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Changes restaurants could make to accomodate eating disorders

When you’re in rehab for an eating disorder, one of your final challenges before being discharged is going out to eat at a restaurant. It’s the ultimate test, meant to confirm how you respond when confronted with food in the real world. Of course, the experience itself is pretty removed from the “real world”: You’ve already memorised the menu and chosen what to order with your dietitian; you’ve got a slip of paper in your pocket with coping mechanisms; you can’t use the bathroom or put your hands under the table. The atmosphere is tense, the energy weird, and disaster can strike at any moment.

I remember one woman being pulled out of the restaurant by a counselor and the conspiratorial whispers that followed, when, on a field trip to a Cheesecake Factory outside Pasadena, she went rogue and changed her order last minute. I remember the panic bubbling in my stomach when, at a restaurant in Cambridge, my order arrived with a cream sauce the menu hadn’t mentioned. Mostly, I remember feeling unsettled at the end of these outings, unsure if I’d done it right. It must have been unsettling for the servers, too, witnessing this motley table of grown women not speaking to each other, pushing food around their plates. Though in those moments, my anorexia left me far too myopic to register anyone but myself.

My discharge from my final stint in treatment was filled with all the hope and ambition of a graduation — I had learned the skills and passed the tests, and from then on I would have a transformed relationship with food and my body. I pictured doing things I’d missed out on for over a decade: eating snacks, skipping a workout, having carefree meals out with friends. But, as with a graduation, those hopes were a bit out of touch with reality. The world has far more challenges than the bubble of residential treatment, and restaurants are one of the toughest.

These days I eat out a lot, and venture to say I’m pretty chill about it all. But because eating disorders can lie dormant but don’t really ever go away, being attentive enough to notice my surroundings also means I’m highly sensitive to what servers say and do — and I’d wager many others are in the same boat. Servers, after all, are our shepherds through this tricky experience of eating in public, and they can make all the difference between a meal where we obsess over the flavor of the gnocchi and one where we obsess over its calorie count.

Of course, it’s not a server’s responsibility to manage the psychological machinations of an eating-disordered brain. But, as the term “hospitality industry” suggests, restaurants are meant to be welcoming places; and if managers better understood what their service staff might be doing that could trigger someone with an eating disorder, it would be a big step toward creating a space that feels inclusive to everyone. As America’s relationship with food grows increasingly complex, this effort becomes doubly important, and could impact a far bigger group than just those with a diagnosis.

With that in mind, for those working in the hospitality industry, here’s are some changes I would suggest:

Don’t ask to take our order before we’ve finished looking at the menu.

A menu, especially a big one, can be overwhelming to someone with an eating disorder. Having ample time to look it over and come up with a game plan is essential to staying calm, while feeling rushed can make for a very bad evening. If a server asks if I’m ready to order before I’ve decided, there’s no way I’ll say that I need more time — nobody with an eating disorder wants to cause a fuss or attract attention to themselves around food — and I’ll end up choosing in a panic and left with lingering distress. To play it safe, just wait until everyone puts down their menus before asking if we’ve decided.

Don’t make value judgements about menu items.

When I ask for a recommendation between two items on the menu, nothing ratchets up my anxiety more than a server answering in terms of one dish being “lighter” and the other “heavier.” Once those descriptions are out there, there’s no chance my eating disorder will let me order the latter option. Similarly, words like “healthy,” “filling,” or “rich” can be super triggering. Obviously, it can be tough to describe food without using some of these words, but in most cases simply listing the ingredients and primary flavors will give all the information needed without projecting virtuosity or sinfulness onto any item.

Whenever possible, don’t come over to the table when someone is chewing or putting food in their mouth.

Nobody likes to be asked a question when their mouth is full of braised octopus, and that’s doubly true for someone with an eating disorder. For most people who struggle with the disease, eating is a shameful activity, and we want nothing more than to become invisible when doing it. That’s obviously not happening at a restaurant, but as long as someone doesn’t come and address us head-on while we’re chomping away, we can at least pretend. By waiting to check in with a table until people are chatting or taking sips of their drinks, you can avoid leaving someone feeling exposed and embarrassed.

Don’t make comments about how much or little someone ate.

If I clean my plate at a restaurant — which I often do — I’m immediately filled with dread that when the server comes to clear the table, I’ll be hit with the old, “Guess you didn’t like that!” witticism. People with eating disorders don’t want to feel like their eating is being seen, let alone remarked upon in public by a stranger. This is true whether they’re worried about eating “too much” or uncomfortable because they didn’t make a dent. Clearing the dishes without comment, or with a simple “How was everything?” gives people the opportunity to share any feedback without putting someone who is struggling on the spot.

Don’t ask if I “saved room” for dessert.

An eating disorder’s insidious logic requires that food be “earned.” You can’t simply eat a cookie or a sandwich or an apple because you want it — no, you need to have done something to deserve it, something like going to the gym or skipping breakfast or, say, foregoing part of your dinner. The common “saved room” question might seem totally harmless, but it frames dessert as something that’s contingent on a previous deprivation. When someone with an eating disorder hears this phrasing, chances are they’ll deem themselves undeserving of the baked Alaska, even if they really want it. So next time, just ask if we want it.

Don’t — please, please don’t — clear any plates before everyone is done eating.

Nothing ruins a nice meal out like someone taking away my partner’s plate while I’m still eating. A lot of people with eating disorders have a complex relationship with their eating speed — we’re self-conscious about being too slow, or worried that we’re uncontrollable pigs who eat faster than any human on the planet — and anyone who’s been in treatment has dealt with draconian time requirements for meals. Having a busser begin clearing plates while some at the table are still eating reinforces whatever those fears may be (“I ate too fast, I’m disgusting,” or “I’m eating so slowly, everyone is watching”). It’s the mother of all triggering behaviors, the one guaranteed to make me fall into unhealthy thoughts no matter how well I’m doing. So please, leave everything on the table until everyone sits back from their plates.

Of course, I still have work to do on finding healthy ways to cope when something triggering happens while I’m out at dinner. But I also envision a world where those in eating disorder recovery don’t need to sidestep landmines whenever they enter a restaurant, where our stomachs are filled with only hunger or fullness, not anxiety. By shelving the practices above, managers and servers could help create that reality, and make eating at a restaurant the carefree experience I’d always hoped to have — not a test to be passed.

Kate Willsky