Post-Meal Distress in Eating Disorder Recovery: Why It Happens and How to Cope

Believe it or not, eating the food isn’t always the scariest part of meals in recovery. In fact, for anyone struggling in their relationship to food (whether it’s disordered eating or an eating disorder), the time after the meal can often be even more fraught than the meal itself. In these moments, it’s as if the disordered part of the brain is trying to do damage control, because eating anything—and especially a full meal—is its biggest threat and worst-case scenario. Those minutes to hours after your last bite may include a storm of difficult thoughts, emotions, and urges that can feel crippling and insurmountable. Read on to learn more about post-meal distress, why it occurs, and how to move through mealtime aftermath in healthy and supportive ways.

Types of post-meal distress and why it happens

Post-meal distress can come in many different forms: emotional, psychological, and physical.

In terms of physical distress, gastrointestinal pain or discomfort is often the primary symptom. Post-meal fullness and abdominal distension are the most typical GI complaints from people with eating disorders, followed by bloating, nausea, stomach pain, early satiety, constipation, heartburn, and gastritis. “These physical discomforts can exacerbate emotional distress, can be extremely distressing, and may contribute to a cycle of negative thoughts and behaviors surrounding food and eating,” explains eating disorder dietitian Jaclyn Leocata, RDN. One 2021 systematic review shows GI disorders like irritable bowel syndrome and functional dyspepsia (chronic indigestion that comes with bloating and stomachaches after meals) in eating disorder patients are significantly high and often linked to psychological, hormonal, and functional factors.

According to eating disorder dietitian Libby Parker, RD, anyone who has been restricting may experience stomach stretching once they are having regular meals or eating more than their typical intake, because their body has adjusted to different intake patterns and fullness cues. Parker explains, “this stretching, which is a normal response to food and fluid intake, sends a signal to the brain that the person is getting full and to stop eating, and when this happens early in the meal, it can make it physically difficult to eat enough.” She says such physical issues can cause the eating disorder voice to pipe up, saying things like, “You're supposed to honor your hunger and fullness cues, and you are full.” This can be particularly confusing, because while this might sound valid, people in early eating disorder recovery often can’t trust their hunger and fullness cues, and need to actively override them. Parker adds that those with binge eating disorder may have different types of physical distress, like delayed fullness if eating too quickly.

In my practice, I also see clients who experience other post-meal visceral responses—typically triggered by their nervous systems sensing a perceived threat—such as rapid heart rate, sweating, clamminess, and disassociation.

Several of my clients also experience emotional and mental distress following meals. Most commonly, it starts with harsh, judgmental thoughts from the eating disorder brain, telling a story about why eating that meal was the worst thing possible. Those thoughts typically lead to highly uncomfortable emotions, including guilt, anxiety, anger, fear, and shame about the quantity or types of foods eaten, and feeling a loss of control and safety. Such feelings are common for those with disordered eating and across eating disorder diagnoses. “While the specific experiences may vary, the emotional impact can be quite similar across different eating disorder diagnoses,” Leocata says. “For instance, those with anorexia nervosa may struggle with an intense fear of weight gain after eating, whereas people with bulimia nervosa may feel a strong urge to engage in compensatory behaviors like purging, excessive exercise, or future restriction.”

The reasons for such emotional and mental distress are often linked to the psychological and emotional functions of the eating disorder or disordered eating, which are threatened when their rigid food rules and rituals are broken. “Deviating from these rules, even slightly, can provoke significant distress due to feelings of failure or inadequacy,” Leocata explains. Body image may also be negatively impacted, Leocata says, since after eating, someone with an eating disorder might “perceive their body negatively, leading to feelings of disgust and self-hatred. They might catastrophize the consequences of eating or have irrational beliefs about food and its effects on their body.”

Eating disorders and disordered eating also often have an emotional purpose and function as a maladaptive coping tool. So, if someone is using their eating disorder to numb out feelings of sadness by restricting food intake, for example, eating an adequate meal is going to feel exceptionally difficult. Often, they haven’t yet developed healthy ways of coping with sadness or other tough emotions, and so I describe this as being thrown out to sea without a life raft to hold onto. “Emotionally, eating disorders use a fixation on food as a coping mechanism,” Parker says, “and so anything that causes discomfort, whether physical, or against the eating disorder, will create a heightened emotional reaction.”

Additionally, eating disorders often co-occur with other mental health issues like depression, anxiety, and trauma-related disorders, according to Leocata. “These underlying psychological factors can amplify post-meal distress,” she says. When someone’s trauma is at the root of their eating disorder, it can be particularly hard to feel safe after meals, since their body may perceive eating as a serious threat, and old wounds can become entangled with the eating disorder.

How to navigate post-meal distress

Having challenging moments after eating is an inevitable part of eating disorder recovery—but there are things you can do to make those minutes or hours more manageable.

Here are several approaches that you can try to cope with post-meal distress:

  1. Eat slowly and limit fluids. During the meal, Parker suggests eating relatively slowly and avoiding drinking excessive fluids. This will minimize physical distress and promote an easier post-meal period.
  2. Work with a therapist to learn healthy emotional coping skills. One of the hardest parts of recovery can be learning how to feel the full spectrum of human emotions, after months or years of numbing them through behaviors like restriction. However, it’s critical to learn how to navigate all emotions, including the hard ones that can surface after meals, and to replace unhealthy coping tools with life-supportive ones.
  3. Be kind to yourself. There are three steps to applying self-compassion to your experience, according to researcher Kristin Neff. First, extend kindness to yourself instead of judgment; my clients tend to find it helpful to imagine they’re speaking to a loved one who is struggling. You can also show yourself kindness through action, like giving yourself a hug or wrapping yourself up in a blanket with a warm cup of tea. Second, tap into common humanity: remember that you’re not alone and that other people are having difficult emotions after meals, too. Here are some free practices to integrate self-compassion into your post-mealtimes. Lastly, remember that you’re not your thoughts or emotions. Try to be mindful of them instead of over-identifying with them, even though they can feel all-consuming.
  4. Try mindfulness practices. To develop a more mindful approach to your hard thoughts and feelings after meals, be intentional about choosing a specific practice to support the process. Leocata suggests guided meditations (here’s an example of one you can try when flooded with eating disorder thoughts after meals). Many of my clients like to pick a sense (sight, sound, taste, smell, or touch), and engage with it, to help them get more present in the moment and less fused with their thoughts. Research shows such sensory modulation, or self-soothing through sense engagement, reduced post-meal distress by 10 to 20 percent in eating disorder patients. Sensory tools like essential oils, weighted items, and massage and rocking chairs can be helpful for connecting with your body’s senses.
  5. Work with your nervous system. Since the time after a meal can feel emotionally unsafe in recovery, it can be helpful to create a safer internal environment by regulating your nervous systems. Regulating practices include sensory modulation (as mentioned above), using cold water or an ice pack on your face or hands, being with a person who feels safe to you, petting your dog or cat, spending time outside or in nature, and taking several rounds of extended exhale breaths. Parker adds that deep diaphragmatic breathing, which activates the parasympathetic (or rest-and-digest) nervous system, can help calm anxiety.
  6. Choose another post-meal activity. Distraction is a powerful tool, so planning an activity for after meals can be helpful: crafting, journaling, listening to podcasts, reading, watching TV, listening to music, anything that will help take your mind off of the meal or snack. Music might be particularly helpful—research shows music therapy significantly reduced post-meal distress and anxiety in patients with anorexia, when compared with a standard post-meal therapy group. Research also shows that staying occupied and supported after meals can help soften hard thoughts and emotions and prevent compensatory behaviors.
  7. Process feelings after the meal. Whether alone or with a support person, identifying and safely expressing your feelings can provide some relief after meals. Depending on what you’re feeling, safe emotional expression can include talking about it, drawing or painting, journaling, crying, yelling into or punching a pillow, or whatever helps you healthfully express yourself.

Dealing with post-meal distress can be physically, emotionally, and mentally exhausting. However, by taking each meal at a time, and using your tools intentionally and consistently, your brain will build new, supportive neural pathways in place of the destructive ones put in place by an eating disorder.

  1. Hedr, T. (2022). The Overlap Between Eating Disorders and Gastrointestinal Disorders.
  2. ‌Hanel, V., Schalla, M. A., & Stengel, A. (2021). Irritable bowel syndrome and functional dyspepsia in patients with eating disorders ‐ a systematic review. European Eating Disorders Review.
  3. Cleveland Clinic. (2022, January 10). Functional Dyspepsia: Symptoms, Diet, Treatment & Living With. Cleveland Clinic.
  4. Clarke, R. (2014). Sensory modulation and post meal distress at Royal Melbourne Hospital Eating Disorders Specialist Unit. Journal of Eating Disorders2(S1).
  5. ‌Brown, A., Tse, T., & Fortune, T. (2018). Defining sensory modulation: A review of the concept and a contemporary definition for application by occupational therapists. Scandinavian Journal of Occupational Therapy26(7), 515–523.
  6. ‌Bibb, J., Castle, D., & Newton, R. (2015). The role of music therapy in reducing post meal related anxiety for patients with anorexia nervosa. Journal of Eating Disorders3(1).
  7. ‌Monaghan, M., & Doyle, L. (2022). “It stopped you thinking about food” – The experiences of mealtimes and attending a post‐meal support group for young people with anorexia nervosa. International Journal of Mental Health Nursing32(1).

Caroline Young
Contributing Writer, RD
Our Editorial Policy
Get support in your inbox
Sign up to receive helpful articles, videos, and other resources.