Choking Phobia and ARFID

swallowing or choking fears -phagophobia 29
swallowing or choking fears -phagophobia

Choking phobia, also known as swallowing or phagophobia, though rare, can have a profound impact on an individual’s life, affecting not only their physical health but also their emotional well-being. In this blog post, we will explore the intricacies of choking phobia and its potential relationship with Avoidant/Restrictive Food Intake Disorder (ARFID) and extreme fussy eating. Additionally, we’ll delve into the promising approach of hypnotherapy in addressing this challenging condition.

What choking phobia looks like to parents

  • Refusal to Eat: Children may consistently refuse to eat or drink, especially certain types of food or drinks.
  • Difficulty Swallowing: They may exhibit signs of difficulty swallowing, such as gagging, choking, or coughing during meals.
  • Limited Diet: They may have a very limited diet, often preferring only a few specific foods or textures that they feel comfortable with.
  • Weight Loss or Poor Growth: Over time, if the phagophobia is severe and untreated, it may lead to weight loss or poor growth due to inadequate nutrition.
  • Avoidance Behaviours: Children may avoid social situations involving food, such as parties or gatherings where eating is expected.
  • Physical Symptoms: In some cases, physical symptoms such as stomach aches or headaches may accompany the anxiety related to eating.
  • Fear or Anxiety: Children with phagophobia may express anxiety about eating, even when they’re hungry, or not even eating. They may worry about food getting stuck in their throat or feel a tightness there. Some kids are concerned about being able to breathe properly while eating. They might eat very slowly or take a drink after every bite. Some avoid eating alone altogether, while others prefer it because they’re embarrassed by their difficulties or fear making noise or a mess. Overall the anxiety is overblown.

Medical investigation for extreme fussy eaters 

It’s crucial for individuals experiencing choking phobia or phagophobia to undergo a thorough medical evaluation,  under the guidance of a healthcare professional. This evaluation aims to rule out any underlying medical conditions that may contribute to swallowing difficulties, such Gastroesophageal Reflux Disease (GERD) , or Eosinophilic Oesophagitis (EoE) or other structural abnormalities of the throat and oesophagus. By addressing potential medical factors first, parents can ensure their child receives appropriate treatment, paving the way for a more comprehensive approach to managing their swallowing fears.

Understanding choking phobia

Choking phobia is characterised by an intense fear of swallowing solid foods, liquids, or pills. This fear often arises from a traumatic choking incident but can also manifest without any specific triggering event. Individuals with choking phobia may experience panic attacks, severe anxiety, and even weight loss due to their avoidance of certain foods.

Phagophobia, ARFID and extreme fussy eating 

The fear of swallowing, centred around the dread of choking, can lead to the development of restrictive eating habits similar to those observed in   Individuals with extreme fussy eating or Avoidant/Restrictive Food Intake Disorder (ARFID). They may refuse certain foods based on texture, taste, or appearance, while those with choking phobia avoid foods due to the fear of choking.

Addressing choking phobia with Hypnotherapy 

Hypnotherapy has emerged as a promising approach for addressing choking phobia, offering a non-invasive and holistic treatment option. By accessing the subconscious mind, hypnotherapy aims to reframe negative beliefs and associations related to swallowing and food consumption. Through guided relaxation and suggestion techniques, individuals can learn to overcome their fear of choking and develop healthier eating habits.
Numerous case studies and success stories highlight the effectiveness of hypnotherapy[1] in treating choking phobia. Individuals who once struggled to eat solid foods or swallow pills have reported significant improvements in their symptoms after undergoing hypnotherapy sessions. By addressing the root cause of the phobia and promoting relaxation and confidence, hypnotherapy empowers individuals to reclaim control over.

Other therapies 

  • Cognitive Behavioural Therapy (CBT): CBT helps you spot negative thinking patterns, challenge them, and adopt new behaviours. It teaches coping techniques like distraction and provides education about phagophobia.
  • Eye Movement Desensitisation and Reprocessing (EMDR): EMDR uses sensory methods, like eye movements or tapping, to ease swallowing-related distress and trauma.
  • Exposure Therapy: This involves gradually facing the fear of swallowing with therapist guidance, starting from less daunting situations and progressing to swallowing food or drink.
  • Medication: Some medications, such as antidepressants and beta-blockers, may be prescribed to reduce anxiety levels during therapy, aiding the treatment process.


Choking phobia can present significant challenges, impacting both physical and mental well-being. However, with the right approach, such as hypnotherapy, individuals can overcome their fear of swallowing and embrace a more positive relationship with food. By raising awareness of this often overlooked condition and exploring innovative treatment options, we can support individuals on their journey to healing and recovery. 

For more info on how I can help your extreme fussy eater with a fear of swallowing why not book a chat with me.




Sahoo S, Hazari N, Padhy SK. Choking Phobia : An Uncommon Phobic Disorder, Treated with Behavior Therapy : A Case Report and Review of the Literature. Shanghai Arch Psychiatry. 2016 Dec 25;28(6):349-352. doi: 10.11919/j.issn.1002-0829.216055. PMID: 28638212; PMCID: PMC5434294.

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