Meals can be be difficult for any young person with an eating disorder and it is helpful for parents/carers to be aware of the possible ways a young person, in their distress around food, may attempt to avoid food and drinks by getting rid of them.
It is important to set firm expectations about what must be eaten in what time frame. For example, 40 minutes for a meal and 15 minutes for a snack. Expectations should be set around normal eating behaviour at the table in order to help a young person challenge the eating disorder. Setting time frames for meals prevents multiple mealtimes running together. This is important as without this it can feel as if you are constantly directly fighting the eating disorder. It is important for yourself and your loved one to be able to step away and recharge your batteries. Many eating disorder forums may advise the need to “break” the eating disorder by sticking with a meal “as long as it takes”. However, our experience is that, while at some point you may need to go slightly over your assigned time limit if it feels as if your loved one is just about there, attempting to do this in such an extreme way can be an adverse experience for you and your loved one.
This list is not exhaustive but these are some common eating disorder behaviours which need to be firmly challenged:
- Hiding food in clothing or up sleeves
- Smearing food on body/hair/clothes
- Sticking food under table or chair
- Spreading food around the plate or up to the edge
- Feeding food to a pet
- Crumbling food items and spreading over the plate/table
- Pretending to cough into a tissue while spitting out food
- Using a straw instead of drinking from a cup (liquid gets hidden in straw/avoidance of liquid touching teeth)
- Segregating food (e.g. peeling apart lasagne)
- Scraping sauces off of food
- Using particular crockery or cutlery (usually small to support smaller portion sizes or as a way to consistently measure all intake)
- Wanting food reheated (myth that this may reduce calories but also acts as a distraction)
An eating disorder can take advantage of opportunities to drink in excess to curb hunger, to aid vomiting or to overload with fluid prior to being weighed at the appointments. Other young people may be so entrenched with the eating disorder thoughts that they may even restrict their fluid intake out of fear. In these situations, all drinks should be monitored where possible.
Eva Musby has a video clip that may be helpful for meal times called “Stuck, not Eating”. You can view it here, on Eva’s youtube.