Food is an essential part of our lives. It’s fuel for our bodies that provides us with the necessary nutrients to survive and thrive. But it’s also so much more than this — as food is central to socialising, connection, memories and more.

This article will discuss what a healthy relationship with food looks like as well as how you can check in with this so you know if and when you or a loved one will need to take action.

What is a healthy relationship with food?

Although you’ve likely heard about the importance of a healthy relationship with food, there isn’t one clear cut definition of what this means as this is subjective and variable by nature.

However, most experts agree that the following features play an important role when it comes to a healthy relationship with food (1, 2, 3): 

• The absence of an eating disorder

• No disordered habits such as extreme restriction of food intake, bingeing, purging, excessive exercise, taking diet pills etc.

• Being relaxed and flexible with food - no rules about what can or cannot be eaten

• Consuming enough calories and nutrients regularly during the day

• Enjoying a variety of foods

• Comfortable eating socially and spontaneously

• Not being obsessed, rigid, guilty or anxious about food

• Respecting your body

• Honouring hunger and fullness cues (flexibly)

• Having more coping mechanisms for strong emotions than food alone

• Ability to eat mindfully at times

• Nutrition goals are centred on self-care rather than self-hate 

Some people define a healthy relationship with food as eating ‘intuitively’. This is a specific 10 part framework that was devised by two American Dietitians which they describe as “a personal process of honouring health by listening and responding to the direct messages of the body in order to meet your physical and psychological needs” (4).

Others use this explanation of ‘normal eating’ by Ellen Satter to describe a healthy relationship with food.

Whichever definition you use, you can see your relationship with food is about so much more than just food, this is related to mental health, body image, relationship with movement and more. 

How to check-in with your relationship with food

It's important to check in with your relationship with food regularly, as a difficult relationship with food can have a serious impact on your quality of life and increases your risk of developing an eating disorder. Here are some pointers on how to do this.

Questionnaire’s and Quizzes

There are questionnaires that can be used to assess relationship with food such as the Intuitive Eating Scale 2 (IES-2) and the Eating Disorder Examination Questionnaire (EDEQ) (5, 6). However, these are mainly used in research or with support from a healthcare professional as they can’t provide the full picture by themselves.

Another commonly used eating disorder screening tool is SCOFF which asks the following questions(7):

• Do you ever make yourself sick because you feel uncomfortably full?

• Do you worry that you have lost control over how much you eat?

• Have you recently lost more than one stone in a 3-month period?

• Do you believe yourself to be fat when others say you are too thin?

• Would you say that food dominates your life?

2 or more positive answers is considered to be concerning; but answering yes to any of the questions above is a valid reason to speak to a health professional about this.

As this topic is very nuanced it’s not recommended to use a questionnaire or scale as the only way to check in with your relationship with food, and they are best used with support from an experienced health professional (7).

Monitor your thoughts and feelings around food

Pay attention to the thoughts and feelings that come up related to food. Journaling or speaking to a trusted person might help with digging deeper into these.

Red flag thoughts and feelings to look out for:

• Thinking of food in a ‘good vs. bad’ way — watch out for words like ‘naughty’, ‘treat’, ‘junk’ etc.

• Guilt, shame or anxiety linked with eating

• Thinking or worrying about food all the time

• Food rules e.g. I can only eat 2 slices of bread per day, or I can only eat chocolate on a Friday (etc.)

• Food feels like your only coping mechanism for strong emotions and this feels like a problem

Check-in with your body image

There is a strong link between body image issues and a difficult relationship with food, as being unhappy with your body can be a trigger for disordered eating.

Red flags to look out for with body image:

• Regularly worrying about how your body looks

• Seeing your body differently to how others see you

• Frequently checking your body size using scales, measuring tape, mirrors or your hands

• Feeling that your self-worth is linked with your weight or shape

• Thinking about extreme ways of changing your body

Watch out for physical signs

There are a number of physical signs that your body isn’t being properly nourished. These don’t need to be present for there to be an issue with food and one of these by themselves doesn’t necessarily indicate an issue with your relationship with food; as they can  be linked to a number of things. But if you notice some of the following red flags coupled with food/body image distress, or if you are worried or unsure, please seek an individual assessment from a health professional.

Red flag physical signs and symptoms*:

• A sudden change in weight

• Certain issues with blood test results - your health professional can explore this with you if relevant

• Low blood pressure or heart rate

• Missing or irregular period

• Weakness, dizziness or fatigue

• Always feeling cold

• Frequent illness and slow wound healing

• Digestive issues

• Sleep problems

• Weak muscles

• Frequent injuries and reduced performance

• Developing a layer of fine hair on body

• Dry skin

• Brittle nails

• Thinning hair

Disordered behaviours to look out for

It’s important to be aware of disordered behaviours when it comes to food and eating so these can be dealt with as soon as possible.

Red flag disordered behaviours related to food include:

• Heavily restricting your diet or calories

• Cutting out food groups and eating a very limited number of foods

• Fasting or skipping meals

• Vomiting after eating

• Eating a lot of diet foods

• Following rigid rules about what and when you eat 

• Avoiding eating out or with others

• Spitting out food rather than swallowing 

• Obsessively tracking your food intake or movement

• Compensating for food with exercise

• Binge eating

• Using laxatives, diuretics, steroids or diet pills in an attempt to change your body or lose weight

Would you be concerned for a friend?

One of the most important questions to reflect on when it comes to your relationship with food, is would you be concerned for a friend or family member if they had the same relationship with food as you?

This helps you to take a step back and see whether your relationship with food is free, flexible, nurturing and enjoyable — or on the flipside whether it seems disordered, rigid or difficult. Does it add or take away from your quality of life?

So it’s a good idea to reflect on this question regularly, as our relationship with food fluctuates throughout our life, especially when there’s been a big life change.

Summary

Having a healthy relationship with food has a big impact on your physical and mental health. This can either be a joyful and nourishing part of your life, or it can make your life smaller, more limited and isolated.

So an important part of taking care of yourself is regularly checking in with your thoughts, feelings and behaviours when it comes to food and your body image.

If you have any concerns about this, even just a niggle, then please seek support. The earlier you deal with disordered eating the better the outcomes tend to be. Speaking to your GP is a good place to start. Specialist support from a disordered eating specialist dietitian and mental health professional may be needed, or in higher risk cases a full eating disorder team.