Meal Support: Practical Tools to Help a Loved One at Mealtimes

8 Apr, 2019

For people recovering from an eating disorder, mealtimes can be extremely stressful. Eating well is often the hardest part of the recovery journey.

The eating disorder can take over, creating resistance to eating and fear of food. This can result in anger and conflict. The eating disorder can also cause problematic behaviours, such as hoarding, food rituals and purging.

The emotional support of a loved one or carer during and after a meal is essential. This is called Meal Support. It is especially important in acute phases of recovery and when making the transition from treatment to home.

It is vital that people in recovery consume enough nutrition to support their treatment goals, whether that is to maintain or gain weight. That usually means three main meals and three snacks per day. But the goal of meal support is not just about weight. It also aims to normalise eating patterns and behaviours, to increase self-confidence around healthy eating choices, make meals a pleasant and social event, and to decrease disordered behaviours.

Here are some practical tips to help get through mealtimes.

During the Meal

Provide a calm setting.

Make sure that the surrounding environment is calm, pleasant and predictable. Sit down and eat together. Try to model healthy eating behaviours, and remain relaxed at the table. Talk and listen.

Stick to general topics of conversation, or words of encouragement. Each meal and snack can be a big challenge for someone with an eating disorder, triggering anxiety and guilt. Be empathetic. Validate the person’s struggle. Acknowledge how hard it is. And be an active listener, attend to how they are feeling.

It’s understandable that you might feel angry/anxious/guilty – challenging the eating disorder is going to be tough.

It is best to avoid talking about food, weight, shape, exercise or physical appearance. This can be distressing and it emphasises the importance of appearance.

Avoid making threats and taking an authorative stance if your loved one resists eating. This will only alienate them. Whenever possible, try to take a collaborative approach. Find compromises together on the road to healthy, normal eating. Put the control and power in their hands, and remind them of their goals. For example, you could say:

Finishing this snack will be a step towards getting better and showing the eating disorder that you are in charge.” “Why don’t you try to take a few more bites? I can see that this is a struggle for you, but we’re working to get you well again.” “Eating this meal now will help you achieve your goal of being able to go out with your friends.

Set a time frame

Setting a time limit provides boundaries around meals and snacks that parallel normal eating patterns. It also helps to limit the opportunities for disordered behaviours, such as hiding food.

A reasonable time frame to finish a meal is around 30 minutes, and 20 minutes for a snack. If helpful, time updates throughout the meal can allow them to pace their meal.

After the Meal

For some people, the period immediately after a meal or snack can be the most stressful of all. The goal of the carer is to help the person manage overwhelming negative emotions, such as disgust and anxiety. This can last an hour or more.

Again, acknowledge and validate your loved ones feelings. It is also important to acknowledge small steps forward. This might include eating more or different foods, or being more engaged in conversation.

It is also important to watch out for any compensatory behaviours, such as purging or exercising.

Offer a distraction

It can be helpful to offer the person a quiet distraction after a meal, when the eating disorder thoughts are often at their worst.

Watch a TV series or a movie. Listen to music. Read a book or magazine. Do some journaling or writing. Play a board game or cards. Simply be with them. Click here for more ideas.

Meal support is a vital part of recovery. It is a collaborative process between you and your loved one, so be sure to make time (outside of meal times) to decide with them about the ways they would most like to be supported. Everyone has different needs, and it may take some trial and error to work out what works best.

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