Understanding Fight, Flight, and Freeze in Anorexia Recovery

Why recovery often feels harder than the illness itself

When someone you love is recovering from anorexia nervosa, it can be deeply confusing and distressing to watch their reactions to food and weight gain. They may become angry, withdrawn, or seem to shut down entirely. These behaviours often leave caregivers feeling helpless and hurt, but they are not signs of 'non-compliance' or defiance. They are signs of survival.

What you’re seeing is the body’s acute stress response , better known as fight, flight, or freeze , in action. This automatic physiological reaction is the nervous system’s way of protecting us from perceived danger.

The Biology of Survival

Our stress response evolved to keep us alive in life-or-death situations. When we encounter a threat, the brain signals the sympathetic nervous system to kick in. Hormones like adrenaline and norepinephrine flood the system, preparing us to fight off a predator or flee from danger. This can cause:

• Rapid heart rate

• Increased blood pressure

• Tense or shaking muscles

• Heightened vigilance, fear, or aggression

There’s also a third option: freeze. This is a shutdown or immobilisation response that kicks in when fighting or fleeing doesn’t feel possible , like a deer frozen in headlights or a child in an overwhelming situation going quiet and still.

These responses aren’t conscious choices. They are automatic, hard-wired reactions designed to keep us safe.

Ancient Responses in a Modern World

Our brains don’t always distinguish between physical danger (a predator) and psychological threats (public speaking, exams, or, in the case of anorexia, food and weight gain). The body responds in the same way : as if its survival is at stake.

For someone in recovery from anorexia nervosa, the most essential part of healing , eating food and gaining weight , feels exactly like a threat to survival. Their nervous system reacts accordingly.

For someone in recovery from anorexia nervosa, the most essential part of healing , eating food and gaining weight , feels exactly like a threat to survival. Their nervous system reacts accordingly.

Anorexia Recovery and the Stress Response

While someone is actively unwell with anorexia, they often manage their intense fears by avoiding them: skipping meals, restricting food, weighing themselves obsessively, or engaging in rituals that soothe the eating disorder. In this state, their anxiety may feel oddly manageable.

in recovery, we're asking them to confront these fears multiple times a day. Every meal, every snack, every bite, becomes a threat to the eating disorder, and, to their nervous system, a threat to survival.

This is why recovery often feels so much harder than the illness itself and why extreme behaviours during recovery are not unusual. Here’s how each branch of the acute stress response may show up:

FIGHT

The “fight” response targets the perceived source of threat which might be a parent, therapist, partner, or even their own changing body.

You might see:

• Verbal or physical outbursts

• Rage directed at loved ones or professionals

• Intense self-criticism, self-harm, or suicidal feelings

• Hatred or aggression toward food (e.g., throwing plates or food)

This is not a reflection of your loved one’s character or how they feel about you. It’s the nervous system’s attempt to reject the perceived danger.

FLIGHT

The “flight” response tries to escape the threat.

You might see:

• Running away from meals or treatment

• Locking themselves in their room

• Avoiding firm caregivers, isolating or gravitating toward those who seem “easier”

• Skipping appointments or disappearing from treatment settings

Again, this is not a rational choice. Their body is screaming 'get away' , even if the threat is just a bowl of pasta or a therapist’s expectations.

FREEZE

The “freeze” response can look like silence, stillness, or shutting down.

You might see:

• Total withdrawal during meals

• Difficulty swallowing or picking up a fork

• Non-responsiveness in therapy sessions

• Appearing “zoned out” or dissociated, especially around food or weight conversations

Some people in freeze may need meal support or, on occasions, even tube feeding — not because they are refusing help, but because their body has gone into protective paralysis.

What This Means for Families and Supporters

If your loved one seems to be fighting you, avoiding meals, or shutting down entirely, please know: this is not a failure. These are expected responses to recovery that reflect just how intense their fear is.

It’s also a sign that the eating disorder is being challenged, which is essential for recovery. If no distress is being triggered, it could be a sign the anorexia is still running the show.

This can be one of the hardest parts of supporting someone with anorexia — watching them struggle, knowing you're doing what’s necessary to help them heal. It’s painful, but it’s purposeful.

Staying the Course

As a caregiver, you play a vital role in helping your loved one move through fear toward safety. That means:

• Continuing to provide consistent, full nutrition

• Supporting prompt and complete weight restoration

• Staying grounded, even when the acute stress response is at its peak

• Holding compassionate boundaries and staying connected through the storm

Recovery takes time, courage, and enormous resilience — from the person healing and from the people who love them. These stress responses will ease as the body and brain relearn that food is not a threat, that weight gain is not dangerous, and that safety can be found again.

These stress responses will ease as the body and brain relearn that food is not a threat, that weight gain is not dangerous, and that safety can be found again.

You are not alone. The fight, flight, and freeze reactions are part of the process and they will eventually pass . Keep going. Keep showing up. Recovery is not just possible — it’s worth it.