Meal Plans in Eating Disorder Recovery: Why They Matter

Eating disorder recovery is a journey. Meal plans are often seen both a frustrating and helpful part of this journey - for those with all diagnoses - including anorexia nervosa, ARFID, binge eating disorder, bulimia nervosa and more.

While meal plans can be seen as rigid or controlling, they can be a supportive tool designed to reduce the mental burden around food choices and ensure consistent, adequate nourishment during a time when appetite may be confusing, other factors are dysregulating the nervous system and there is fear around eating/food.

Many folks want to avoid them, which makes sense as it often means facing one’s fear, logistics, increased stress and more! I often get asked how I think about meal plans, how/when I implement them and if they really a necessary part of eating disorder recovery and beyond.

Benefits of a nourishment plan

Rather than restricting freedom, meal (or nourishment) plans can do the following:

• Create a sense of structure and safety

• Help folks get enough to eat

  
  

• Help individuals rebuild trust with their bodies

• Reduce and completely stop eating disorder behaviors like chewing and spitting, purging or binge eating

• Improve appetite regulation

• Support a more regulated mood

• Build more appropriate expectations with food during recovery versus feel like food is always ‘messy’

• Support a well functioning digestive system to the degree possible

• Allow for movement and exercise to be beneficial and part of recovery by providing nourishment

• Improve compulsions/fears tied to OCD like hand washing or eating from a package

• Learn what foods you like and what foods you don’t like

• Support cooking skill building

• Create more food interest

When used with the support of a dietitian, nourishment plans can aid in the recovery process and help build sustainable skills and a healthier relationship with food and eating.

Meal plans can be also be helpful with type 2 diabetes, PMOS, chronic disease challenges, poor appetite, healing from surgery and more.

It is important to acknowledge that planning out food is a normal part of life for everyone, not only those in eating disorder recovery.  To find balance with food, we do need to keep an eye on (most of the time) eating regular, meals and snacks made up of healthful, varied foods.

What is a meal plan?

The way we approach meal plans is always in the service of: meeting you where you are at, ADDING and not subtracting food and sustainability.

Meal plans can be as simple as a list of meals and snacks for a given period of time, or can range to a complex overview, including recipes and exact portions.

However, meal plans are not about strict rules or perfection, but rather about providing structure, flexibility and guidance.

The goal is usually to get to a place of regular adequate eating without appropriate planning ahead, but without a strict plan and ability to be flexible to realities of life.

A meal plan can take many forms depending on the needs and goals of the person it is created for. It typically outlines eating multiple times per day.

A typical nourishment plan will include 4–7 eating times (a combination of meals and snacks) at regular intervals.

It may mean eating enough for weight restoration, which can bring physical discomfort and mental challenges - but it does not have to be handled alone. More on this later.

Each eating time is generally structured around incorporating a mix of the three macronutrients: carbohydrates, proteins, and fats and ensuring adequate micronutrients as well.

Meal plans can also include caloric drinks, shakes/supplements, electrolytes and other hydration.

These nutrients all play essential roles in the body. Managing the necessary macro- and micronutrients can be overwhelming. This is where meal plans are very helpful in creating a simple structure for consistently including a varied balance of them on a daily basis.

Balancing Nutrients

Some foods are pretty straightforward sources of each macronutrient:

Potatoes, pasta and rice are carbs. Everyone need carbs.

Olive oil, nuts and avocado are fats.

Fish, meat and tofu are protein.

However, this categorized view doesn’t account for the variety of foods that can fall into multiple categories at once, which can make nourishment complex, and also a lot more interesting.

For instance, quinoa. It is a great base of a lot of dishes, and could be considered a carb source, but it also has a considerable amount of protein. Lentils are also similarly a good source of both carbs and protein.

Salmon, while it is a considerable protein source, it also boasts more than 300% of our daily omega-3s, making it an excellent healthy fat source.

Building meals and snacks with multi-faceted foods can result in nourishment that not only provides a great variety of sources for the necessary nutrients, but also creates satisfaction, food interest and even a better relationship with food.

Development and implementation of meal plans in eating disorder recovery

Implementing a meal plan in eating disorder recovery or other conditions involves more than simply following a prescribed structure.

Collaboration, support, and a clear understanding of overall readiness and motivation for change are key components to make a meal plan a successful tool of recovery or in other considerations.

Expectations should be clarified at the beginning and monitored throughout.

An effective meal plan will not remain static. The plan should evolve throughout the process, posing manageable challenges, offering exciting new foods, meals, and approaches to eating and matching the capacity of the person using it.

This may mean:

• Someone eating 3 meals moves to 3 meals and 1 snack with 2 components

• Someone who is eating according to calories adds a certain amount of calories more per week

• Someone struggling with binge eating including a breakfast meal to reduce vulnerability for binge eating later in the day

• Doing a meal plan for someone with ARFID that includes adequate nourishment through all safe foods, even if that means eating the same thing every day, and adding one fear food a week

• Having meals that are convenient and easy to make if someone doesn't have much time

• A parent makes one meal per day for an adult client they live with

• Creating ways to cue a person with ADHD to eat on work days

• Mixing meal prep options with convenient frozen food options

• Learning one new recipe per week

Discomfort and some distress can come along with implementation. It is completely possible to manage this.

Strategies and tools for distress tolerance include:

• Acknowledging thoughts and feelings about the eating time

• Using distraction when appropriate (not all the time!)

• Grounding strategies like using a hot blanket or squeezing a tennis ball while eating

• Adequate sleep

• Self-compassion

• Journalling

• Eating with candles, music, etc

• Eating with others

• Reminding yourself why you are eating

• and, more.

It is so important to remember that meal plan implementation is rarely linear, and deviations from the plan are to be expected.

Expect challenges to arise. Feast eating can happen if you’re mentally hungry. Schedules change. Life happens.

For instance, a friend asks you to go to dinner. Dinner is on your meal plan, but it may be scary to go out to eat and not have full control over what is in the food. You want to go out and you know that you need to choose a full meal that you are accountable for. So, you say yes, talk to your RD about what to get and go for it!

Another example may be that you get a bad cold and need to rest . It may be hard to eat the meal plan, so instead of 3 meals and 3 snacks, you switch it to 6 eating times with more even intake that matches your nutrition needs while also helping you feel better, like choosing soups, smoothies, crackers, etc.

Monitoring meal plan implementation

A treatment team including providers supports like family, friends, coaches, school nurses and more may provide accountability and hands-on support throughout the process.

Support and monitoring can include:

• Eating together

• Cooking or meal planning/prepping together

• Apps like Recovery record to support consistency and provide valuable insight for both the client and their treatment team

• Check-ins through regular appointments

• Utilizing a recovery coach in the process

• Doing meal support with a coach, therapist or dietitian

• Discussions about fear and discomfort and doing exposure work with food

• Building in exercise in sustainable, balanced ways

• Doing a sticker board or creating rewards for yourself when you reach certain milestones

• and, more.

Weight Restoration while on a Meal Plan

Throughout recovery and implementation of a meal plan, the body will change, including with weight restoration.

This can be met with a mix of fear and acceptance.

Body change can be used as a chance to learn, grow and further the recovery progress through acceptance and compassion. However, putting it into practice is not always easy.

Coming back to the values and motivation for recovery can also be extremely helpful.

Some tools and practices that can make dealing with this discomfort a bit easier include:

• Deciding on blind vs exposed weights with your team

• Buying clothes that fit

• Eating if you’re mentally hungry - even if not on the meal plan

• Working on body checking and body image

• Being educated on how weight restoration works in the body (hint: your organs need fat to pad them and survive!)

• and, so much more.

Closing Thoughts

Meal plans are not meant to remove the intuition from eating by giving a concrete plan on exactly what to eat when. In fact, quite the opposite.

Nourishment plans provide a very clear definition of boundaries, within which there is a freedom to explore hunger and satiety cues, eating for joy and eating for fuel.

Meal plans can take the pressure off of those suffering from eating disorders by giving them a chance to safely experiment and learn what they like, try new foods, different portion sizes and explore how it feels within their body, without having to do it alone.

It also can serve as a form of exposure, aid in learning new cooking skills, grocery shopping and cooking for and eating with others as well as going out to eat.

For those without eating disorders, meal plans can also take the pressure off, provide structure and flexibility, and allow for guidelines that are about adding to ones life to provide energy, disease management and more.

All of these factors can lead to the development of a healthy relationship with food.