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F.O.M.O., Spoon Theory, and Living with Rheumatoid Arthritis

We’re dedicated to sharing the perspectives of people affected by chronic inflammatory conditions like rheumatoid arthritis (RA). That’s why we created, a place where people living with RA can find inspiration, lifestyle advice, tools and disease information. Following is an article from contributor Stephanie Aleite, who is living with RA. Pfizer asked Stephanie to share her story and she was compensated for this article.

For those of you who don’t know what F.O.M.O. is, here is what I understand it to be:  

F.O.M.O.: [acronym for] Fear of Missing Out 

Otherwise known as the feeling of anxiety or fear that other people are experiencing an exciting, rewarding, or fun event/activity from which you are missing out! 

In a sentence: Even though Tommy had to be at work at 7:00 a.m. the next day, his F.O.M.O. got the best of him, and he accepted the invitation to go out with friends. 

In a sentence about someone with RA: Even though Stephanie was experiencing a RA flare-up, her F.O.M.O. got the best of her, and she accepted an invitation to go to the beach with friends. When she returned from the beach, her RA flare-up had worsened and she spent the next three days recovering. 

Anyone can experience F.O.M.O. However, despite having RA, I tend to go against my better judgment and accept invitations to events I probably shouldn’t attend because I’m afraid that if I keep saying “no,” my friends will stop inviting me.  

In an article I authored for, The RA Juggling Act, I briefly discussed pulling out your “I have RA” card when you need to cancel events. But what if you’re tired of constantly pulling out that card? What if you’re convinced that if you miss one more event, your friends will forget you exist?  

In my opinion, the best ways to deal with F.O.M.O. when living with a chronic inflammatory condition are: 

  1. Realizing you won’t always miss out  

It’s easy to get caught up in F.O.M.O. and push yourself past your limits just to ease the anxiety that you’ll stop receiving invitations to fun events. If you’re keeping in touch, I’m willing to bet that your friends and family aren’t going to forget you in the future just because you miss happy hour every now and again.  

Tip: Keep in contact via social media, text, email, and other outlets. Let your friends and family know that even though you can’t always be there in person, you are still aware of, and involved in, their major life events—and even the little things in between.  

Even when you feel guilty about canceling last minute, resist the urge to allow emotional distance to come between you and your loved ones. Set aside time to call your friends on the phone after an event has passed and allow them to give you play-by-play details on how the party went down. They’ll love filling you in on all of the gossip—which guests got along well, and who avoided each other at the buffet table! In turn, you’ll feel good about showing up by getting the scoop – even if you weren’t able to be there physically. 

  1. The quicker you are to “scale back” and prioritize, the more quality events you’ll be able to enjoy 

As a person living with a chronic condition, I often refer to the “spoon theory” to explain how much energy I have each day. For those of you who are new to the RA community, the spoon theory is a common metaphor used to explain the reduced amount of energy a person with a chronic condition has available for performing daily activities (i.e., brushing your teeth, walking the dog, making lunch, going grocery shopping, etc.). For instance, if a person living with RA allots themselves 20 spoons (energy) for each day, and each activity uses a certain number of those spoons depending on how much effort it takes to complete, once you use 20 spoons, you have no choice but to rest until the spoons/energy are replenished. 

Application of the Spoon Theory 

This is how I apply the spoon theory to help me plan ahead. I’ve always been a fan of math, so I use a point system to calculate and prioritize events.  

My simple calculation is: 

Importance of event [on a scale of 0-20]  
Minus (-) cost of spoons (or amount of energy needed to attend event) [on a scale of 0-20]  
Total Value [on a scale of 0-20]  

Event importance variables include:  

  • Guest list (Will your closest family and friends be there? How long has it been since you’ve seen them?)  
  • Rarity of event (Does this type of invitation come up often?)  
  • Fun value  
  • Value to career 

I may rate an invitation to go to the movies with a friend lower on the importance scale than, say, a weekend getaway with my husband in the Florida Keys. Holidays, birthdays and anniversaries also rate higher because they only happen once a year.  

Now, the tricky part. For calculating “cost of spoons,” I like to factor in the number of spoons it will “cost” me to get dressed for, drive to and attend the event. Here are two examples of how I calculated the total value of spoons for a trip to the movies with one of my closest friends who I don’t get to see very often, versus a snorkeling expedition with my folks. 


Movies with my best friend 

Snorkeling with my parents 

Importance of Event 

[scale of 0-20] 

15 points (3 points for the fun factor of the movies plus 12 for rarity of the guest list)  


20 points (15 points for the fun factor and 5 for the guest list – sorry Mom and Dad, but I see you pretty often!

Cost of Spoons 

[scale of 0-20] 

2 points (getting dressed, driving to the movies) 

10 points (snorkeling would easily cost me a full 10 spoons) 

Total Value  

[scale of 0-20; importance of event minus cost of spoons] 

13 of 20 points 

10 of 20 points 


Using this method, the decision becomes easy! Going to the movies with one of my best friends gives me more emotional “bang” for my “buck.”  

Disclaimer: This may not work for everything. Some events no matter how boring or unexciting, require attendance for career advancement, networking, or even avoiding the hurt feelings of your loved ones. For example, as boring as a Lamaze class might seem, being there to offer support to a pregnant friend means going anyway. No calculations needed!  

  1. Ask your friends to give you advanced notice…so you can save your spoons! 

It’s always important to be up front with your loved ones about your physical limitations. One way to do this is to introduce them to the spoon theory!  

Let them know that advanced notice of events means you’ll be able to attend more often. Then—stick with it. Don’t promise “spoon-saving” and then waste them on another event the night before. Also, be sure to let them know that even in the case of spoon-saving, RA flare-ups can be unavoidable. Save the date at least a week in advance and confirm whether you will make it or not the morning of the event. If you wake up with joint pain due to RA and you’re still deciding, inform them immediately that you’re not feeling so hot and keep them updated throughout the day. Let them know at least two hours before the event if you need to cancel. Clear communication shows your loved ones you value your time together and are considerate of their feelings.  

Saving spoons for that special event means less cost of spoons to you and guarantees a better time for you and your loved ones.  

When it comes to F.O.M.O. with a chronic inflammatory condition, there will always be times where you just won’t have enough spoons to make it. Prioritize events that won’t happen often and remember that others happen more frequently. They might seem like can’t-miss opportunities, but, in reality, these events happen every week … so you can catch the next one! 

More on Spoon Theory Economics 

When calculating the “cost of spoons,” think of the spoon theory backwards. Starting the day off feeling great puts you at 0 of 20 spoons “spent,” and starting the day off with a huge RA flare-up puts you at 8 of 20 spoons “spent.” If the cost of the spoons for an event puts you over your 20-spoon daily limit, you may have fewer spoons the next day as a result.  

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Images appearing on this page are actor portrayals. 

Let your friends and family know that even though you can’t always be there in person, you are still aware of, and involved in, their major life events—and even the little things in between.

Stephanie Aleite