How to Make an Eating Disorder Recovery Meal Plan
Recovering from an eating disorder almost always requires treatment. According to the Substance Abuse and Mental Health Services Administration, treatment plans for eating disorders must be highly individualized, based on each person’s unique needs and issues. 1 They should be holistic, involving a variety of therapies to address a wide range of underlying problems and the negative effects of the disorder on health, wellbeing, relationships and quality of life.
Psychotherapies like cognitive-behavioral therapy and dialectical behavior therapy help individuals address a variety of issues behind an eating disorder, such as trauma, low self-esteem, and rigid thinking. Medications can help manage some symptoms of binge eating disorders and bulimia, and they can help address symptoms of anxiety or depression, which commonly co-occur with eating disorders. Nutrition therapy and nutrition education are central to helping people with an eating disorder normalize eating patterns.
Nutrition education and therapy can make a big difference in recovery. According to a study published in the journal Nutricion Hospitalaria, eating disorder patients who participated in nutrition education programming for four to six months had improved eating disorder symptoms and more normalized eating patterns. 2 Seventy percent of participants were eating from at least three of the six food groups at the end of the study, compared to just 34 percent at the beginning, and the percentage of participants who ate fewer than four meals a day decreased from 70 percent to 19 percent after the program was complete.
How Nutrition Education Helps
Eating disorders like bulimia nervosa, anorexia nervosa and binge eating disorder can take a major toll on your health and wellbeing. People with an eating disorder may lose touch with their body’s natural signals concerning fullness and hunger. Their metabolism may be affected, and they may lose the ability to regulate their eating habits or enjoy food. A registered dietitian provides nutrition education and nutrition therapy to help people with an eating disorder change their relationship with food and restore healthy, intuitive eating patterns. Understanding how good nutrition promotes physical and mental health and a healthy body weight helps people in recovery make better food and eating choices. Nutrition education provides information on overall good nutrition and helps clients address beliefs about food and nutrition that are inaccurate, misleading or even dangerous, such as believing that eating fat makes you fat or labeling certain foods as “good” and “bad.” During nutrition education, portion sizes and the kinds of carbohydrates, fats and proteins the body needs for optimal functioning are taught. Lessons also include the metabolism and the health effects of bingeing, purging, and restricting foods. Nutrition education can go a long way toward helping teach the many benefits of eating a well-rounded diet, and it improves mindfulness surrounding eating and nutrition.
What Nutrition Therapy Does
Nutrition therapy goes beyond education and helps individuals identify their personal beliefs about food and body weight that may be contributing to their disordered eating. During nutrition therapy, a dietitian will assess your eating patterns, typical food intake, weight and exercise history, body image issues, supplement use, and gastrointestinal symptoms. The dietitian will offer skills and strategies to help reduce unhealthy thoughts and behaviors surrounding food.
Nutrition therapy helps people in recovery:
- Understand internal and external cues related to hunger and fullness
- Address fear surrounding eating certain foods and make peace will all foods
- Learn to feel comfortable eating in a variety of social settings
- Develop a healthy relationship with food, mind and body
- Differentiate between emotional and physical hunger
- Decrease the time spent thinking about food
- Decrease negative or distorted thoughts about food
- Learn how to eat in a moderate and balanced way
- Set healthy eating and exercise goals
The dietitian will recommend supplements if a nutritional deficiency is present. Together, the dietitian and the client will create a structured meal plan to promote good nutrition and healthy eating habits and ensure the body’s daily nutritional needs are met.
Meal Planning in Recovery
Meal planning is an important skill for all people. Recovery requires normalizing eating patterns. Planning ahead of time when and what to eat takes the guesswork and choices out of the equation so that shopping for, preparing and eating meals according to the plan is easier. A pre-conceived, structured meal plans serve as a road map for people in recovery, but there is no one-size-fits-all plan or approach. How the meal plan shapes up depends on the type of eating disorder a client has, the issues behind the eating disorder, any nutritional deficiencies and personal preferences. Meal planning should consider lifestyle, including budget, whether or not they enjoy cooking, how busy they are and how many people are in the household. Creating and successfully maintaining a meal plan requires organization and planning ahead. Dietitians recommend their clients start with a list of foods they like in each food group. Then, meals are built around those foods. An eating schedule helps prevent skipped meals. Meal planning also helps to cut down the number of necessary grocery store trips, which is helpful for those who experience grocery shopping anxiety. The meal plan helps individuals develop intuitive eating skills by demonstrating normal food quantities and eating frequency. It gives permission to eat, and it demystifies the job of eating. The plan will include a variety of foods in each food group and provide an appropriate balance of carbohydrates, proteins and fats. It will promote the idea of food as medicine and as fuel. Ultimately, the goal for normalized eating patterns is to no longer need to follow a meal plan, but rather to know intuitively when, what and how much to eat. Different people wean off their meal plans at different rates, but for some, meal planning will become a lifelong endeavor to control eating disorder symptoms and ensure the best possible nutrition.
The Value of Keeping a Food Journal
Keeping a food journal can be an important part of the eating disorder recovery process, according to a study published in the Journal of Food and Nutritional Disorders. 3 A food log enables the dietitian to see a bigger picture, and it allows people in recovery to monitor their own progress. A food journal can take many forms, including writing down notes in a personal notebook, filling out forms provided by the dietitian, or using an online journal or food log app. Whatever form it takes, the food journal tracks the food you eat, when you eat it and the thoughts and emotions that occurred before, during and after eating. Over time, the food journal reveals trends and patterns surrounding eating. Dietitians are likely to notice patterns that the client doesn’t and can offer tips, skills and strategies to help promote better nutrition and healthier thoughts and emotions surrounding food. Other benefits of food journaling include:
StructureFood journals help you create structure around eating, which is important for learning to recognize and appropriately respond to hunger and fullness signals.
MindfulnessJournaling about your thoughts and feelings before eating increases mindfulness while you’re eating, and it improves awareness about how certain foods make your body feel.
Relapse preventionKeeping a journal helps you self-monitor your food consumption and associated thoughts and emotions, and doing so enables you to recognize old patterns creeping in. Knowing when you need extra support can help you stave off a relapse.
It’s not uncommon for people with eating disorders to resist keeping a food journal. Some feel that writing everything down makes things worse or reminds them of the unhealthy tracking they did while their eating disorder was active. Others feel embarrassed to show their food log to anyone else, including the dietitian. For people who have perfectionist tendencies, the food journal can feel like an amplification of their imperfections, which can be uncomfortable. It’s important to remember that a dietitian is not the food police, but rather a specialist whose role is to help you develop intuitive eating patterns. Keeping track of your successes and slip-ups gives the dietitian insight into the barriers and challenges you face so that he or she can help you address and overcome them.
Complete Recovery is Always Possible
Through a variety of treatment therapies, including nutrition therapy, many people fully recover from an eating disorder, according to the National Institute of Mental Health. 4 The more engaged you are with your treatment plan, and the more closely you follow your meal plan and write honestly in your food journal, the better the outcomes of treatment. Keep an open mind, practice flexibility and never lose hope that a healthier, happier future awaits.