The Reality of Dining-Out Phobia and Fear of Eating in Front of Others

The more impatient they get, the more they choke, the more nauseous they feel.

There are people who find dining with others distressing. “Dining-out phobia” is a condition where anxiety and tension rise when eating in front of others or with others, leading to symptoms like nausea, stomach pain, and swallowing difficulties.

Many individuals cite the clean plate rule enforced during school lunches or club activities as the trigger for this phobia. Tomonori Nakanishi, a 48-year-old hospital worker living in Kansai, is one such person who developed dining-out phobia due to the strict “clean plate” guidance in elementary school.

Nakanishi recalls that during the first and second grades, he felt immense pressure from his class teacher’s instruction to eat everything without leaving any leftovers, making lunchtime a painful experience. Although he was a light eater, he didn’t have particular likes or dislikes.

“The teacher’s words, ‘You can’t leave any leftovers,’ felt like an obsession to me.

I felt cornered, and the more I felt rushed to finish within the lunchtime, the harder it became to swallow. Ultimately, I couldn’t finish my food and was made to stay behind until I did. It was extremely unpleasant to be under the scrutiny of my classmates and to be asked, ‘Why can’t you eat?’” Nakanishi explained.

Being unable to eat wasn’t due to picky eating or unappetizing school lunches. It was painful that those around him couldn’t understand this.

As he got older, he would sometimes reduce the amount of lunch by pretending to have a sore throat or a cold.

“In junior high and high school, I had packed lunches, so I didn’t face any issues if I left food uneaten. However, when I went out with friends on holidays and had to eat with them, it was distressing.

Even though I tried to keep pace with everyone by ordering the same menu, memories of the school lunch guidance drove me to feel the need to finish at the same time as everyone else. The fear of being noticed for eating slowly made me feel nauseous.

I’ve never actually thrown up in front of people. But throughout meals, the anxiety of ‘What if I vomit?’ persisted.”

Desiring to overcome this condition, Nakanishi began visiting a psychosomatic clinic during high school. He was diagnosed with panic disorder and was prescribed medication. However, his symptoms did not improve, and he continued to struggle throughout university.

“Parties were tough. At izakayas, where you don’t have to eat much to avoid notice, it was relatively easier. But sit-down dinners with individual plates were quite challenging. Looking back, I feel like I turned down about half of the invitations.”

Experiencing a job change due to dining issues.

After graduating from university and starting a job at a logistics company, Nakanishi experienced a job change due to issues related to dining.

“The company primarily involved long-term business trips, and since we worked in teams during trips, I had to eat with company colleagues every time. I left the company within a year.”

Nakanishi became aware of his “dining-out phobia” about three years ago after coming across information from the Japan Dining-Out Phobia Overcoming Support Association online.

The association describes dining-out phobia as follows:

“It is a type of social anxiety disorder. Individuals experience strong tension and anxiety merely imagining or being in dining situations, and this anxiety leads to avoidance, impacting work, friendships, and romantic relationships, lasting for more than six months.”

Now, 40 years after the onset of his symptoms, Nakanishi reports experiencing them intermittently. 

“When a dining-out event is scheduled, my condition gradually worsens as the day approaches. On the day, I often end up attending in the worst possible state.

However, even if my condition is poor, I always think ‘I’m glad I went instead of avoiding it’ after the event. Therefore, I try not to refuse invitations.”

Although he has not yet overcome his dining-out phobia, Nakanishi feels that he has overcome tough situations.

“I used to think that ‘overcoming’ meant being able to eat normally, but after hearing various experiences from others with the same condition, I now believe that overcoming phobia can take many forms. I am now accepting my dining-out phobia and trying to manage it effectively.”

“I was surprised that there are so many people with the same problem.”

Kenta Yamaguchi (30), the representative of the Japan Dining-Out Phobia Overcoming Support Association, is also someone who has experienced dining-out phobia.

In Yamaguchi’s case, it wasn’t school lunches but rather the strict eating regimen from his high school baseball club that triggered his condition.

“One of the training programs in the club was food training, where during camp we were required to eat two servings of white rice for breakfast and lunch, and three servings for dinner. During the first camp, I couldn’t finish my rice, and in front of all the club members, the coach scolded me, ‘Why didn’t you eat it?’ From that point on, I began experiencing symptoms like nausea just imagining dining situations,” Yamaguchi explained.

However, he found a breakthrough during his university years.

“While working part-time at a restaurant in college, the staff would prepare meals for us after work. But I couldn’t eat much, and those mealtimes with everyone were extremely painful. I decided to talk to the restaurant staff about it, and they told me, ‘You don’t have to force yourself. Just eat what you can.’

It felt like they understood my situation. That kind word made me feel a lot better, and I gradually started eating more.”

 

As his symptoms improved significantly, he discovered posts from others with similar struggles on social media. He researched through books and online sources, learning that dining-out phobia is a recognized mental health condition.

“At the same time, I realized that there was very little information about dining-out phobia, so I decided to share my experiences and the knowledge I had gained through studying on my blog and social media. When I started these activities, I received a lot of responses. I was surprised to find so many people with the same struggles.”

In 2017, Yamaguchi established the Japan Dining-Out Phobia Overcoming Support Association to support others with similar experiences. He is currently involved in various activities, including disseminating information via newsletters and social media, organizing consultations, counseling, lectures, and managing a community for those with dining-out phobia. Additionally, he serves as the editor-in-chief of “Kyuuken | Monthly School Lunch Instruction Training Materials,” where he provides information, training, and lectures on school lunch guidance to educators and related professionals.

The complete meal instruction of forced behavior that seems to be a story of the Showa period and continues to this day in Reiwa.

According to a 2019 survey by the Japan Dining-Out Phobia Overcoming Support Association, 34.7% of those with dining-out phobia identified the cause as compulsory clean plate policies and pressure from others. Of these, 72.1% attributed it to instructions from teachers during school lunches.

“I believe that school lunch guidance has changed. In the past, it was clean your plate, but now teachers reportedly say, ‘If there’s too much, you can reduce it’ before meals.

However, the practice of forcing students to stay behind to finish their food is still heard of. I’ve heard that parents exchange information like ‘That teacher is very strict about school lunches.'”

The Ministry of Education, Culture, Sports, Science and Technology (MEXT) revised its “Guidelines for Food Instruction – Second Edition” in 2019. Chapter 5, “Food Instruction During Lunchtime,” states that the role of teachers is to ensure that lunchtime is a time for students to eat in a pleasant and enjoyable manner with friends and teachers. (Omitted) It is important to create a meal environment where students can eat with peace of mind.

“From my impression at teacher training sessions, it seems that most teachers in the field have not read the MEXT guidelines. While some nutrition teachers might review them, class teachers likely don’t have the time or mental capacity to do so.

Teachers who make students stay behind may be doing so with good intentions, following their own strict guidelines.”

Despite this, Yamaguchi is surprised that such coercive practices still persist in the Reiwa era.

“I hope society will come to recognize that forcing someone is unacceptable. If that happens, I think the number of people suffering from dining-out phobia will decrease.”

As for Yamaguchi’s own experience with dining-out phobia, he says, 

“I no longer experience symptoms severe enough to disrupt my social life, so I consider myself to have overcome it.

Many people with dining-out phobia aim to enjoy dining out, which is a wonderful goal. However, through various approaches, some may come to think, ‘It’s okay to just do things at my own pace because I’m not comfortable eating with others.’ This, too, can be a form of overcoming the phobia.”

When counseling those with dining-out phobia, Yamaguchi always emphasizes, 

“Please don’t blame yourself. Like myself, people with this condition often think, ‘I’m a bad person for not being able to eat.’ Blaming yourself doesn’t solve the problem; it only lowers self-esteem and makes symptoms worse.

So I always tell those affected, ‘There’s no need to blame yourself.'”

Kenta Yamaguchi is the representative director of the Japan Dining-Out Phobia Overcoming Support Association, editor-in-chief of “Kyuuken | Monthly School Lunch Instruction Training Materials,” and a psychological counselor. Drawing on his personal experience of overcoming dining-out phobia, he provides counseling for those struggling with the condition and consulting on school and daycare lunch guidance. His books include “A Textbook on Picky Eating for Children and Parents” (Seishun Shuppansha) and “Magical Words That Change Children Who Don’t Eat” (Tatsumi Publishing).

Click here for the website of the Japan Association to Support Overcoming Fears of Eating Disorders.

For the website of ” Kyuken｜Monthly School Lunch Guidance and Training Materials,” click here.