How Meal Support Can Help Recover Eating Disorder
Eating disorders present a confrontation. Across the spectrum of anorexia nervosa , bulimia nervosa , binge eating disorder and other specified eating disorder , all involve conditioned abnormal eating behaviors. Individuals with eating disorders are often afraid to eat or to eat certain foods. This leads to an avoidance reaction: many people with eating disorders avoid meals or foods that they consider dangerous.
However, the body needs to be repaired to recover . Therefore, treatment requires new eating habits that reduce the effects of malnutrition and the eating disorders suffer to a wider range of foods. Often the sufferer has to make these changes in spite of persistent eating disorder thoughts and intense anxiety. Meal support is one tool that can facilitate the transition.
What is meal support?
Meal support is the provision of emotional support during meals, specifically focused on the patient’s help to digest the food on their meal plan and redirecting behaviors that sabotage eating and recovery. Meal support can be provided individually or in groups. Treatment team members , family members and friends can all support meal.
Meal support in traditional settings
Traditionally, many patients have attended residential treatment for eating disorders. Meal support has been an important component of hospital and residential treatment for eating disorders for many years .
In the residential area, all meals and snacks are supervised. Typically, they are highly structured and closely supervised to confront eating disorder behaviors and ensure customers eat.
Recently, treatment options have expanded to partial hospitalization and intensive outpatient treatment programs where supervision of certain meals plays a central role.
However, in an era of cost constraints, many individuals with eating disorders are treated in the outpatient setting . All too often, in my experience, individual outpatient therapy (consisting of 1 or 2 sessions per week with a therapist and / or dietitian) does not take the place of meal supervision to encourage encouraging meal behaviors. Significant repairs take place during meals, including exposure to fear foods and the learning of conditioned eating disorder behaviors (restriction, slow eating, food decomposition, food in small pieces, etc.). During meals, irrational thoughts about food and how it works with your body can be confronted with reality-based ideas and again confront the eating disorder.
Innovative Newer Options
In the growing recognition of the centrality of food and eating to the recovery process , an emerging trend is the provision of food support in additional institutions. Recently, there have been several innovative developments in the field of meal support for eating disorders, making this much-needed support more accessible.
In Family- Based Treatment (CBT) , a new evidence-based outpatient treatment for adolescents with anorexia nervosa and bulimia nervosa, parents are accused of supervising their adolescent at family meals.
The therapist or other trained health professional coaches the parents to help their adolescents eat the foods that will feed them back to health. Parents learn to stay calm in the face of an adolescent’s anxiety attacks and angry outbursts, which are supported by meals including foods they fear.
In addition, there are now outpatient providers who specialize in providing food support to individuals in recovery. Here are some examples:
- Dine Monte Nido was founded by providers who have acknowledged a lack of “real” meal support to help customers work through anxiety related to eating within the outpatient setting. This service offers an additional weekly super-vegan group meal.
- Joie Meal Support is another program that provides individual meal support through “meal partners”, who are trained professionals who prepare meals and eat with clients in their home, school or workplace. They will also help with groceries, cooking, and eating meals.
In my own practice, the dietitian regularly eats meals with clients in different settings and is involved in tasks such as groceries, cooking and planning menus. I see that this support during meal-related activities enables clients to experience fearful situations with support and it facilitates both their problems and the recovery process.
As there is greater recognition that eating disorders affect individuals of all socioeconomic statuses, including many individuals who are uninsured, I believe that additional options for food support will be available. For example, some community organizers are currently discussing the provision of therapeutic meals in the community. Other providers are considering a potential training program as well as a qualification for “meal partners.” Schools may have a teacher or other school staff trained to provide meal support to students who need it, and who can access school support for their illness through IEPs (individual educational plans).
According to Brooke Glazer, RD, co-founder of Joie Meal Support, “Outpatient meal support is helpful at any stage of recovery. It can be used as a prevention to keep one’s in one’s life and out of treatment, used in conjunction with the traditional outpatient team, or used as aftercare to ensure continued success after discharge from a treatment program. We have been successful in assisting clients in all of these stages.
