Social anxiety can take many forms. A common misconception is that social anxiety is an interchangeable term for being shy, but it is much more complex and debilitating than shyness. It can have a serious impact on aspects of your life, from social events, to the workplace, or simply being out and about in public, having to interact with other people or be noticed by them.
What is deipnophobia?
Deipnophobia is a particular form of social anxiety that relates to eating in public or around other people. Its prevalence is not well known, as it has not been studied as extensively as other forms of social anxiety. A person suffering from deipnophobia may suffer from symptoms of anxiety and panic attacks, as found with other forms of social anxiety too, but this specifically occurs when eating in the presence of other people. It is not necessarily related to an eating disorder, but social anxiety and eating disorders are frequently comorbid, meaning they co-occur. For example, people with a history of eating disorders who are conscious of their body image may feel uncomfortable eating in front of others, especially if they have a history of feeling pressured to eat, or if they feel people will judge their eating in relation to their body image.
Deipnophobia can also stem from another anxiety disorder such as agoraphobia - the fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong. Here, eating outside of the home or being in a public place would have caused them anxiety. When we suffer from anxiety in public, our fight or flight system kicks in and makes us feel sick or leads us to need to use the toilet. This fight or flight system is trying to aid our escape from a perceived threat, and it does not work well with eating. Our bodies are telling us not to eat but rather to focus on survival, and so eating can become a stressful experience as we are fighting against our bodily instincts.
What do we know about deipnophobia?
One case study of deipnophobia was published in 2022, which discussed a woman who experienced it only in the presence of her partner, with no history of eating disorders or social anxiety in other situations. The paper refers to the cause of the anxiety as fear of embarrassment, being judged, and loss of control.
The woman in the case study experienced the fear both at home and when in restaurants, and as such it is important to note that deipnophobia is not restricted to being out of the home or outside of a safe space. It is directly related to eating in the presence of others, regardless of location. A restaurant might be more stressful than at home due to the sheer number of people in the building, but this will vary from person to person. The case report by Das et al. highlights the fear of being judged and being embarrassed, a common theme reported by sufferers of social anxiety. Someone suffering from deipnophobia may experience anxiety symptoms such as sweating, dizziness, shaking, increased heart rate and shortness of breath when eating in front of others. These physical symptoms, alongside not being able to eat when feeling anxious, can lead to individuals feeling embarrassment.
My experience with deipnophobia
My personal experience with deipnophobia came as an extension of my agoraphobia. It began as a fear of eating in restaurants with others due to feeling trapped. This was not a fear of being physically trapped like you might experience on a bus or a plane where you can’t exit the vehicle until you reach the destination, but rather a social fear of not being able to just get up and walk away without having to explain myself. Like many anxieties, the fear is not rational, as there is no need to get up and leave the table, but simply not having the option can make you feel trapped.
As a result of this anxiety, I would immediately lose my appetite in any restaurant or setting that involved eating. Being anxious would lead me to feel sick, and before I knew it, I was completely worked up about having to order something to eat. Because of this, I stopped going to places where I’d have to eat in front of others. Bars were fine because there was no social obligation to eat, and places where you can control the amount of food you receive were fine too – for example, a buffet or a meal that involved sharing a platter instead of one meal for myself. It was all related to the social expectation that I should order and eat an entire meal to myself.
As with all phobias, exposure is often a great way to resolve and overcome the fear. I find that as soon as I start eating, the anxiety subsides, and I can get through the meal. However, it’s no fun to dread an upcoming meal with a friend or panic for a week solid about going to a restaurant with colleagues. By continuously going to restaurants and learning that I will be fine once the food comes and I start eating, I have been able to reduce the anticipatory anxiety that comes with it.
How can it be treated?
Deipnophobia is treated in the same way as other social anxiety disorders – via cognitive behavioural therapy (CBT), medication, or a mixture of both.
CBT is cited by the NHS as the best form of treatment for social anxiety. It focuses on a combination of cognitive and behavioural elements, challenging our thoughts and beliefs encouraging us to change our behaviour through exposure therapy and reducing avoidance of the thing we are afraid of.
For deipnophobia, a CBT therapist might encourage you to think about what it is you are afraid of when eating in front of other people, how likely it is your fear will come true, how important it is in the grand scheme of things, the likelihood of whether you are being judged or not and guide you to consider a more positive outlook. For example, thinking ‘My friend is going to judge me for not eating my food’, can be reframed as ‘If I don’t eat all my food, I will take the rest home. My friend won’t judge me for not being hungry, and we will still have a nice time.’ The behavioural element puts this into practice, exposing yourself to the situation and testing these new thoughts in the environment. Once you discover that the anxiety is reduced, you can feel more confident about eating in front of others the next time.
Further research is needed to understand the many different causes of deipnophobia, but the likelihood is that it’s a common issue found in sufferers of social anxiety, generalised anxiety, and people with eating disorders. It can feel debilitating, but it can be treated. I still get nervous when going out to eat with people I don’t know as well as my close circle of friends and family, but I know to stay in the situation and face the fear head-on, so that the next time I face it, it’ll be a little bit smaller and a little bit easier to manage.