Meal times are often challenging for both the person with an eating disorder and their family or friends who are trying to provide support. People with eating disorders can have a range of unusual eating behaviours including:
- Not eating or eating a very small amount
- Not eating certain foods
- Cutting food into small pieces
- Stalling mealtime
- Eating very slowly or very quickly
- Eating very small or very large mouthfuls
- Eating foods in a particular order (e.g. by food groups)
- Going to the bathroom during meals or immediately after meals
- Exercising after a meal
Supporting someone with an eating disorder during meal times can be extremely stressful and many carers report that while they want to help, they do not know the right thing to say and/or do.
We have compiled a list of tips to help carers assist loved ones during meal times. Of course this is only a general guide, as each person with an eating disorder will have slight differences regarding what is helpful and unhelpful to him or her.
What is helpful?
- Provide authentic encouragement e.g. “I’m really proud of your hard work”.
- Empathise with how they are feeling e.g. “I know this is very difficult for you”.
- Observe and describe their emotions e.g. “I may be wrong but you seem anxious, angry, sad…
- Validate their feelings and behaviours e.g. “It’s understandable that you would feel anxious, angry, sad… but you deserve to eat”.
- Making conversation during mealtime can serve as a form of distraction from eating disordered thoughts for the sufferer. Examples of appropriate conversation topics are: movies, TV shows, school, news events, travel plans etc.
- Model eating a balanced diet.
- Eat in a comfortable and relaxed manner.
- If the person is struggling to get through a meal it can be useful to remind them about any advantages of overcoming the eating disorder that they have previously identified e.g. “I remember that you said that you would like to be able to eat normally again so that you can go out with your friends again”.
- It is important that meal support boundaries and the expectations of everyone are clear before eating begins. Examples of boundaries include: The person has 30 minutes to eat the meal, the person must take bigger bites, and meals must contain a balance of carbohydrate, protein, vegetables, and a fat source. Reminders of agreements and boundaries can be helpful to get through a meal. For example you might say ‘we agreed that we don’t change plans and goals during a meal. Lets stick to our plan and talk about it later”.
- If they are feeling particularly anxious it can be helpful to remind them of their anxiety management skills such as breathing.
What is unhelpful?
- Making hostile comments such as “What a waste!” “Think of all the starving children in the world”.
- Lecturing about health risks associated with eating disorders.
- Talking about food, weight, body shape, exercise, or events that might trigger feelings of distress.
- Eating in public as this is usually a goal for later on in treatment.
- Talking about foods as “good” or “bad”/ “healthy” or “unhealthy”. Each food type has its place in a balanced diet. Labels such as “everyday food” and “sometimes food” are more appropriate.
- Talking about your own body weight/shape concerns.
What about after the meal?
People often report feelings of distress after a meal. These feelings can remain for one hour or more after the meal. Distress may be exhibited through complaints about body weight or shape, seeking re-assurance about their body weight/shape, crying, fidgeting, or purging. As a result it can be helpful to continue to support the person after a meal. This can be done by recognising how they feel and validating those feelings. It can also be useful to provide a distraction for the loved one such as watching a TV show or movie together, playing a game, or engaging in general conversation. Furthermore it can be helpful to remind your loved one of strategies or activities that their therapist may have recommended.
Tailoring meal support to your loved one
As mentioned above, these recommendations are general in nature. It can be a good idea to discuss things that are specifically helpful or unhelpful to your loved one. You could start this conversation by stating that you would like to talk about things you do that they find helpful and unhelpful. It may be beneficial to let your loved one decide a day and time to do this.
Questions that can be helpful to ask include:
- What can I do/say to help you with your eating?
- What are things that I do/say that are not helpful?
- How can I support you when you are doing well with your eating?
- How can I support you at times when eating is difficult?
- What signs show me that you are going okay with your eating?
- What signs show me that you are struggling with eating?
- What are the advantages and disadvantages to recovering from your eating disorder?
At BodyMatters we run a carers support group on the first Saturday of each month from 5:00pm-6:30pm. Many carers report this group to be helpful to share their experience, hear the experiences of other carers, learn about eating disorders, and share ideas about being a carer of someone with an eating disorder. In addition our therapists also offer one-on-one sessions for carers supporting loved ones with eating disorders. For more information please contact the BodyMatters team.