Meal Support Strategies: How to Support Loved Ones in Recovery
How To Make Mealtimes More Manageable During Recovery
Coping with an eating disorder in the family can be overwhelming. Meal times can be especially difficult for everyone. The strategies outlined below can help lower anxiety and arguments at meal time, and help your loved one complete their meal.
REMEMBER: 4C’s of Meal Support:
Remain CALM: your loved one will pick up on your anxiety, and this could make them more anxious
Be CONFIDENT: The more confident you appear, the more reassured they will feel
Be CONSISTENT: Stick with what you have decided and don’t negotiate
Be COMPASSIONATE: Understand that they are doing something that is terrifying for them
Meal Planning:
Plan meals ahead of time with or without your loved one. Take into account where they are in their recovery, and the level of stress and anxiety meal planning could create. This can help lower anxiety, minimize negotiation, and ensure adequate nutrition.
Plan several days in advance: This will give you time to work through any disagreements that you and your loved one may have about the planned meals
Provide only minimal choices: a few choices can be helpful, and provide positive food challenges, but too many options can be overwhelming for your loved one
Address who, what, when and where: Be specific about who will be involved in the meal, what you are going to eat, what time you will eat, and where the meal will take place
Provide meals at consistent times: Plan meals to be ready and on the table at consistent times from day to day. This practice creates an environment of mechanical eating.
Mechanical eating is the method used to re-nourish your child in the beginning of their eating disorder recovery, when their child’s hunger and fullness cues are no longer present due to ED.
Mechanical eating is vital in the restoration of hunger and fullness cues in the body. Mechanical eating is also known as “eating on the clock”. It is essentially an eating schedule that must be followed regardless of how your child feels.
Meal Preparation:
Your loved one will want to be involved in the meal preparation and serving, but this can be very triggering and stressful for them. Your loved one may be worried about ingredients, calories, serving sizes, and types of food being served. Here are some ground rules to help:
No negotiations are allowed in the kitchen or at the table
Remove your loved one from the kitchen until recovery allows them to participate
Avoid diet, low fat, or any other “lifestyle” approaches to food
Caregivers have the final word on portion sizes if you feel your loved one has not served themselves enough
Supported Eating:
Your loved one could be struggling with intrusive thoughts and fears about the food they are eating. Remember that you are asking your loved one to face their greatest fear – multiple times per day! To reduce stress and anxiety at the table, here are some DO’s and DON’Ts:
Meal Support DO’s:
Caregiver prepares and serves meals in same way they would have prior to the ED.
Caregiver decides on amount and variety of food (it will always be overwhelming to your loved one and seem like too much).
Caregiver is to eat same/similar foods as your loved one. It is not fair and very triggering to your loved one if caregiver eats differently.
Caregiver to create balanced meals and include ALL THE FOOD GROUPS.
Caregiver to stay with your loved one throughout the ENTIRE meal. Keep an eye on them and their food. This also shows moral and emotional support.
Caregiver keeps distractions light and/or can use distractions to help.
Caregiver is empathic, caring, and supportive, but also firm – this can be a tough balance to find.
Caregiver to remember: pushback or conflict is coming from a place of FEAR.
Meal Support DON’Ts:
Do not comment on the food, diets, or other nutrition messages
Do not comment on weight, shape, calories, fat, and carbohydrates.
Do not discuss body image related issues or other people’s (including your own) appearance.
Do not discuss the eating disorder.
Do not assume your loved one ate their food if you did not see them eat it. Staying with them for meals helps to eliminate (or lessen) conflict around asking questions/checking in to see if they ate properly.
Do not get up from the table, answer your phone, internet/computer, text, use the bathroom etc.
Do not have intense or difficult discussions at the table/at meal times.
Do not express anger or frustration that you may feel toward your loved one. They are not being willfully disobedient – any push back comes from fear.
Do not negotiate about the served meal.
Do not praise your loved one after eating. For some people this can be very triggering, even though it comes from a good place, and is meant to be encouraging.
What to Say During Meal Support:
It can be difficult as a caregiver to know what to do or to say in the moment when you see your loved one struggling to eat. Here are some phrases to try:
I love you too much to watch this eating disorder take over your life. I am here with you, and we will complete this meal together.
You don’t have to like the food. It is your medicine and will help you recover.
I can only imagine how difficult this is for you.
Strategies:
Bite for bite: suggest that your loved one matches every bite you take. Caregiver takes a bite of food, then your loved one takes one, and so on.
Suggest a food to start with: if you notice your loved one unable to begin their meal, gently suggest a food to start with. This can give your loved one the permission they may need to start eating.
Sit: after the meal, sit with your loved one for 20 minutes or more. This will help them learn to sit with the very uncomfortable feeling of fullness, and the caregiver can also help serve as a distraction to lessen strong thoughts and feelings.
After the Meal:
For some people, the time after a meal can be more stressful than the meal itself. They may feel extremely guilty or anxious, and may experience physical pain from eating more than they have been used to. Their emotions and thoughts may be much louder and become overwhelming, which they could deal with in an unhealthy way.
To prevent these types of behaviours, try this:
Supervision: stay with your loved one for 1 hour after the meal. Minimize or eliminate bathroom breaks, and encourage them not to isolate in their rooms. Plan activities together such as a movie, a walk (when appropriate), crafts, conversations etc.
Distraction: offer distracting activities such as games, homework, watching a movie, etc.
Check in with them: do a gentle check in with your loved one. Ask them how they are feeling, and how their day was. This is less about finding a solution or solving the uncomfortable emotions, and more a safe opportunity for your loved one to express their emotions after a difficult task. This shows you care, and hear them.
Meal times and eating are an essential component of eating disorder recovery AND can be exceptionally challenging for the whole family. If you would like to learn more about how we can support, please book a free discovery call. We are always happy to connect.
Adapted from www.keltymentalhealth.ca