Nutrition education and counseling are important components of any anorexia nervosa recovery plan. Anorexia is often accompanied by fearful and obsessive ideas and misconceptions about food. Learning and applying the truth about nutrition and changing negative thought patterns surrounding food and eating is central to successful recovery.
A study published in the journal Nutricion Hospitalaria found that after a four- to six-month nutrition counseling program, participants with eating disorders had improved symptoms and more normalized eating patterns.1 In the beginning of the program, 34 percent of participants were eating from at least three food groups, while 70 percent were doing so after the program. Additionally, 19 percent of participants were eating fewer than four meals a day at the end of the program, compared to 70 percent at the program’s start.
The Importance of Nutrition Education in Recovery from Anorexia
The goal of nutrition education is to help people in recovery understand how food fuels the body and how it promotes physical and emotional healing. Anorexia can lead you to lose touch with your body’s natural hunger and fullness signals. It can lead to problems with metabolism, the ability to regulate food intake and the ability to enjoy food. Nutrition education addresses these issues and helps with understanding the key role of nutrition in regaining health and in maintaining optimum health for the long-term.
It’s common for people with anorexia to have extensive and detailed knowledge about nutrition, but many apply the information in ways that promote unhealthy eating habits. Additionally, many people with anorexia rigidly adhere to misleading or inaccurate information that can ultimately be dangerous to their health. Nutrition education addresses myths and misconceptions about food and provides information about the relationship between a healthy diet and good physical and mental health.
Nutrition Therapy Aids Recovery
Nutrition therapy delves deeper into an individual’s relationship with food. It helps identify personal beliefs and misconceptions about food that may be contributing to an eating disorder. Facilitated by a registered dietitian, nutrition therapy begins with an initial assessment of eating patterns, typical caloric intake, exercise and weight history, body image issues, gastrointestinal symptoms and supplement use.
Based on the symptoms and current nutrition, the dietitian will address any nutritional deficiencies and recommend supplementation if necessary. Weekly nutritional counseling sessions help participants:
- Understand their physical and emotional cues related to hunger and fullness
- Make peace with all types of foods
- Increase comfort while eating in a social setting
- Develop a healthier mind-body relationship with food
- Learn the difference between emotional and physical hunger
- Learn to eat intuitively in a balanced way
- Reduce negative and distorted thoughts about food
- Reduce the time spent thinking about food and eating
The Holistic Approach in Recovery from Anorexia
Nutrition counseling is just one component of a comprehensive treatment plan. Other components will include traditional “talk” therapies like cognitive-behavioral therapy and complementary therapies like art therapy that help improve self-esteem and self-awareness. This holistic approach, according to the Substance Abuse and Mental Health Services Administration, offers the best outcomes of treatment.
Meal Planning for Anorexia Recovery
The goals of anorexia recovery are supported by a personalized meal plan that’s carefully developed with a dietitian. Meal planning serves several purposes in recovery from anorexia. A meal plan:
- Takes the guesswork out of what and when to eat
- Includes regular meals to fuel the body and helps with the development of normal eating patterns
- Gives permission to eat and demystifies the task of eating
- Reduces the number of necessary trips to the grocery store each week
- Reduces stress and anxiety surrounding grocery shopping, preparing food and eating
- Helps create a routine around eating
- Helps prevent skipped meals
- Helps maintain a high level of mindfulness surrounding healthy eating
Creating the Meal Plan
Each week, the meal plan is created for the following week and will typically include five to six lunches and dinners for the coming days. It’s important to consider obligations during the week and plan accordingly so that preparing and sitting down to meals is easy and convenient.
To populate the meal plan, the dietitian will have you make a list of foods you like to eat from each food group. Meals are built around those foods, and each meal will contain an optimal number of calories to promote weight gain or help you maintain a healthy weight. Snacks are included in the meal plan, which will usually include four or five scheduled eating episodes each day.
There is no one-size-fits-all meal plan for recovery from anorexia. Each meal plan is based on unique needs and issues; current level of nutrition and health; and lifestyle and preferences. The meal plan will include the appropriate balance of carbohydrates, fats and proteins and will provide the body with the essential nutrients needed for good health.
Why use Meal Plans?
The meal plan is designed to demonstrate normal, healthy eating frequencies and food quantities. The end goal of a meal plan is to help restore natural hunger cues and normalize eating habits so that following a meal plan is no longer necessary. However, there should be no rush to wean off of the meal plan. Some people will continue to use meal planning as a way to save money on groceries, reduce mealtime stress and prevent relapse for the long-term.
The Role of the Food Journal in Anorexia Recovery
A food journal is a tool that you share with your dietitian each week. In it, you track the food eaten and write about your thoughts before, during and after eating. Over time, the dietitian will recognize patterns that you may not be aware of and can recommend strategies to help reduce negative thoughts and emotions and unhealthy behaviors associated with mealtime.
How to Keep a Food Journal
According to a study published in the Journal of Food and Nutritional Disorders, a food journal is an important component of the anorexia recovery process. A food journal can take the form of a personal notebook you record your thoughts in, or it can consist of forms you fill out and return to your dietitian. It can even be an online food diary or a smart phone app. The important thing is to record all the food you eat, when you eat it and your thoughts and feelings about eating. In this way, you’ll become more familiar with thought processes, your body’s cues, and you’ll stay more mindful about eating.
How A Food Journal Helps
Keeping a food journal helps you create structure and routine around eating, which is very important in early recovery from anorexia. Structure helps to ensure good nutrition, and it helps you learn to recognize and appropriately respond to your body’s hunger and fullness cues. The journal is a self-monitoring tool as well and can help you recognize old, unhealthy thought and behavior patterns creeping back in. Knowing when, how and why you’re struggling can help you get the extra support you need to prevent a relapse.
Challenges in Keeping a Food Journal
For some, the idea of keeping a food journal in recovery is a reminder of the obsessive record-keeping they did while in the midst of the eating disorder. Others may feel like the food journal amplifies their failures, or they’re embarrassed to show their dietitian the food journal each week. However, the food journal isn’t meant to shame, embarrass, or promote unhealthy habits. Rather, its purpose is to help you monitor your own recovery progress and illuminate your thought, emotion and behavior patterns surrounding eating. Your dietitian will never judge or belittle you, but will help you develop the skills and strategies you need to restore your health and become an intuitive eater.
Flexibility is Key in Recovery from an Eating Disorder
The National Institute of Mental Health stresses that most people who engage in a holistic treatment program and adhere to their meal plan enjoy full recovery.Treatment can help you end your eating disorder and enjoy a higher quality of life and sense of wellbeing well into the future. It’s important to remember that learning to eat intuitively is a process, and there will be ups, downs and setbacks. Flexibility is key when it comes to changing your thoughts and behaviors surrounding food. Keep an open mind, and always be kind to yourself. Follow your meal plan as closely as possible, and strive to be honest in your food journal. Over time, you’ll begin to recognize your body’s own natural hunger and fullness cues, and you’ll be one step closer to normalized eating habits and full recovery from anorexia.