorders yet existing interventions for individuals struggling with disordered eating do not address food anxieties and there is little support outside of the clinical setting. While treatment and understanding of food anxieties might offer scope to improve recovery rates and prevent eating disorders becoming severe, food anxieties currently slip through the cracks in both research and practice.

What did the project involve? 

Food+Anxiety was a co-produced research project which helps people who experience food anxieties and eating disorders to live well as a result of our creative resolve to examine “uncertainties” in the support provided by the healthcare service. The team co-designed a programme of creative workshops that re-encourage positive relationships to food, for people affected by eating disorders and food anxieties.

Food+Anxiety was supported from academics and Bristol Health Advocates with links to Bristol’s Clinical Commissioning Group who worked together, to co-produce creative workshops with clients of BEAT, ABC, Wellsprings HLC and the networks provided by Marcus Munafo and Annie Zimmerman. The workshops offered novel approachs to addressing food anxieties, with the aim of identifying possible interventions that might arise out of what the team learned.

The project involved a programme of four workshops in which participants interacted in creative, playful ways to explore and intervene in anxieties. These workshops were co-designed by expert collaborators and volunteer participants.

In the first month, the team recruited interviewees from their contacts in the Wellsprings and BEAT teams and carried out interviews into experiences of food anxiety. After these interviews, volunteers from amongst the interviewees helped design activities to understand and address food anxieties.

The design sought to build on the successful “Cuisine+Colour” model and creative multisensory interaction was at the heart, but the role of food was decided by participants in each of the workshops. Once the model was designed, it was promoted to clients working with Wellsprings and BEAT who were then able to volunteer to participate.

Who are the team and what do they bring?

  • Marcus Munafò (Biological Psychology, University of Bristol) is a researcher who explores lifestyle behaviours and health. He has experience in epidemiology, human laboratory studies, and intervention studies (including treatment development, field trials and clinical trials).
  • Annie Zimmerman (Experimental Psychology, University of Bristol) is a psychological researcher, specialising in eating behaviour and disordered eating. She has expertise in eating disorder treatments and the psychology behind them, as well as in clinical interviews, mental health support work and working with challenging and sensitive groups.
  • Elaine Flint (CEO, Wellspring Healthy Living Centre) is Chief Executive at Wellspring Healthy Living Centre, which is the health and wellbeing hub for inner-city and east Bristol. Elaine has deep roots in Bristol’s voluntary and social enterprise sector having previously run Social Enterprise Works and the Southville Centre.
  • Laura Colebrooke (Geography and Planning, University of Cardiff) is a human geographer and brings expertise in science and technology studies and agro-food studies and is a member of the Sustainable Places Research Institute and the Social and Cultural Geography research group.
  • Sabrina Shirazi (Cuisine+Colour) is an artist who has produced high profile public food events for the past 4 years, through projects such as Cuisine+Colour,  as well as bespoke food projects for Shambala and Camp Bestival. She produces meals that challenge the etiquette of fine dining through creativity.

What were the results?

The project resulted in a dining experience activity. The process consisted of interviews with people with a history of eating disorders, then out of these interviews emerged a methodology for doing creative focus groups. The methodology co-produced through this project were workshops in which participants were brought together to talk whilst doing pottery. This was then followed by a dining experience for participants and also people working in this area to share and talk together.

The dining experience utilised colourful food and was set up in a way to prevent the use of knives and forks. Rather, participants ate straight off the table cloth while wearing white aprons. The idea behind this was to replace the anxiety of eating with a fun creative experience in which no one can eat ‘correctly’. Rather, classic cutlery was replaced by funny and odd implements that could be used to try and pick up food or spread items etc. This prohibited a culture of ‘eating with etiquette’ to foster a more relaxed eating environment. After the dining experience ceramic plates were  created that were decoupaged with quotes from the interviews about eating.