By Tracy N. Welchoff, Ph.D.
Supporting your loved one through eating disorder recovery can be confusing, frustrating, and worrisome. In some instances, meals may become a battleground as family members try to beg, bribe, cajole, threaten, or scare the ED sufferer into completing a meal. It may be a silent, angry affair, full or arguing or tears, or empty seats as family members (including the ED sufferer) storm off or refuse to come to the table. For the patient, meals can feel agonizingly long and stressful, feelings which are compounded by being in the “spotlight” as the rest of the family watches to see what will happen. Other family members may resent the tension at the table, become too worried to eat, or talk about topics that are upsetting or “triggering” to the patient. Often, families give up on eating together.
If any of this sounds familiar, don’t despair. We are here to walk you through the process of returning some normalcy to the family meal. It may take some time, but with patience and willingness to try new ways of managing meals, improvement will come.
Although it is unrealistic to run your kitchen at home as we do in our therapeutic kitchen, understanding how we handle meals at NEDC can be a helpful place to start. First, the structure and consistency of meals are critical in containing anxiety and normalizing eating. When meals are predictable experiences, they contribute to a set of expectations in terms of mealtime behavior, food completion, and managing emotion at the table. Making sure that the atmosphere is supportive matters as well, perhaps even more so. Understanding that your loved one is not deliberately being difficult helps them feel less judged, hopefully countering the self-judgment that they are undoubtedly experiencing. In the NEDC kitchen, meals are at the same time every day, the table is set beforehand, and when food is served, everyone remains seated for the duration of the meal. All food and drink must be completed with no exceptions. There are no substitutions once food is served, no playing with food, and no using the bathroom during or immediately after meals. Meal plans are made in advance to prevent last-minute indecision or negotiating about what to eat.
In implementing supported meals at home, please consider the following:
Despite what you make think, it is not your job to “make” your loved one eat. Your job is to gently encourage (“try your best” or “try another bite”), support (“I know this is hard”), acknowledge (“I know this is hard” or “I’m sorry you are having a rough day”), and provide positive focus (“we will get through this”). You can never go wrong with making eye contact, giving a supportive smile, conveying an “I don’t mind this because you are SO worth it” attitude, and simply saying “I love you”. You do not need to know the “perfect” thing to say or feel responsible for the completion of the meal. Report to the treatment team what is and is not being eaten, and move forward from there.
This information may seem overwhelming, but with some practice, patience, and ongoing communication, long-term recovery is absolutely possible. No matter how worrisome, challenging, or endless this process may seem right now, the effort is worth it, so never, ever give up.