Supporting Someone Experiencing Eating Distress at Christmas and Beyond: A nervous-system-aware guide for friends, family & supporters

What do we mean by Eating Distress?

Eating distress describes ongoing difficulty with food, eating, or the body that is driven by fear, overwhelm, sensory sensitivity, trauma, or threat responses in the nervous system.

Rather than seeing the person as “disordered”, this framework recognises that many eating patterns develop as protective strategies, intelligent responses to experiences that felt unsafe, unpredictable, or overwhelming at the time.

Someone may meet diagnostic criteria for an eating disorder, but the distress came first.

Common Situations That Can Increase Eating Distress

People experiencing eating distress often report heightened anxiety in situations such as:

• Being watched while eating or having their eating noticed

• Comments about portion size, food choices, or “balance”

• Encouragement to eat more, eat faster, or eat foods that currently feel unsafe

• Eating in front of large groups or unfamiliar people

• Others appearing tense, awkward, or unsure what to say

• Arguments about food, quantity, or timing

• Comments about weight, shape, dieting, or bodies (their own or others’)

• Compliments about appearance (often interpreted as “you’ve gained weight”)

• Being rushed during meals

  
  

These reactions are rarely about food itself, they are about safety, control, and threat.

A Crucial Starting Point

There is no universal “right” way to support someone with eating distress.

What feels containing to one person may feel intrusive or shaming to another.

The most supportive question is often:

“What helps you feel supported around food, and what makes it harder?”

This respects autonomy and reduces well-intentioned but unhelpful pressure.

General Principles for Support

• Avoid commenting on appearance, weight, or eating, even positively

• Remember eating distress is often misunderstood and misrepresented

• Lead with curiosity rather than correction

• Expect anxiety and respond with calm, not urgency

• Avoid unsolicited questions about food or recovery, especially during meals

• If the person raises something themselves, follow their lead

• Avoid diet talk or body-focused commentary about anyone

  
  

The Mealtime Environment

A calm environment helps signal safety to the nervous system.

Helpful conditions include:

• Keeping mealtimes ordinary and low-key

• Minimising rushing, conflict, or last-minute changes

• Remembering eating is not a performance to be evaluated

  
  

Before a Meal

• Where possible, decide what and how much in advance, unpredictability often increases distress

• Some people prefer meals to be served away from the table to reduce comparison

• If others are serving themselves, sitting next to a supportive person can help

• Predictability often feels safer than flexibility during early stages of recovery

  
  

During a Meal

• Light, neutral conversation can reduce internal focus on anxiety

• Background sound (music, radio) can help lower tension

• Avoid staring,even supportive watching can feel threatening

• Avoid commenting on pace, portions, or food choices

  
  

If Protective Eating Responses Appear

(e.g. rituals, avoidance, hiding food)

• These are fear-based coping strategies, not defiance

• If they need addressing, do so quietly, respectfully, and without shaming

• Humiliation strengthens distress; safety reduces it

  
  

Helpful language may include:

• “I can see this is really hard, is there anything that would help right now?”

• “Would you prefer distraction, quiet, or support?”

  
  

Rather than blaming an “illness”, it is often more helpful to recognise:

The distress response can take over when the nervous system feels under threat, this isn’t the person choosing to be difficult.

After a Meal

People differ in how they experience acknowledgement:

• Some find encouragement grounding

• Others experience praise as increasing shame or self-criticism

  
  

Acknowledgement without evaluation is often safest:

• “That looked really hard, you stayed with it.”

• “You got through something challenging.”

  
  

Many people benefit from a planned, neutral activity afterwards:

• watching something familiar

• a board game or puzzle

• gentle movement

• sitting together without talking

  
  

This helps the nervous system settle.

A Final Note for Supporters

You don’t need to get this perfect.

Consistency, respect, and willingness to listen matter far more than saying the “right” thing. And supporting someone with eating distress can be emotionally demanding, support for you matters too.

Why I use the term “Eating Distress”

I use the term eating distress rather than eating disorder because food struggles are usually intelligent responses to fear, trauma, sensory overload, or loss of control, not evidence that someone is broken.

This language reduces shame, avoids identity-fusion, and makes space for neurodivergence and nervous-system-based healing.

A person may still meet diagnostic criteria, but the distress came first.

Eating Distress & Neurodivergence

For autistic and ADHD individuals, eating distress may also involve:

• Sensory sensitivity (textures, smells, temperature, noise)

• Strong need for predictability and routine

• Difficulty eating under observation or social pressure

• Interoceptive differences (hunger/fullness cues)

• Demand avoidance or threat responses when encouraged or praised

  
  

Support is most effective when it:

• prioritises choice and autonomy

• respects sensory needs without judgement

• avoids power struggles or “exposure by force”

• recognises that safety often precedes flexibility

  
  

Progress may look non-linear, and that is not failure.

While I work from an eating-distress framework clinically, I remain fully able to assess, diagnose, and document eating disorders where required for NHS pathways, insurance, or multidisciplinary communication.

The diagnostic label may describe what is happening; the eating-distress framework helps us understand why, and how to support recovery without increasing shame or threat.