Food Anxiety and Cancer, with Julie Lanford, MPH, RD, CSO, LDN and Debra L. Benfield, MEd, RDN, LDN, RYT

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In this podcast, registered dietitians Julie Lanford and Debra Benfield will discuss food anxiety before, during, and after cancer treatment, including potential causes and healthy ways to address food anxiety at any stage of treatment. Julie Lanford is a registered dietitian with Cancer Services in Winston-Salem, North Carolina. Debra Benfield is a Master’s Level Nutritionist as well as a Registered Dietitian Nutritionist and Licensed Dietitian Nutritionist in Winston-Salem, North Carolina.

ASCO would like to thank Ms. Lanford and Ms. Benfield for discussing this topic.

Julie Lanford: Hello. I'm Julie, and I have been a registered dietitian for 13 years, and almost all of that time has been spent helping people facing cancer. Currently, I work for Cancer Services, a community non-profit in Winston-Salem, North Carolina. I have a master's degree in Public Health. And I'm a board-certified specialist in oncology nutrition, as well as being a registered dietitian. And I write cancerdietician.com. And today, I am here with my friend and colleague, Debra Benfield.

Debra Benfield: Hello. Thank you for having me. So just a few sentences about me, my name is Debra Benfield. And I am also a registered dietitian. I have been in practice about 30 years. And most of my time has been working with folks who have a complicated relationship with food and their bodies, all sorts of disordered eating, as well as actual eating disorders. And I'm also a yoga teacher, so I bring in somatic practices or practices that include the body and breath, along with helping people normalize their relationship with food. So that's what we'll be talking about today, I think.

Julie Lanford: That's right. So our topic today is food anxiety, which is an interesting topic, I think. Having worked in oncology, it's sort of something that, I guess, maybe I refer to on occasion. But the interesting thing is that we don't really have a definition for it in a clinical kind of environment. And so having Debra here, with so many years of experience working with this sort of complicated thing, I wanted to get her thoughts, in terms of, how do you define food anxiety? Or what does that mean?

Debra Benfield: So when you first asked me about this, we did talk about the fact that it is a term that doesn't exist in the world. So I think we've created a lot of anxiety around food. I think our current cultural conversation around food is full of fear and anxiety and very dogmatic belief systems that create more emotion. So the actual definition of anxiety, as I looked it up, is "distress or uneasiness of mind caused by fear." And I think if you apply that to food, it makes perfect sense. That is what I think I work with a lot in my practice, is a sense of distress or uneasiness of the mind, that is actually caused by fear around food choice, which is a very uncomfortable reality. Because we all know we need to eat many times, every day. We can talk about what that feels like. But that's a pretty hard place to be in the world. Because food, in my opinion, is something that brings pleasure into our lives and gives us a sense of energy. And we're going to talk a little bit more about the mental health aspect of how we feed ourselves to nourish ourselves. So that's what I think now exists, as far as food anxiety.

Julie Lanford: Great. So in an oncology setting, there are sort of 2 areas that I see, maybe 2 groups—I don't know what you would call it—regarding food anxiety around time of diagnosis or during treatment or after treatment. So the 2 types, for lack of a better term—1 is when cancer and its treatments cause difficulty with eating or digestion, and therefore that makes mealtime or post mealtime stressful. So some examples on that would be, if somebody has had part of their GI tract removed—so part of their colon—or when they have an ostomy bag, or they just have a change in their bowel habits, where whenever they eat, they have to be located close to a bathroom. Or they have side effects from certain foods that cause them to not want to be in public or that make them afraid that the food they're eating is going to cause a problem. Or if they're...