Franz Kafka (1883–1924) was a visionary writer whose haunting, surreal tales of alienation and bureaucratic absurdity originated the term ‘Kafkaesque’. Nearly four decades have passed since Sándor Fichter first diagnosed him with anorexia nervosa. Reference Fichter1 However, apart from Trosciano’s studies, Reference Troscianko2 the implications of this diagnosis have received little sustained attention in either medical or literary scholarship. Kafka, like many who suffer from eating disorders, was deeply fixated on food. Reference Lydecker, Simpson, Smith, White and Grilo3 It permeated his consciousness, shaped his interpersonal relationships and informed his creative work. In both his life and fiction, food serves as a symbolic matrix through which questions of power, identity and alienation are negotiated. Reference Benbow4
Kafka’s food fantasies
Kafka’s diaries and letters evidence his disturbed relationship with food. They document several surreal and disturbing food fantasies that indicate a deeply conflicted relationship with eating, the body and self-identity. He told his friend and mentor Max Brod:
‘My mind is daily prey to fantasies, for example, that I lie stretched out on the floor, sliced up like a roast, and with my hand am slowly pushing a slice of the meat toward a dog in the corner’. Reference Kafka5
This echoes a diary entry about his body being butchered:
‘Always the image of a pork butcher’s broad knife that quickly and with mechanical regularity chops into me from the side and cuts off very thin slices which fly off almost like shavings because of the speed of the action’. Reference Kafka and Brod6
On 30 October 1911, he recorded what reads like a bulimic reverie:
‘This longing I almost always have, once I feel my stomach is healthy, to heap up in myself fantasies of taking terrible risks with food… I bite into [a sausage] in my imagination with all my teeth and swallow quickly, regularly and heedlessly like a machine… I shove the long rinds of rib meat unbitten into my mouth and then pull them out again from behind tearing through my stomach and intestines… I eat dirty grocery stores completely empty. Fill myself with herrings, pickles and all the bad old sharp foods’. Reference Kafka and Brod6
The passage reveals not only compulsive craving but also a violent, abnegatory undercurrent. The imagery of food ripped out of the body evokes Kafka’s sadomasochism, whereas the frenzied swallowing suggests loss of control. Other entries reflect a fascination with purging. In 1910, Kafka wrote: ‘Tomorrow I am going to treat myself to a stomach pump. I have a feeling disgusting thing will come out’. Reference Kafka5 Although these fantasies appear bulimic, their violent and self-destructive character points to a more profound psychopathology related to food – one expressed not through bulimia, but through the extreme restrictive behaviours characteristic of avoidant/restrictive food intake disorder (ARFID).
Food and family: Franz Kafka
Kafka’s own writings reveal how his anorexia unsettled his family, a pattern illuminated by family-systems theory, which understands individuals through the relational dynamics of their household. Reference Minuchin7 In Kafka’s case, his father’s patriarchal authoritarianism, his mother’s passivity and his sister Ottla’s role as mediator exemplify such systemic configurations. In Letter to His Father, Kafka recalls the oppressive atmosphere of family meals:
‘Because in accordance with your strong appetite and your particular habit you ate everything fast, hot and in big mouthfuls, the child had to hurry, there was a sombre silence at table, interrupted by admonitions: “Eat first, talk afterwards,” or “Faster, faster, faster.”’ These moments, he writes, ‘only became depressing for me’. Reference Kafka8
In Kafka’s world, food was not nourishment; it was a site of anxiety, disgust and alienation.
Kafka’s most salient symptoms were anorexia and food selectivity. He was acutely aware of the emotional toll these symptoms exacted on his family: ‘My sister… is aware that I have been eating practically nothing and now wants to know if I was going to have any supper. But feeling no desire to talk, I just turned and stared at her’. Reference Kafka9 Like many parents faced with a child’s anorexia, his mother struggled to cope; her anguish is palpable: ‘…my poor mother’s whimpering because of my not eating’. Reference Kafka and Brod10 Kafka registers not only her distress but also his own impotence in the face of the disorder: ‘Her helplessness is almost as great as my own’. Reference Kafka11 The differential responses of Kafka’s father (hostile), mother (helpless) and sister (supportive) to his anorexia echo in The Metamorphosis, in which feeding rituals chart shifting familial dynamics. The narrative’s emotional trajectory, from care to exclusion, exposes the fragility of kinship under the demands of disability.
Food and family: The Metamorphosis
In Kafka’s The Metamorphosis, travelling salesman Gregor Samsa awakens to find himself transformed into an insect. Food then becomes a powerful symbol of his changing identity and the disintegration of family bonds under the demands of disability. His initial ‘ravenous’ hunger briefly connects him to his human self, but his visceral rejection of milk – his favourite food – marks the first sign of estrangement from that identity.
Typical of familial responses to sudden disability, initial concern often coexists with adaptive improvisation. Grete exemplifies this through her dietary experiments with Gregor, ranging from fresh provisions to decomposing scraps. His preference for decay signals both cognitive transformation and symbolic abjection. Over time, caregiving devolves into routine: empathy erodes, meals arrive without ceremony and many go uneaten.
‘She shoved any old food in with her foot before hurrying off to work in the morning and at midday. In the evening, without even bothering to see whether he’d touched his meal or not – usually, he hadn’t – she would sweep away the leftovers’. Reference Kafka12
Gregors appetite diminishes as his family’s empathy fades. His starvation – bodily and affective – marks his shift from provider to pariah. This progression mirrors findings of caregiving research, in which compassion often gives way to emotional exhaustion. Reference Liao, Wang, Zhang, Luo, Zeng and Wang13 Kafka’s food symbolism is stark: rejecting milk marks the loss of humanity, preferring decay reflects abjection and the shift from attentive feeding to perfunctory care shows empathy’s erosion. Starvation becomes the emblem of alienation – denying nourishment, love, recognition and dignity – culminating in death.
Food and starvation in Kafka’s fiction
These themes of starvation and emotional deprivation echo across much of Kafka’s work, in which hunger functions less as a literal condition than as an existential, epistemic and psychological form of absence. In Investigations of a Dog, starvation becomes a crisis of knowledge: the dog-narrator is unable to understand where food comes from, and this produces a deeper metaphysical hunger for explanation. His pursuit of answers highlights a world that withholds essential truths, leaving its inhabitants permanently undernourished in both body and mind. A related logic shapes The Burrow, in which an unidentified and ever-present threat drives the burrower into obsessive efforts to secure food and safety. The creature’s elaborate engineering of tunnels and stores becomes a desperate attempt to fend off future scarcity, yet this very vigilance intensifies his fear. Here, securing food and safety symbolises the impossibility of achieving lasting security in a world defined by vulnerability. In Jackals and Arabs, deprivation takes on an ideological form. The jackals imagine themselves starved not only of purity, freedom and justice but also of the very food that would sustain them. They project these grievances on to the Arabs, whom they cast as obstacles to their deliverance. Their ‘hunger’ thus signifies more than bodily need: it represents a craving for absolute solutions, a desire that can never be fed because it originates in myth rather than reality. Here, Kafka reveals how starvation can be weaponised as narrative and ideology. In Josephine the Singer, material scarcity defines the existence of the mouse community, shaping its conflicted reliance on Josephine’s fragile art as a fleeting source of sustenance. Elsewhere, food operates more subtly as a symbolic undercurrent. In The Trial, for instance, the unserved breakfast quietly signals a rupture in the everyday order – a harbinger of the disorientation and dispossession that follow.
Diagnosing Kafka’s eating disorder
The issues that Kafka explored in his fiction resonate with his clinical picture. A medical examination from 1907, when Kafka was 24, recorded him at a height of 5′11″ and a weight of 134 lb; this corresponds to a body mass index of approximately 17, already below the threshold for a healthy weight. Reference Stach14 The same report also noted residual signs of rickets, suggesting dietary restrictions during childhood. Given his family’s prosperity, such deficiencies were almost certainly behavioural rather than economic.
By the early 1910s, as Kafka began producing the literary works that would define his legacy, he adopted a strict vegetarian diet and insisted on obsessively chewing each mouthful 32 times before swallowing. This dietary regime, which persisted until tuberculosis worsened his condition, has been retrospectively viewed as anorexia nervosa in the literature. Reference Troscianko2,Reference Medeiros, Furst and Graham15
Although Kafka meets several behavioural features of anorexia nervosa, he does not exhibit one of its hallmark traits: the body image distortion enshrined in the third diagnostic criterion of DSM-5. Research shows that anorexic patients typically overestimate their body size, especially their body fat, a misperception that often drives restrictive eating. Reference Brown, Shott and Frank16 Kafka’s case is the reverse, as he repeatedly describes himself as puny and frail: ‘My body is too long for its weakness, it hasn’t the least bit of fat’ Reference Gilman17 and ‘Just as I am thin, and I am the thinnest person I know (and that’s saying something, for I am no stranger to sanatoria)’. Reference Kafka18 These views are corroborated by his doctor’s note that ‘His body is thin and delicate (gracil). He is relatively weak’. Reference Gilman17
Body image theory distinguishes between perceptual and attitudinal dimensions of body image. Reference Cornelissen, Widdrington, McCarty, Pollet, Tovée and Cornelissen19 Although Kafka shows no perceptual distortion, his writings reveal a pronounced attitudinal negativity towards his body: ‘I was I, skinny, weakly, slight; you (his father) strong, tall, broad… (me) a little skeleton’. Reference Kafka8 ‘My own body became insecure; I shot up, tall and lanky… the burden being too heavy, the back becoming bent… and so I remained weakly’. Reference Gilman20 Thus, whereas he does not meet the dysmorphic criterion, he does display a persistent and severe negative evaluation of his body.
ARFID
An unexplored dimension of Kafka’s disordered eating is its potential alignment with the newly recognised DSM-5 diagnosis of ARFID. ARFID is characterised by a persistent failure to meet nutritional needs due to avoidance or restriction of food, motivated not by body image concerns – as in Kafka’s case – but by one or more of three factors: (a) a lack of interest in eating or food; (b) avoidance based on sensory characteristics (e.g. texture, taste smell); or (c) concern about aversive consequences such as choking or vomiting. The ‘lack of interest’ subtype, marked by diminished appetite, early satiety and limited motivation to eat, Reference Fonseca, Curtarelli, Bertoletti, Azevedo, Cardinal and Moreira21 seems particularly relevant to Kafka’s personal symptomatology and resonates with the fasting circus performer in A Hunger Artist, who confesses:
‘I have to fast; I can’t help it… I couldn’t find the food I liked. If I had found it, believe me, I should have made no fuss and stuffed myself like you and anyone else’. Reference Kafka22
His capacity for prolonged fasting arises not from heroic self-control but from an innately apathetic appetite. Kafka’s autobiographical portrayal thus anticipates contemporary diagnostic frameworks, offering a literary articulation of a condition that eluded psychiatric nosology for nearly another century.
Kafka’s conception of starvation as an ascetic ritual, intended to purify artistic intention and serve as a portal to perfection and self-knowledge, Reference Kafka and Brod23 echoes Hunger (1890) by Knut Hamsun, Reference Hamsun24 a writer Kafka openly admired. Both texts probe the religious, philosophical and psychological foundations that cast starvation as a pathway to artistic integrity. They interrogate the romantic association between suffering and creativity, exposing its seductive allure alongside its destructive consequences. Whereas Hamsun’s novel concludes ambiguously, with the protagonist’s apparent escape, Kafka, reflecting the high mortality associated with eating disorders, portrays his hunger artist dying alienated, alone and ignored. In doing so, he drives the aestheticisation of fasting to its extreme, fusing the hunger artist’s pursuit of perfection with self-annihilation.
Mirroring the protagonist of A Hunger Artist, Kafka’s diaries and correspondence reveal an impaired appetite coupled with marked dietary selectivity. He maintained a strict vegetarian regimen, subsisting largely on greens and nuts while rejecting meat, which he linked to illness and moral decay. His indifference to food is evident in self-reports such as: ‘The food is the same as usual, and I as indifferent to it as ever’. Reference Kafka25 ‘Didn’t go home for dinner… lack of appetite’. Reference Kafka and Brod26 Summarising his disposition, Kafka observed: ‘My attitude to the food and drink which I myself never, or only in dire need, eat or drink, is not as might be expected’. Reference Kafka27
This disinterest had behavioural consequences: ‘I have been eating practically nothing’. Reference Kafka and Brod26 ‘This morning, I had to regret that my principles would not allow me to eat anything’. Reference Kafka27 ‘The quantity of food I consume at present is insufficient for the body to mend’. Reference Kafka28 Kafka repeatedly lamented his inability to eat or sleep. His chronically low body weight and fragile health, later compounded by tuberculosis, retrospectively correspond to DSM-5 criteria for ARFID, which emphasise persistent nutritional insufficiency resulting in weight loss and somatic impairment. His childhood rickets and recurrent sanatoria admissions further underscore the physiological toll of restricted intake. Taken together, Kafka’s self-documented symptoms – diminished appetite, anorexia, rigid dietary preferences, slow and obsessive mastication, underweight status and pronounced psychosocial distress – converge with the diagnostic profile of ARFID.
Advances in our understanding of eating disorders, particularly the distinction between anorexia nervosa and ARFID, offer a new lens through which to interpret aspects of Kafka’s life and literary output. Behaviours once viewed as asceticism, symbolic fasting or sociocultural responses to food Reference Deleuze29 now reveal an additional, deeper psychological layer: a complex neurocognitive relationship with eating shaped by aversion, sensory sensitivity and existential struggle.
This reframing not only deepens our understanding of eating disorders and Kafka’s suffering but also enriches our reading of his fiction, in which food becomes a intensely personal metaphor for alienation, moral resistance and the pursuit of asceticism driven by neurotypically embodied cognitive impulses. Recognising the biographical, biological and psychological dimensions of Kafka’s food-related themes enables a deeper understanding of how, like his eponymous hunger artist, he transmuted private bodily struggle into art. Significantly, Kafka wrote A Hunger Artist and Josephine the Singer while dying from laryngeal tuberculosis, a condition that caused him agonising pain when eating and speaking. By staging fasting and singing as aesthetic acts, Kafka transforms corporeal suffering into artistic expression; both texts interrogate the ontology of art, its reception and the existential cost of artistic creation. Although retrospective diagnosis remains innately speculative, ARFID offers a compelling framework for interrogation of Kafka’s documented eating behaviours and aesthetic articulation.
About the author
Lawrence Ratna, MBBS, DPM, MRCPsych, is an honorary consultant psychiatrist in the Research Department at St Ann’s Hospital, North London NHS Foundation Trust, London, UK.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Declaration of interest
None.
Ethical statement
This study involves retrospective interpretation of publicly available personal documents. While such analysis entails inherent ethical sensitivities, it is justified by its potential to enhance clinical and phenomenological understanding of eating disorders.
eLetters
No eLetters have been published for this article.