Skills

Getting Back to Eating

Under-nutrition and overfeeding are both concerns in the early stages of treatment of an eating disorder. It can be a tricky place for parents and carers to be in – “I know I need to feed them but how much?” It is very common to feel disabled by the eating disorder in making decisions.

Your clinicians should have discussed with you or your loved one if there was any refeeding risk, particularly if your loved one has gone several days without eating anything or has eaten very little for a long time.

Reintroducing food needs to be done appropriately depending on your loved one’s physical risk and previous intake.

However, generally, the main points are:

• Food selection should be based around normal foods and all “diet” versions of foods should be avoided.
• Establishing a regular structure of three meals and three snacks per day. Each meal should contain some carbohydrate, protein, vegetables/salad with milk and carbohydrate based snacks in between.
• Introducing cow’s milk is strongly advised as it’s a good source of phosphate. This is why clinicians recommend it as phosphate decreases the risk of refeeding syndrome.
• All sweet, sugary foods including drinks should be avoided for a short period of time only if your loved one has been assessed as at risk of refeeding syndrome. However, these can then very quickly be reintroduced.

Further dietetic advice can be found in the Dietetic Advice & the EAT approach to Normal Eating section.
NHS Lothian Dieticians have also developed Initial Dietary and Eating Support Leaflet for Families.