Ritualistic Eating and Eating Disorders

We all have rituals pertaining to food, whether they impact the way we prepare, present, or eat our meals.

Most of the time, these habits are harmless. But sometimes, behaviors can intensify, and point to something more serious going on.

What Are Food Rituals?

Eating rituals refer to any compulsory behaviors involving food, whether they involve the preparation of food, the consumption of food, or other situations involving food or eating.

While they may sound concerning, food rituals can often have a benign origin, including:

• Tradition: These are passed-down behaviors involving food and eating. Clinking glasses when making a toast or blowing out birthday cake candles are examples of food-related traditions.
• Convention: This describes the way something is “usually” done. If you see turkey, stuffing, cranberry sauce, and pumpkin pie on a table, you’ll likely be able to tell what holiday it is, thanks to convention.
• Comfort: Patterns we’ve developed around food or eating can help us feel good. This could be something like ordering the same thing every time at your favorite coffee shop.

It’s very common for people to have individualized and sometimes even strange ways of eating. This doesn’t necessarily indicate the presence of an eating disorder.

But there are some ways to parcel out the difference between quirky behavior and something that’s potentially concerning.

When Rituals Become Problems

Generally, food rituals describe something that’s considered compulsory—or, mandatory—behavior. But how far people are willing to go in order to keep up these actions marks the difference between what’s considered harmless, or potentially harmful.

When someone’s dedication to their rituals becomes so extreme that it impedes their ability to partake in a normal, healthy diet, it’s a good indication that something larger may be at play.

Someone experiencing a problem with ritualistic eating behavior may feel too embarrassed to eat in public, for example, and express undue fear of people teasing them about their habits.

Some people may also feel acute distress if they can’t follow their rituals, which can lead to a number of other anxiety-related issues.

Ritualistic Eating Behavior and Anorexia Nervosa

One of the major symptoms of anorexia nervosa (AN) is the fear of gaining weight.

In their attempt to avoid this outcome, people who struggle with the condition may develop a number of ritualistic eating behaviors. Some of the most common include: [1]

• Pacing: These behaviors are meant to slow the pace of eating. They include taking time to add several condiments, chewing food for a long time, and taking tiny bites over a prolonged period of time.
• Pretending: Someone with AN may mimic eating food, without actually consuming it. This can look like cutting food into little pieces, pushing food around the plate, using specific cutlery, like a very small spoon, or leaving large portions of food uneaten.
• Researching: Looking through ingredient lists, keeping track of calorie content, or determining what food group each item comes from are examples of ritualistic researching behaviors.
• Managing: Behaviors concerning how someone eats their food can be ritualistic, including keeping foods from touching, eating foods in a specific order, choosing foods of just one temperature, or choosing to eat alone.

What Causes Food Rituals in People with Anorexia Nervosa?

Many people with eating disorders, including anorexia nervosa, have elaborate rules and regulations that govern the way they eat. The causes are complex and varied.

Rituals Ease Stress

Anxiety plays a key role in many eating disorders, and many disordered eating behaviors develop as an attempt to control these unhelpful feelings.

Since so much of the stress experienced by people with eating disorders is expressed as a deep fear of food or gaining weight, these individuals can often feel overwhelmed or out of control when they are near food or have to eat.

In these cases, ritualistic eating can be used as a maladaptive coping mechanism. For example:

• Someone with AN may cut up their food into small pieces to control their portion sizes, and make a tiny meal last longer.
• Counting calories can offer assurance that overeating will not occur.
• Being strict about mealtimes can help convince a person they won’t snack too much.

Co-Occurring Conditions Play a Role

Anxiety disorders aren’t the only common co-occurring conditions for people with anorexia nervosa.

More than 40% of people experiencing an eating disorder were found to simultaneously struggle with obsessive-compulsive disorder (OCD) in one formative study. [2]

OCD is characterized by intrusive, unhelpful thoughts that are only quieted by performing a ritual.

Someone who continuously tells themselves that gaining too much weight will make them unlovable, for example, might satisfy that thought by participating in ritualistic eating.

Rituals Hide Disordered Eating

For many people, eating disorders are deeply personal, painful, and possibly embarrassing situations. So rather than speaking to a trusted loved one about their concerns, they may employ eating rituals to mask their condition.

When it comes to anorexia nervosa, cutting food into small pieces can help the person camouflage the true amount of food they’re eating. Using child-sized spoons can also help it look like they’re eating just as much as everyone else.

How Are Food Rituals Treated for People with Anorexia Nervosa?

Generally, when someone seeks treatment for an eating disorder, the program will focus on all aspects of their condition.

But some therapies are designed to target ritualized eating directly.

Exposure Therapy

Because many ritualistic eating patterns develop to cope with anxiety around eating and food, challenging those rituals can be a daunting undertaking. But exposure therapy can help someone face these difficult situations in a safe, controlled environment.

The idea is that continued exposure to these uncomfortable scenarios, coupled with the therapy to help understand the situation, can eventually help someone overcome their fears and break their habits.

Cognitive Behavioral Therapy (CBT)

For many people, eating rituals manifest as an attempt to deal with unhelpful thoughts. Cognitive behavioral therapy works to change those thoughts—and, therefore, help change unhelpful behavior.

And among the many treatments used to address eating disorders, CBT has become one of the most widely-recommended programs, thanks to numerous studies that show its potential for curbing ritualized eating behaviors, among other benefits. [3]

Habit-Reversal Therapy

Some evidence shows that the same mechanics in the brain that allow us to form habits are “hijacked” in the case of eating disorders, reinforcing unhelpful behaviors until they’re deeply ingrained in the brain. [4]

As such, some doctors are now trying forms of therapy that have proven effective at stopping other unhelpful habits to help people struggling with eating disorders.

Finding Help for an Eating Disorder

Still, in many cases, eating rituals are deeply tied to an eating disorder. The best way to help someone overcome these behaviors is by helping them address their condition in toto.

The good news is that it’s never too late to treat an eating disorder. Even if you or a loved one are already expressing unhelpful ritualistic eating behavior, it’s still possible to find the help you need to start on the path to recovery.

References

1. Glasofer, J., Albano, A. M., Simpson, H. B., Steinglass, J. (2016, June). Overcoming Fear of Eating: A Case Study of a Novel Use of Exposure and Response Prevention. Psychotherapy Theory Research Practice Training; 53: 223-231.
2. Neziroglu, F., Sandler, F. The Relationship Between Eating Disorders and OCD Part of the Spectrum. International OCD Foundation. Accessed August 2022.
3. Calugi, S., Chignola, E., Dalle Grave, R. (2019, January 18). A Longitudinal Study of Eating Rituals in Patients with Anorexia Nervosa. Frontiers in Psychology; 10:15.
4. Glasofer, D., Steinglass, J. (2016, September 1). Disrupting the Habits of Anorexia. Scientific American. Accessed August 2022.

Reviewed And Updated By:  Jacquelyn Ekern, MS, LPC on February 22, 2023
Published on EatingDisorderHope.com