This post was written by Jessica Steinbach, MPH, RD.

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Anxiety can impact the majority of our bodies major functions including breathing, sleeping, ability to use logic, talking, and digestion. For folks affected by anxiety and eating disorders, mealtimes can be particularly difficult. Our ability to sense hunger and cravings, and even the effectiveness of our digestion are impacted by the onset of anxiety. Those with irritable bowel syndrome (IBS), or any other persistent gastrointestinal discomfort, know how big of a role anxiety plays in triggering flares and symptoms. Here are ways to reduce mealtime anxiety to help introduce more freedom, joy, and comfort into your day!

What is IBS?

IBS is defined by the National Institutes of Health (NIH) as “a group of symptoms that occur together including repeated pain in your abdomen and changes in your bowel movements which may be diarrhea, constipation, or both.” 

IBS can be triggered by a variety of factors including food, dehydration, lack of sleep, and anxiety. Working with a physician and dietitian is important for understanding your unique triggers and how to address them. 

One important intervention is making mealtimes as calm as possible. This helps our nervous system get into “rest and digest” mode.

How Do You Know If You Have IBS?

IBS requires diagnosis from a physician and often includes physical examination, and at times, blood testing. 

Physicians often diagnose IBS if “you have had symptoms at least once a week in the last 3 months, and your symptoms first started at least 6 months ago” (NIH). 

Diagnostic criteria may vary doctor to doctor and can include three specific types; IBS-constipation subtype (IBS-C), IBS- diarrhea subtype (IBS-D), and IBS- mixed (IBS-M) subtypes which includes both constipation and diarrhea. 

If you suspect that you may have IBS, or have other concerns about your digestion, reach out to your physician for further testing and assessment. 

Recovering From an Eating Disorder While Managing IBS

Eating disorder recovery with IBS can be quite challenging and often takes awareness of physical symptoms, understanding triggers, and adjusting types of food when necessary. 

It can be tempting to push meal times, avoid eating specific foods, or restrict all together to avoid the onset of pain or other unpleasant symptoms, but try to avoid doing this! 

Emerging research in the field suggests that the National Institute for Health Care and Excellence (NICE) guidelines for managing IBS are more effective than other restrictive intervention methods. Restriction is contraindicated when recovering from an eating disorder.

These guidelines include interventions such as having regular meals, avoiding missing meals or leaving long gaps between eating, and reducing caffeinated beverages to three per day. 

And, research shows that gut-directed hypnotherapy can improve IBS symptoms by up to 80%!

It is very important to work with your individual care team to review these strategies and develop a plan that works best for you and prioritizes both easing pain and maintaining recovery. 

Adding Ease into Eating

Explore these strategies to minimize anxiety at mealtime and promote peaceful digestion!

Create a Safe Environment

Eating disorders are often triggered by threats to safety, which increases the importance of bringing safety into the eating environment. How can you adjust your space to introduce calmness, warmth, freedom, and security? Can you change the colors of your eating space? Maybe you can add pictures of loved ones or places that spark joy. Explore what elicits feelings of safety within you and work towards bringing those into our eating space. 

Ideas to Adjust Your Eating Environment:

• Dim the lighting or use lamps instead of harsh overhead lights
• Light some candles
• Turn on calming music
• Use your favorite bowls, cups, plates, and utensils
• Use cloth napkins or other linens with fabric you enjoy the feel of
• Declutter the table or eating space before enjoying your food
• Ask others to eat with you (or alternatively if it feels safer, ask others to give you some space)

Include all the Senses

Sense can be a powerful tool for grounding. What can you bring to meals to engage all of your senses? 

Do you have a favorite smell that can be present at the table? How about a fidget tool to engage tactical senses? Do you need to wear headphones to listen to calming music or an encouraging podcast? Maybe wearing headphones to drown out distracting or unpleasant noises. 

Pay attention to how addition of removal of sensation can change the experience of the meal. 

Set Boundaries 

Consider the boundaries that are necessary to create a safe and calming environment. 

Do you need to silence your phone? Or ask family and friends to refrain from diet talk during meal times? Turn off the news on the TV? It’s OK to voice your needs! 

This is a great time to practice asking for what you need during times of eating. 

Practice Deep Breathing

Deep breathing not only brings relaxation to your body, but it can also help you connect with your body and it encourages more peaceful digestion! 

Connection to the body is imperative during meals. Using breath work to form deeper physical connections with your body can help with understanding physiological cues such as hunger, fullness, pain, and how to respond to each of these cues. 

Wear Comfortable Clothes 

Being physically comfortable can make or break a meal time. Make sure that you are introducing comfort into all aspects of the meal, including clothing. Did you know that tight clothing can impact digestion?

Do you need to change out of your jeans and into sweats? Consider which clothing items bring a sense of ease to your body. Maybe put on your favorite sweatshirt or take off your shoes. 

Comfort is a key part of minimizing unpleasant physical sensations so that we can connect more with the  sensations that help us nourish ourselves. 

Be Mindful 

If mindfulness during meals does not feel attainable, that’s OK! You can skip this point. 

If it does, try checking in with yourself throughout the meal. Are you full? Are you enjoying the flavors and textures of the food? Do you need to make any adjustments to your eating environment? 

Mindfulness can be a great tool to maintain a stress-free eating space. 

Take Breaks 

Meals do not need to be a race. Take your time, and take breaks if you need to. 

Eating at a slower pace can help significantly with digestion. This is especially important if you struggle with any GI distress after meals. 

Eating at a slower pace and taking breaks to check in with yourself could reduce the likelihood of developing stomach pain or other digestive discomfort after the meal. 

Bring Coping Skills to the Table 

What coping skills can you bring to the table (or wherever you eat) to help reduce any anxiety that may develop? 

Do you need to have fidget tools available? What about a coloring or puzzle book? Explore what tools may help shift anxious energy away from your food. 

Recall that breathwork is incredibly simple and can have a significantly positive impact on anxiety and digestion!

Honor Cravings 

Eat what you want to eat! Enjoying food significantly helps with digestion. 

Though food exposures may bring their own feelings of discomfort, working on honoring cravings on a regular basis will help with better digestion, improved nutrition, and a better connection with your bodily cues around food. 

Before you engage in any food exposures, be sure to have a plan for coping strategies you’ll use to help you get through it. 

Reach Out for Support 

Support can be a wonderful tool for minimizing anxiety and promoting peaceful digestion. Eating with a loved one can introduce feelings of love and warmth.

If you do not have any support available in person, consider calling or video chatting with someone who ignites feelings of safety. You may even consider looking into live mealtime support groups — many are free via social media throughout the day.

Support does not always need to be a human! Is there an animal who can serve as your support system during meals? 

Everybody has different needs during mealtime. If one of the skills listed above doesn’t work for you, that’s OK! Focus on the skills that work best for you. 

Sometimes anxiety at meals is inevitable. The goal doesn’t need to be centered around anxious-free eating, but rather reducing and coping through anxiety as much as you can before, during, and after meals. 

Any reduction in anxiety is likely to improve digestion. If you are struggling with incorporating any of these tools, reach out to your care team for support with implementing them! Looking for additional support with anxiety around food? Learn more about our nutrition counseling services.