Food as a Relational Symptom: A Systemic Perspective on Eating Behaviour

Article written in collaboration with @milionedipsicologia

Abstract. 

This article explores eating behaviour through the lens of systemic-relational psychology, proposing a reading of food not merely as a response to physiological needs but as symbolic and relational language. Drawing on attachment theory, the Milan systemic therapy model, and the Palo Alto school, the article argues that eating symptoms can serve communicative functions within family and interpersonal systems. Clinical implications of this approach and possible therapeutic interventions are also discussed.

Introduction

Eating behaviour has traditionally been studied within neuroscience, internal medicine, and cognitive-behavioural psychology, with primary attention given to the biological mechanisms of hunger, satiety, and metabolic regulation. However, an exclusively physiological reading proves insufficient to account for the complexity of eating disorders and, more broadly, for the relationship each individual develops with food throughout their life.

Since the 1970s, psychological research has progressively recognised the determining influence of emotional, relational, and cultural factors on food choices and eating behaviours (Minuchin et al., 1978). From this perspective, food is not merely nourishment: it is language, symbol, and a tool of communication within systems of relationships.

This article aims to explore the relational dimension of eating behaviour by adopting a systemic lens, with particular reference to systemic family therapy and the contributions of attachment theory and the Palo Alto school.

Food as Language: A Systemic-Relational Perspective

Systemic-relational therapy proposes observing symptoms not as isolated individual phenomena, but as events that emerge within a system of relationships and reflect its dynamics (Selvini Palazzoli et al., 1988). Applied to eating behaviour, this perspective implies that the way a person eats — how much, how, when, in what contexts — cannot be fully understood outside their relational context.

The body, and in particular the relationship with food, can be considered a veritable archive of relational history. When the caregiving figure is not emotionally consistently available, the child develops alternative regulation strategies. Food, due to its immediacy, accessibility, and sensory qualities, can assume functions of consolation, calming, and containment that, under optimal conditions, would have been provided by the primary relationship (Bruch, 2003; Schulman, 2013)

Eating behaviour can serve multiple systemic functions. It may express a distress that is difficult to put into words, acting as an alternative channel for emotional communication; it may signal a relational tension within the family or social group; it may maintain equilibrium within the system, serving a homeostatic function; and it may represent an attempt to adapt to relational dynamics perceived as rigid or threatening.

In this sense, the eating symptom should be read not as individual pathology, but as a form of communication — often the only one accessible to the person at that particular moment in their history (Selvini Palazzoli et al., 1988; Ugazio, 2012).

Early Roots: Attachment, Care, and Nourishment

From the very earliest phases of life, nourishment takes place within a relationship. The act of feeding an infant concerns far more than caloric intake: it involves physical contact, emotional attunement, regulation of internal states, and the experience of safety and caregiving (Bowlby, 1969).

Attachment theory has demonstrated how early relational experiences with caregiving figures contribute to the construction of internal working models — mental representations of the self, the other, and the relationship — that pervasively influence emotional regulation throughout life (Bowlby, 1969; Ainsworth et al., 1978). The body, and with it the relationship with food, thus becomes an archive of relational history.

When the caregiving figure is not emotionally available in a consistent manner, the child develops alternative regulatory strategies. Food — owing to its immediacy, accessibility, and sensory nature — can become one such substitute tool, taking on functions of comfort, calm, and containment that in the early phases should have been provided by the relationship itself (Bruch, 2003).

Empirical studies have associated different attachment styles with specific ways of relating to food and the body. An anxious-ambivalent attachment style may correlate with a hypervigilant relationship with food, characterised by cycles of intense emotional hunger and guilt; an avoidant style may manifest as disconnection from bodily signals of hunger and satiety; and a disorganised style may be associated with chaotic and contradictory eating behaviours (Troisi et al., 2006).

The Meal as Relational Scene: Family Dynamics and Implicit Messages

The table is one of the most quintessentially relational spaces. Mealtime rituals — who cooks, who sits where, what is discussed, how conflicts are managed, what is eaten and what is not — constitute a microcosm of family dynamics (Minuchin et al., 1978).

Minuchin's research on psychosomatic families highlighted how specific relational patterns — including enmeshment, rigidity, conflict avoidance, and triangulation — are frequently associated with the development of eating symptoms in children (Minuchin et al., 1978). In these families, the body of the most vulnerable member becomes the "battleground" on which systemic tensions are played out, tensions that have found no other channel of expression.

The verbal and non-verbal messages transmitted around food also contribute significantly to shaping one's relationship with eating. Phrases such as "if you finish everything, you get dessert" or "be good and you can have cake" link food to rewards, control, and expectations, transforming it into a tool of relational regulation rather than nourishment (Baldassarre, 2024). Similarly, mealtimes experienced as the only space for family connection can load food with very intense and sometimes ambivalent relational meanings.

De Clercq (2021) describes eloquently how, in many families, food becomes a vehicle for unexpressed declarations of love, unmet needs for closeness, and control disguised as care. In these contexts, refusing food can be symbolically equivalent to refusing the relationship, while accepting it may mean conforming to a family script that leaves no room for individuation.

The Attempted Solution: The Contribution of the Palo Alto School

The Palo Alto school, and in particular the Mental Research Institute founded by Bateson, Watzlawick, Weakland, and Fisch, introduced the concept of the attempted solution to describe those behaviours that, although arising as a response to a problem, ultimately serve to maintain and amplify it (Watzlawick et al., 1974).

Applied to eating behaviour, this concept has extraordinary explanatory power. Eating to reduce anxiety provides immediate relief but reinforces the association between negative emotion and food, increasing over time both the frequency of the behaviour and the intensity of distress. Rigid control over eating may originate as an attempt to manage an internal sense of chaos or unpredictability, but ends up further rigidifying the system and amplifying preoccupation with food. Refusal of food may initially represent a claim for autonomy within a family system perceived as stifling, but itself becomes a source of new relational tensions and conflicts.

From this perspective, therapeutic change does not require "eliminating" the symptom, but rather interrupting the cycle of the attempted solution by modifying the context that makes it necessary (Watzlawick et al., 1974). This shift in perspective — from symptom as problem to symptom as failed solution — opens up possibilities for intervention that are radically different from those offered by traditional models.

The Clinical Gaze in Systemic Therapy

In a systemic psychotherapeutic process, eating behaviour is not observed as an exclusively individual problem. Clinical attention extends to the person's relational context, exploring family dynamics and communicative patterns, roles and positions within the system, the meanings that the symptom holds for the various family members, and the ways in which the system organises itself around the symptom (Ugazio, 2012).

The central clinical question is not "why does this person eat this way?" but rather "what purpose does this symptom serve within the system? What would it say, if it could speak? What would happen if it disappeared?" These circular questions (Selvini Palazzoli et al., 1988) allow the symptom to be explored as a relational phenomenon without attributing blame to the individual who carries it.

Della Ragione (2005) describes with precision how, in cases of anorexia, the emaciated body can visually represent a distress that has found no words within the family system — a silent appeal to relationship, expressed through the body precisely because the relationship itself has become inaccessible by other means.

Sarzanini (2022) broadens the lens to encompass social and cultural dynamics, showing how eating disorders in young people cannot be understood outside the wider relational context — relationships with peers, with media, and with social expectations surrounding the body and performance.

Towards an Integrated Reading: Implications and Concluding Reflections

The body of contributions examined here converges towards a coherent theoretical and clinical proposal: eating behaviour cannot be fully understood if isolated from the relational, emotional, and cultural context in which it manifests. Food is language, and as such carries meanings that extend well beyond the nutritional dimension.

Adopting a systemic-relational perspective means recognising that the eating symptom — however painful and dysfunctional — has a history, a function, and a meaning within the system from which it emerged. This recognition does not equate to justifying it or leaving it unchanged: it means understanding it as the best possible adaptation to a context that, at a certain point, offered no alternatives (Minuchin et al., 1978; Ugazio, 2012).

The clinical implications of this approach are significant. An effective intervention cannot be limited to modifying eating behaviour as such, but must necessarily engage with the relational context that sustains it. Systemic family therapy, individual therapy with attention to relational dynamics, and multidisciplinary interventions that integrate the biological, psychological, and family dimensions currently represent the approaches with the strongest evidence base for the treatment of eating disorders (Baldassarre, 2024).

Ultimately, helping a person transform their relationship with food often means helping them transform their relationship with their emotions, their body, and others. Because, as Bruch (2003) reminds us, sometimes food does not only speak of hunger: it speaks of emotions, relationships, and needs that have not yet found words.

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