Content warning: mentions of weight loss and difficulties with eating
"Reet, please eat something, anything! You’re breaking my heart", my mum said whilst anxiously rubbing her hands together.
What is phagophobia?
Phagophobia. I hadn’t heard of it until it landed in my lap. Phagophobia is the phobia of swallowing and is usually followed along by the phobia of choking. To be more specific, it is the fear of swallowing and choking on food.
"Just eat your burger, you won’t choke on it, I promise, you’re safe, you’re with me!" is just one of the things I’ve heard over the years from well-meaning friends and family since I acquired phagophobia. What they don’t know is that just looking at steak can bring me out in a rash, a cold sweat, and an a raised heartbeat.
"It’s a scary predicament to be in when your brain is telling you 'you’re going to choke on this food and die'. Scary and morbid".
Eating became difficult, especially in public. When I first began experiencing phagophobia I lived on soup and yoghurt and the occasional toast with the crusts cut off.
Phagophobia often results in weight loss due to food restriction so is often mistakenly thought of as an eating disorder. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders classifies it as a specific phobia within the category of anxiety disorders.
When eating becomes a source of anxiety
I never realised how often people eat until I developed phagophobia. Whilst other people ate for pleasure, for me eating became an anxious wait to see the menu and figure out what I could eat. I understand why it appeared like an eating disorder to an onlooker, especially when I would say "I had a big lunch so I’m not hungry" or "that coffee filled me up".
No one was able to give me the support I needed because they misunderstood the reasoning behind my behaviour. And so, I started telling a few people about my disorder and doing this helped my meal time anxiety. Most people I told were supportive and would recommend food they thought I could eat.
But where did this fear of swallowing in case I choked come from? The only time I remember feeling like I was choking was when I was aged six and swallowed a whole Jolly Rancher sweet. It stayed lodged in my throat for the rest of the day before dissolving.
Often people with this phobia seek help and advice from an Ear, Nose, and Throat (ENT) Specialist. Cognitive Behavioural therapy is also an option for people experiencing this difficulty. When I told my therapist about my eating phobia she took me to lunch: "let’s tackle this together at the root of the problem", she said. The root of the problem was eating in front of other people.
Once in a cafe, my therapist gently encouraged me to eat something besides soup, so I had a scone with clotted cream and jam. It took me forty minutes, sweat, and tears to eat it.
It’s a scary predicament to be in when your brain is telling you "you’re going to choke on this food and die". Scary and morbid.
- See more: Body-Focused Repetitive Behaviours: the complex disorders that are more common than you think
- See more: I display symptoms that can be scary, bizarre, or unpalatable
Choking on food is the fourth leading cause of unintentional injury death, more common in the elderly and babies.
Whilst I feel safe eating in public with friends and family, I still get the odd butterfly in my stomach when with someone I don’t know well. I sometimes struggle eating burgers and steak and I will never see eye to eye.
There are phobia self-help groups but not where I live. For the time being I’ll just have to force myself to eat lunch in public alone: sometimes successfully but more often than not I wrap my food in a tissue and eat it in the car. Maybe in the future I'll get more support with this condition.