Meal support is a key part of nutritional rehabilitation for individuals with eating disorders, offering a structured approach to restoring health and fostering normalised eating behaviors. But what does the research tell us about its effectiveness, and how can we ensure it’s implemented in ways that maximize recovery? Let’s explore the evidence.
Eating meals together as a family has been linked to a decreased risk of developing eating disorders. This seemingly simple act plays a pivotal role in fostering healthier relationships with food and reducing the stigma around eating.
However, for individuals with eating disorders, mealtimes can be a period of heightened distress. Negative emotions like fear, anxiety, irritability, and depression often intensify, making this a particularly challenging aspect of recovery. These emotional barriers highlight the importance of targeted, sensitive interventions during meals.
Structured meal support during treatment can support key nutritional goals:
- Restoring Nutritional Intake: Supporting people to meet their nutritional needs.
- Normalising Eating Behaviors Encouraging regular eating patterns and teaching practical skills.
- Promoting Independence: Gradually transitioning from directive support to a collaborative approach as people gain confidence and autonomy over food choices.
Despite it's importance, meal support lacks a standardised, manualised framework, which in my opinion can be really helpful as the support is tailored to an individual. However, this variability can make it difficult for clinicians and caregivers to know the best strategies to employ and also makes it really hard to research the area!
Research Insights
A systematic review of 10 studies examined first-line meal support interventions across eating disorders, including anorexia nervosa, bulimia nervosa, avoidant/restrictive food intake disorder (ARFID), and binge eating disorder. Key findings included:
- Physical Health Improvements: Research shows people experienced increased mean weight, reduced overnight bradycardia and decreased length of hospital stays.
- Behavioral Progress: Food intake and variety increased (with an average of 92 different foods), and inappropriate mealtime behaviors decreased.
- Sustained Gains: Treatment benefits were maintained on average 2.3 years post-intervention.
Tailoring Meal Support to Individual Needs
One of the most critical takeaways from the research is the importance of individualising meal support. Effective interventions needs to consider:
- Stage of Recovery: Early phases may require directive support, gradually transitioning to a collaborative style as the patient progresses.
- Patient Readiness: Tailoring interventions to the patient’s emotional and physical readiness for recovery.
- Skill Development: Teaching practical eating skills and coping mechanisms for managing mealtime distress.
Broader Implications for Practice
Health professionals must acknowledge the emotional toll mealtimes can take on those suffering with eating disorders. Meal support interventions should:
- Foster a Safe Environment: Create a supportive atmosphere where people feel understood and encouraged.
- Address Psychological Health: Recognise and validate the distress people experience during meals, incorporating strategies to reduce anxiety and build resilience.
- Engage Families: Equip families with the tools and confidence to provide effective support, ensuring consistent reinforcement outside clinical settings.
Final Thoughts
Meal support is a powerful tool in eating disorder recovery, offering a path to physical and emotional healing. By combining evidence-based strategies with compassion and individualised care, health professionals and families can help clients and loved ones to navigate the challenges of recovery and move toward a healthier, more independent relationship with food.
If your interested in upksilling yourself or your team check out our workshop on 10th February 2025:
References:
Beukers, L., Berends, T., de Man‐van Ginkel, J.M., van Elburg, A.A. and van Meijel, B., 2015. Restoring normal eating behaviour in adolescents with anorexia nervosa: A video analysis of nursing interventions. International journal of mental health nursing, 24(6), pp.519-526Ellis,
A., Gillespie, K., McCosker, L., Hudson, C., Diamond, G., Machingura, T., Branjerdporn, G. and Woerwag-Mehta, S., 2024. Meal support intervention for eating disorders: a mixed-methods systematic review. Journal of Eating Disorders, 12(1), p.47.
Hage, T.W., Rø, Ø. and Moen, A., 2017. To bend or not to bend? Rule adherence among staff at an eating disorder unit. Eating disorders, 25(2), pp.134-150.
Treasure, J., Smith, G. and Crane, A., 2016. Skills-based caring for a loved one with an eating disorder: The new Maudsley method. Routledge.
Comments