This study explored how the phenomenon of meals appeared in the interrelationship between adolescents and young adults (AYAs) receiving high-emetogenic chemotherapy, their next of kin and health professionals in the clinical setting. Data were collected by 140 h of participant observation conducted to gain insights into the nature of how meals appeared in the interrelationship between 12 AYAs (age 15–29 years), their next-of-kin and health professionals. The AYAs were patients with oncological and haematological diseases recruited from three university hospital departments. Data analysis was guided by van Manen's hermeneutic-phenomenological approach. The essential meaning of the phenomenon may be characterized by the overarching theme; ‘Seeking the joy of meals in the shadow of treatment’ and the following three themes: ‘Meals as a necessary evil’ (AYAs); ‘Meals as a matter of love’ (next-of-kin); and ‘Meals in the shadow of medical treatment’ (health professionals). Meals is a multi-facetted and complex phenomenon that has different meanings to AYAs, next-of-kin and health professionals. To the AYAs, meals emerged as a necessary evil in connection with which urges to eat occurred as glimpses of desire. Prominent feelings of powerlessness and food as love were highlighted by the next-of-kin, whereas food and meals appeared secondary to treatment for health professionals, reflecting the traditional biomedical paradigm. The findings revealed that adopting a holistic approach to AYAs concerning meals can have the potential to increase their food intake. •Meals appears as a duty to AYAs with cancer receiving high-emetogenic chemotherapy.•Ensuring adequate intake among AYAs with cancer is a highly complex phenomenon.•Prominent feelings of powerlessness and food as love were highlighted among the next of kin•Meals appears secondary to primary cancer care services.•Adopting a holistic approach concerning meals had the potential to increase food consumption.