Mechanical Eating in Eating Disorder Recovery
As a nutritionist specializing in eating disorder recovery, one of the most common requests I get from individuals at the onset of their recovery journey is: “I would like to learn to become an intuitive eater”.
My response goes something like this:
“ I think intuitive eating is wonderful. And I love that you want to get to a place where you can listen to your body's cues for hunger and fullness, as well as its wants and needs for different types of foods. BUT, when you have an eating disorder, those cues are disconnected. There is so much “noise” around food and body that it becomes very difficult to tune in and make choices to keep you healthy, nourished, full and satisfied.”
In other words, we need to lay the foundation before we build the house.
At the onset of eating disorder recovery, and for quite some time in the recovery journey, we need to eat mechanically so that we can adequately refeed, weight restore, and become physically stable, while also overcoming all the mental hurdles around engaging with food healthfully and disengaging from the eating disorder, finding new coping mechanisms and overcoming fears around food and body.
So let’s explore together what is mechanical eating, how to begin to eat mechanically, why you should do it, and when it is safe to begin exploring intuitive eating.
What is Mechanical Eating?
Mechanical eating is a vital stage of nutrition for eating disorder recovery. Here, we aim to accomplish the following goals:
Establish a regular pattern of eating:
This means that the individual in recovery will be eating meals and snacks at regular and pre planned intervals through the day, regardless of hunter cues, as those will not be intact yet. Typically, this looks like 3 meals and 3 snacks a day.
Eat a balanced plate, with adequate serving sizes:
For those with eating disorders or disordered eating patterns, there is food avoidance. This may look like an avoidance of foods and/ or food groups, and it may also look like a reduction in serving sizes. When meal planning for mechanical eating in eating disorder recovery, we want to include all different types of foods and food groups to demonstrate that all foods fit, and that we need to consume carbs, fats and proteins at all meals.
The aim here is to create structure and routine around what is consumed and when, which is non- negotiable at this stage of eating disorder recovery. The individual in recovery would not yet be able to accomplish this intuitively, of their own choice. If they could, they would not have an eating disorder.
What Does a Mechanical Eating Plan Look Like?
If you are working with us in our Youth Virtual Recovery Program, we will be guiding you through this every step of the way, from nutrition support, weekly meal planning, planned meal and snack times, family support and guidance, and 1:1 meal support.
If you are not under our care, typically, mechanical eating looks like this:
3 meals and 3 snacks per day:
Ideally, breakfast is consumed within an hour of waking.
There should be around 2-4 hours between each meal or snack, and the individual in recovery should never go more than 4 hours without eating.
Sample Meal Timing:
Breakfast at 8 am
Snack at 10:30 am
Lunch at 12:30 pm
Snack at 3 pm
Dinner at 6 pm
Snack at 8:30 pm
All meals and snacks must be completed:
This is important, as at this stage of recovery there will be negotiation, and the individual in recovery will likely say they are too full, or don’t feel well, or are not ready to eat. With mechanical eating, we aim to create non -negotiable structure. In time, once more health has been regained, there will be space to honor these cues and preferences (and to safely learn how to do so!), but the time for that is not at this stage of recovery.
Many families really struggled with this piece of the recovery process as there can be a lot of negotiating and arguments around what is on the plate, when to eat, and how much to eat. This is where meal support services can be hugely beneficial to supporting your family through this phase of eating disorder recovery.
All different foods and food groups will be included on the plate:
The specificities of what each plate looks like, and how much of each food and food group is required is quite individualized and as such, more specific recommendations will be made for you by your treatment team including your registered nutritionist or dietician.
Meals and snacks should be completed in an appropriate and predetermined time:
One of the food behaviors around many eating disorders is that meals and snacks may take an exceptionally long time to complete. We want to work on structuring not only when we have each meal or snack, but also how long each meal or snack takes to consume, or else one meal time will bleed into the next.
Again, your treatment team will recommend specifics to you for timing, but in general, 30 minutes is great for main meals, and 15 minutes for a snack.
Why is Mechanical Eating Important?
Mechanical eating is so vital in the early stages of one's eating disorder recovery journey for the following reasons:
It gives the individual in recovery permission to eat:
It is easier for them to show up to food because someone tells them to, compared to it being a choice, which would create space for the eating disorder (behaviors and thoughts).
In fact a big leap towards being recovered is inevitably eating what you need in order to be well, without being told you need to. To get to this point, one will need to be externally directed on what and how much to eat for a period of time.
It ensures the individual in recovery is consuming adequate nutrition:
It is important that there is structure and support in place to set the individual in eating disorder recovery up for health and success, especially in these early stages where hunger cues are not yet present and there is a large amount of fear around eating, as well as food and body changes.
It is protective for those who are hypermetabolic:
Many individuals in eating disorder recovery (especially those with Anorexia Nervosa) become hypermetabolic (I wrote an article all about this here). This means that to weight restore, they will need to consume significantly more calories than an average person would need, to even gain a pound. This is more food than someone would intuitively show up to. In fact there is nothing intuitive about this. Mechanical eating in this case is absolutely essential.
Eating in a structured way is protective. It ensures that the individual in recovery is eating enough, before they are mentally or physically ready to make that choice for themselves, without support.
How Long Should You Mechanically Eat?
There is no singular pre-set amount of time that mechanical eating lasts for, just like there is no single duration of time it takes for someone to recover. Every individual, and every eating disorder is different.
Your treatment team will give you personal guidance on when and how to transition out of mechanical eating and towards intuitive eating. For some, they may need to eat mechanically for many years after recovery and that is just fine! There is no one way to do this and there is no right amount of time for this transition. Whatever is the best way for each person to maintain their health and recovery, is wonderful.
In general, before this conversation can even be had, the following factors need to be in place:
One needs to be weight restored, and have maintained this for a good amount of time consistently. (Your team will provide you specifics on the timeline here).
One needs to have regained any health markers lost in recovery (for example: regular menstruation, bone mineral density, heart rate, blood pressure).
One needs to have been showing up consistently to full meals and snacks without negotiations and consistently finishing their plate.
One is no longer engaging in eating disorder symptoms such as over exercising, binge eating, purging, laxative use, hiding food, restricting food when given the chance, etc.
As with everything in recovery, the slower you go, the faster you get there. There is absolutely no rush to release the structure of mechanical eating, and there is a lot of space in between to maintain this structure while also working on honoring more preference and hunger cues in readiness.
Why You Can’t Intuitively Eat Right Away:
Intuitive eating involves trusting your body, honoring your hunger and fullness cues, allowing all foods to fit and removing food rules and restrictions. An individual struggling with an eating disorder does not have clear hunger and fullness cues, has many food fears and avoidances, and is afraid of weight and body changes. These factors would deter them from being able to successfully listen to their body’s cues, their nutritional wants and needs and be able to react accordingly.
It is also important to note that recommending intuitive eating at the beginning stages of eating disorder recovery can be harmful to the recovery process and to the person in eating disorder recovery. It can be slippery, in that the practices can be misinterpreted or misused towards eating disorder behaviors, instead of the healthy self.
For example, someone may not eat all day because they are “not hungry”, or avoid more foods because “their body does not want it”, or binge eat all the foods “because they are being intuitive and this is what they want”.
Intuitive eating is a beautiful way to eat however and is a long term goal. As one progresses in recovery, with the help of their treatment team, they will be guided on how to do this safely in a way that creates space to learn and explore their cues, wants and needs, while also supporting and maintaining the recovery and health they have gained.
