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Contributor: Valerie Carpenter, MS, RDN, LD, adolescent dietitian, Laureate Eating Disorders Program.
If a friend offers a toast to you before taking a sip of their drink, do you clink your glass with theirs before taking a sip of your own? Do you ever blow out birthday cake candles before “Happy Birthday” is sung? If you see turkey, stuffing, cranberry sauce, and pumpkin pie on a table, can you immediately tell what holiday it is?
Do you always go to the same coffee shop (yes, the barista knows you by name), always order coffee with one creamer and two sugars, always sit at the same table and always work a crossword puzzle in black pen?
All of these are examples of rituals. Food rituals are a historical part of our society and can often be traced back for hundreds of years. Food rituals are a part of everyday life. A majority of the time people don’t give them a second thought. However, when you take into account the presence of an eating disorder, then those seemingly innocent food rituals can take on a life of their own.
What are Eating Rituals?
Eating rituals refer to any compulsory behaviors around food, the preparation of food, the consumption of food, or any situation involving food or eating (1). Keep in mind, however, that the presence of ritualistic eating does not necessarily denote an eating disorder. Many sufferers of obsessive compulsive disorder (OCD) have extreme rituals around food and eating, however, they display no other symptoms of an eating disorder (2).
Because eating rituals have become so ingrained in our culture, it can be difficult to identify the presence of an eating disorder solely based on ritualistic eating behaviors. For example, if your friend always eats the crust of a sandwich before eating the middle, you don’t necessarily need to cry “EATING DISORDER!”
Remember that it is very common for people to have individualized and, yes, sometimes strange ways of eating that do not denote the presence of a life-threatening illness such as anorexia or bulimia nervosa. So how can you tell the difference?
Examples of Disordered Eating Rituals
What are some examples of eating rituals associated with eating disorders?
- Cutting food into small pieces before eating
- Arranging food a certain way on a plate
- Only eating foods in a specific order
- Weighing and measuring food
- Only using specific plates or utensils to eat foods
- Disassembling food items
- Counting calories and sticking to a specific calorie limit
- Only eating at specified times or places
- Checking portion sizes, sometimes multiple times
How do Eating Rituals Play into Eating Disorders?
Eating disorders are a very anxiety-driven illness. Because of the high stress associated with that anxiety, it is natural for eating disorder sufferers to try to find different ways to cope with their struggles. Human beings typically derive comfort from the familiar – sticking with the same way of doing things, and for eating disorder sufferers, that comfort is key.
Add to that fact that a study found that around 11-13% of sufferers of OCD also suffer from eating disorders (3), and you get the perfect storm for developing ritualistic eating behaviors. However, this is not to say that ritualistic eating patterns only occur in anorexia nervosa.
Binging can often have ritualistic aspects, for instance if someone only binges at a certain time of day, or with a certain food item.
Using Food as a Way to Control a Stressful Situation
Eating rituals can often evolve as a way to control a stressful situation around food and eating. Because eating is so difficult for people who suffer from eating disorders, they can often feel overwhelmed or out of control when they are near food or have to eat.
People can develop rituals as a way to calm themselves down, giving them the illusion that they have more control over the situation. In this way, chopping food into small pieces becomes a way to control portion sizes. Counting calories becomes a way to ensure that overeating will not occur.
Only eating at specific times of day ensures that snacking will not happen. Most eating disorder rituals can be traced back to a fear centered around eating or food, and evolved into a compulsion as a way to quell that fear.
When the Behaviors Take Over a Person’s Life
While some food rituals with eating disorders may seem mundane, keep in mind that although they can seem inconsequential (watching your portion sizes is a GOOD thing, right?), they can grow into a huge problem.
For example, an individual with ritualistic eating problems can feel too embarrassed to eat in public due to the fear of people teasing them about their odd behaviors – which in turn leads to a convenient excuse as to why this individual can no longer eat in public, and thus becomes one more way for this individual to engage in their eating disorder.
How Do You Challenge Ritualistic Eating?
Because a lot of ritualistic eating patterns develop as a way to cope with anxiety around eating and food, challenging those rituals can be a daunting task. Remember to keep in mind that not only are you asking a person to engage in an activity, eating, that can be a terrifying experience for them, you are also asking them to give up doing the rituals that make them feel more comfortable around eating.
Many of the techniques used by health care professionals in the treatment of eating disorders and ritualistic eating involve continued exposure to the situation that is causing the patient to struggle without the presence of their ritual.
The individual needs to learn that not engaging in their ritual will not cause the world to stop spinning or their weight to spiral out of control or whatever it is that they fear. Although often not a pleasurable experience, going through the act of engaging in an eating behavior without the presence of the patient’s ritual is the best way to challenge the fear of eating.
- Herpertz-Dahlmann B. Adolescent eating disorders: definitions, symptomatology, epidemiology and comorbidity. Child Adolesc Psychiatr Clin N Am. 2008;18(1):31–47.
- Altman SE, Shankman SA. What is the association between obsessive–compulsive disorder and eating disorders? Clin Psychol Rev. 2009; 29(7):638–646.
- Sallet PC, de Alvarenga PG, Ferrao Y, de Mathis MA, Torres AR, Marques A, Hounie AG, Fossaluza V, do Rosario MC, Fontenelle LF, Petribu K, Fleitlich-Bilyk B. Eating disorders in patients with obsessive-compulsive disorder: prevalence and clinical correlates. Int J Eat Disord. 2010;43:315–325.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on April 22, 2015
Reviewed And Updated By: Jacquelyn Ekern, MS, LPC on April 16, 2019.
Published on EatingDisorderHope.com