Anorexia recovery: Challenges with eating around other people

Key Points

• Recovery from anorexia is possible but can take time
• Eating in public during recovery can be challenging
• Staying aware of what to expect can help with navigating recovery
• A support team, including Registered Dietitians, can help with recovery

Eating disorder recovery involves re-learning new ways to navigate everyday life. Although the goal of recovery is ultimately rewarding, all change comes with some discomfort and stress.

Many recovering from anorexia deal with high-stress levels, social anxieties, peer pressure, old triggers, and much more. Anorexia recovery can take months and even years. As the National Eating Disorders Association (NEDA) states, “Slips, backslides, and relapse tend to be the rule, rather than the exception.”

Going through recovery with realistic expectations can help in the journey. Here are some psychological, behavioral, and physical challenges that people with anorexia face during eating disorder recovery.

Fear of weight gain

Anorexia nervosa is an eating disorder of low body weight, a strong fear of gaining weight, a distorted body image, and a strong fear of weight gain. Naturally, many who go into recovery are fearful about gaining weight.

Suzanna Thoe, RD, a Board-certified and Licensed Registered Dietitian, says, “My clients with anorexia are often scared that recovery equals weight gain. This feeling can be terrifying. Many feel like they are losing control of their bodies and identities, and some even miss their eating disorder, even as a part of them wants to break free from their eating disorder. It’s a mental tug-of-war that is complex and exhausting.”

Social anxieties about eating in public

Anorexia recovery may involve anxiety about eating in front of other people. This can be either at home around family and partners, at work, at school, or at larger gatherings. Here are some of the worries that may arise in these situations.

Worrying about other people’s judgment

People with anorexia worry about how others judge their food choices, bodies, and struggles. All of us want a connection with our personal tribes, and people with anorexia are no different. But negative or unhelpful comments like, “Why don’t you just eat?” or “Aren’t you hungry?” can be hurtful. Others may inadvertently bring up potentially triggering topics like weight, diets, or body image.

Even if these comments come from well-meaning and caring individuals, they can be extremely stressful during recovery. As a result, struggles with anorexia often include social isolation and feeling misunderstood.

Learning to navigate negative feelings about food, body, and self-image in social situations is an important part of eating disorder recovery.

Getting competitive about food intake

Social gatherings can trigger intense competition related to food since many people with anorexia are prone to self-oriented perfectionism, where they hold themselves to unrealistic goals.

Thoe, RD explains, “Many compare their food intake with others, and obsess over who eats less, who enjoys their food less, and who can limit their calories the most. This type of thinking means always scanning crowds and noticing or wondering how others perceive them. These types of thoughts can lead to intense guilt, shame, and distress, and could be a trigger for their eating disorder.”

Stress over slips or relapses

Being in social gatherings can be overwhelming when going through eating disorder recovery. After all, going to dinner at a restaurant or someone else’s home means not being able to control the ingredient list and portion sizes. When recovering from anorexia, people may worry that a loss of control over their food could slow their recovery down or trigger a relapse.

Dealing with triggers

A large part of eating disorder recovery is growing aware of personal triggers and developing strategies to manage them. Triggers are often personal and can vary from person to person.

Some may be related to body image, but certain social environments or even negative emotions like stress, sadness, and boredom can be triggers. Traumatic experiences such as abuse, neglect, or other negative life events may have contributed to the disordered eating in the first place. To be effective, the recovery process must address these coping mechanisms.

Getting the right nutrition

For people with anorexia, the dramatic weight loss, extreme calorie restrictions, eliminating essential food groups, potentially purging or binging, and exercising a lot can lead to a host of physical issues.

The body becomes severely malnourished and does not have the ability to function, so it begins to shut processes down to conserve energy. 

According to NEDA, physical issues due to anorexia include:

• Stomach and other gastrointestinal complaints (acid reflux, constipation, bloating)
• Anemia, low potassium, and low blood cell counts
• Cardiovascular issues like low heart rate and electrolyte imbalances (that can cause cardiac arrest)
• Hormonal imbalances that cause missed periods, low thyroid hormone levels, hair thinning
• Dry skin and nails
• Fine hair all over the body (lanugo)
• Weak muscles
• Poor immune function, including wound healing
• Dental issues like cavities, teeth sensitivities, eroded enamel, and more.

These types of issues may make it difficult for people with anorexia to get the right nutrition they need in social situations.

There are challenges, but there is hope. Recovery is possible with a team of professionals and the support of family and friends who help address factors that contribute to the eating disorder.

If you would like help with planning meals and learning to eat in social situations during your eating disorder recovery journey, Fay can help you find a registered dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.