By Sheila Flavin, RDN, Supervising Dietitian
Narins Eating Disorder Center
Supporting your loved one during mealtime at home can be challenging and frustrating. This task can’t be done alone, so please know that you have the help and support of the NEDC team. We want to give you the confidence that you can do this by using “best practice” meal support strategies. This will help us to achieve the goal of recovery and maximize meal plan compliance after discharge.
Eat enough food to meet bodily needs (instead of restricting)
Flexibility and Variety of Foods (instead of rule driven, avoidance eating)
Eat socially (re-integrating food into normal life)
Supportive eating at home requires STRUCTURE, ROUTINE and PREDICTABILITY.
Follow the meal plan. Meals planned beforehand. No choices/changes prevent negotiating and limits internal struggle. However, you can offer ‘limited choices’ of option A or option B.
Establish goals and expectations of mealtimes at home.
Acknowledge the positives, point out progress (any progress).
Avoid fighting during mealtime. Try to stay calm and relaxed during the meal. It helps to identify and acknowledge your feeling and/or the feeling of family member with eating disorder instead of the behavior. CONNECT BEFORE YOU CORRECT.
No bathroom breaks during the meal. No bathroom visits for 30-45 minutes after meal.
Expect post-meal anxiety and have activity planned. Use this time to practice coping techniques and/or incentive for meal completion.
HOW DO I DO THIS???
When you hear:
“You are making me fat”
“I am not hungry, I am so full, I am so uncomfortable”
“Will this make me gain weight- do I look like I have gained weight”
“NO! I will not eat this”
“OMG, this is covered in butter/sugar/oil”
Start by identifying the emotion- I can see you are really scared/upset/stressed/ anxious/afraid
This meal plan meets your nutrition needs right now.
This is the meal plan that NEDC staff has prescribed for you.
Unfortunately eating is not an optional activity.
This food plan is your prescribed medicine.
If you are upset by the meal plan, after you finish the meal write down the questions you want to ask the dietitian.
I can see you are crying, terrified, nervous. This is intense, this is really hard work. Just try to do best you can.
When you hear this:
“When can I stop following this plan?”
“What is my goal weight, and when will I reach it?”
“I can’t keep doing this, how am I ever going to eat after this?”
Keep statements in the immediate and present day. Focus on short term goals for now.