What is Phagophobia? 

By Paula Berry, Deputy Head of Clinical Operations, Claimont Health 

Used to describe someone who suffers from a fear of swallowing, Phagophobia can drastically impact someone’s life, causing eating disorders that can have a really negative impact on your health.

Derived from the Greek words; phagein, “eat” and phobos, “fear”, Phagophobia can appear through various symptoms without any physical appearance. Someone suffering from Phagophobia might avoid certain types or textures of food, over-chew their food or complain of food ‘sticking’. 

Often confused with Pseudodysphagia – a fear of choking – Phagophobia refers to being fearful of the act of swallowing, rather than being afraid that swallowing will lead to choking.

At some point in our lives, everybody has experienced the feeling of choking or a reluctance to swallow certain foods or drinks, which is typically an isolated incident that doesn’t hold much thought. But for some, the sensation of choking creates an all-encompassing fear of swallowing which can cause eating disorders and other health complications, leading to anxiety and isolation during mealtimes.

What causes Phagophobia?

The exact causes of Phagophobia are not known, but the condition is typically caused by a singular or series of traumatic events that involved eating; incidents such as choking, abuse or regurgitation. 

Underlying physical or mental health conditions can also factor into someone’s fear of swallowing. Anxiety can manifest itself by causing tension in the throat muscles leading to a feeling of ‘a lump in the throat’. Physical conditions such as having a tracheotomy can make it more difficult to swallow, causing anxiety, which leads to Phagophobia.

Phobias such as a fear of swallowing can also be learnt by watching others. For example, seeing someone experiencing pain while swallowing may also cause the condition to manifest itself within onlookers.

Phagophobia is one of a few conditions that can occur without any identifiable cause or triggers. This makes it difficult to determine the exact cause of the fear and making it harder to treat.

What are the symptoms of Phagophobia?

If left untreated, Phagophobia can be dangerous, as someone suffering from the condition may completely stop eating or drinking, leading to weight loss, dehydration and malnutrition. The fear of swallowing can cause a number of different symptoms, with the most prevalent being the reluctance of swallowing foods, liquids or pills.

Other Phagophobia symptoms include:

• Anxiety and reluctance before meals
• Rapid heart rate and breathing
• Panic attacks brought on by the idea of swallowing
• Eating in very small mouthfuls and drinking frequently to aid in swallowing
• Having an all-liquid diet to alleviate the anxiety of swallowing solids
• Extreme anxiety and fear at the thought of swallowing

How can Phagophobia be diagnosed?

Phagophobia is a recognised phobia in the Diagnostic and Statistical Manual of Mental Disorders – meaning it can be diagnosed through the aforementioned symptoms.

If you think that you might be suffering from Phagophobia your doctor or therapist will determine your symptoms, seeing how long and the extent that they are impacting the different areas of your life.

If you do have an assessment for Phagophobia, your consultant will first rule out any other physical conditions that impact swallowing, conditions such as gastroesophageal reflux disease and dry mouth. 

Other mental health conditions can also be looked for to help categorise the conditions as Phagophobia, these include; eating disorders, anxiety and panic disorders. 

What treatment is available for Phagophobia?

As the condition develops, it can lead to progressively worse eating and drinking habits, causing significant health complications. However, it has been found that Phagophobia does respond well to treatment and several treatment options are available to those suffering from the phobia.

Exposure therapy

This course of treatment gradually exposes an individual to the fear with the support of a therapist, with a long course of treatment to eventually work the way up to swallowing foods and drinks.

Cognitive-behavioural therapy

Using Cognitive-behavioural therapy (CBT) helps a patient discover the negative thought patterns that make up the anxious feelings leading to the fear of swallowing. CBT allows the patient to challenge these negative thoughts and adopt different behaviours to distract and overcome the distress. 

Eye movement desensitisation and reprocessing

This type of treatment uses repetitive actions such as eye or hand movements to distract an individual to stimulate different senses and reduce the distress felt when swallowing.

Medication

Different medications may help reduce anxiety levels, antidepressants and beta-blockers can be used if necessary to reduce an individual’s anxious feelings and thoughts.

Living with Phagophobia

While professional help is recommended for those suffering from the fear of swallowing, there are self-help coping techniques that can help someone overcome the distress. As throat muscles constrict as a part of anxiety, focusing on remaining calm can help relax the throat and ease swallowing.

Drinking liquids between mouthfuls

Sipping a liquid between each bite can ease the swallowing process as it lubricates the mouth, fighting off dry-mouth and the feeling of having a lump in the throat.

Taking smaller bites

Generally having smaller mouthfuls of food may make it easier to swallow than larger portions. Chewing the food thoroughly might also make it easier and reduce some levels of anxiety.

Eating soft foods

Softer foods irritate the mouth and throat much less than scratchy, harder foods do. By using a process of trial and error, an individual can find the foods they are most comfortable eating. 

Using distractions whilst eating

Watching television or listening to music or the radio provides a distraction that might reduce the severity of chewing and swallowing, helping to alleviate anxious thoughts.

Help and treatment for Phagophobia

At Claimont Health, we specialise in treating mental disorders with extreme compassion and professionalism. Our team of highly trained consultants and therapists intently listen to you and offer the best advice and treatments you need to live a happy and fulfilling life. If you suffer from Phagophobia, get in touch today and privately speak to one of our consultants. We are the perfect solution in conquering any form of eating disorders you currently face.