Mealtimes with anorexia is just one of the most challenging times. Family members and other supporting individuals will encounter these struggles with their loved one while they devote time and effort into ensuring a mealtime runs smoothly and ends favourably- with a meal completed with the least distress as possible. Therefore, it’s important to ensure that mealtimes are neutral and calming and are not accompanied by uncontrollable amounts of anxiety and discomfort. It is helpful therefore to have a plan on what is to be expected and that the individual suffering from the eating disorder feels involved in the process of decision making and have choices. This could include meal planning with a treatment team or family, distracting conversations with others, discouraging discussions around triggering topics such as weight and diet, alongside distractions like games and background noises from TV and radio. 

 

For the ones aiming to support their loved one through a mealtime- it can be a very frustrating and distressing time, especially in the early stages of treatment. Mealtimes can become very disrupted which may impact on the individuals ability to challenge the eating disorder. This is where planning mealtimes is useful. This could include families eating separately to ensure the individual is surrounded by helpful and supportive others. Aiming to provide a calming and more unobtrusive environment. When a more productive and smooth sailing mealtime routine has been established- a more inclusive routine of eating can be reintroduced, and mealtimes can become more of a social event. 

 

It is often observed that individuals struggling with an eating disorder prologue mealtime- often being the last to start which can be seen through the long process of staring at their plate which gives anorexia more power and headspace to decide what is allowed to be eaten. Therefore- the less time spent looking at the meal, and more efforts made towards sitting down and eating straight away is a more helpful way to navigate and manage mealtimes. This can be accompanied by others offering subtle prompts to begin a meal to normalise more intuitive eating and establish rules to challenge the eating disorder. Similarly, once the individual has started their meal, prompts which has been deemed as helpful by the sufferer can be used to help them continue. Prompts which are nurturing and firm are most productive, aiming to guide an individual through their meal using conversation and encouragement. 

 

Furthermore, as well as using prompts and encouragement, others who are present at the mealtime should aim to create a non-artificial environment by displaying healthy behaviours to act as role models. This includes eating age appropriate and intuitive portions, taking appropriate mouthfuls, as well as completing a mealtime in a swift manner. Eating with others is often a distressing time for an individual with an eating disorder. It can trigger concerns about food and weight amongst others. It is important to have an opportunity to consider how mealtimes are affecting everyone present, especially concerning the presence of the eating disorder, to ensure that an environment which suits everyone’s needs is achieved. Therefore, those with an eating disorder may present eating disorder driven habits which should be discouraged and channelled where possible- this will be different for everyone, but can be challenged by the individual, or in early stages of treatment, it may take another individual to directly challenge these behaviours to ensure they don’t go unnoticed and be morphed into behaviours deemed as normal and reinforced. 

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Typical eating disorder habits could include, delaying the start of a meal, dissecting foods into tiny pieces, tearing food apart which is particularly applicable to food such as sandwiches or toast. Picking at parts of the meal and avoiding taking appropriately sized pieces, playing with food such as pushing it around the plate but not committing to eating it, eating at a slow pace, hiding, dropping, or smearing food, and inappropriate mixing of food types. Furthermore, it’s also important to set time guidance for mealtimes to ensure that mealtimes aren’t following anorexia’s rules. It can be discussed with loved ones what is appropriate for a mealtime- and is different for everyone concerning their anorexia’s rules and tendencies. Mealtimes having time constraints sets clear boundaries and guidance of when the food must be consumed and sets an expectation to what is necessary. 

 

Alongside mealtimes- managing mealtimes after they’ve happened is also difficult. This time is often accompanied with a plethora of guilt and anxiety and could be the time where anorexia tendencies and compensatory behaviours kick in. This could include exercise, the battle to keep the meal digested, amongst other unhealthy coping mechanisms to deal with the mealtime that has been endured. Thus, spending time with others can be a useful way to distract an individual and reduce the harsh and torment dominated thoughts created by anorexia- this will be different for everyone as age-appropriate methods must be considered in treatment plans and post mealtimes. Therefore, this time after a mealtime helps should be filled with proactive mechanisms which aren’t dictated by anorexia and should aim to reduce overwhelming amounts of distress or anxiety. This may change during treatment and will be approached with less anxiety further into “recovery”. 

 

There is of course no right way to eat- as everybody’s norms and values surrounding food is different as everyone has such complex and unique needs and requirements. Every family and social group eats differently and requires different amounts of energy and nutrition, alongside dietary rules, and requirements such as veganism, vegetarianism, and intolerances. Alongside this- it’s important to focus on your own plate and ignore what others are eating. Anorexia will try and compare others portion sizes and meals, therefore, when eating with others, it can be useful to eat the same at main mealtimes. This can be supportive and reduces comparing food as well as setting a good example of what is normal and shows an individual that they’re doing nothing wrong as others are doing the same. This may also be accompanied by others portioning and serving up meals as individuals struggling with an eating disorder lose sight on what is conducive to what their body requires to function.  Thus, restabilising structured and healthy eating expectations which have been blurred and lost over the course of eating disorder struggles. An individual’s needs and requirements when designing a meal plan can be done in collaboration with healthcare professionals- but it’s important to stress that loved ones will be able to correctly portion and serve food without being blinded and warped by the presence of anorexia. An individual has managed to feed themselves prior to the eating disorder being developed- so unhealthy methods which may be drawn upon because of developing the mental illness, such weighing food and counting calories, are unhealthy and unnecessary practices to measure exact amounts of nutrition. The aim is to be initiative and trust what the bodies asking for cannot be controlled so specifically.