Why Meal Support Feels Hard in Eating Disorder Recovery (and Why It Helps)

It can be incredibly difficult to experience the discomfort of eating a meal when you are struggling in your relationship with food. When you eat with an eating disorder, it is common to have strong emotions during meals, experience early fullness, gastrointestinal discomfort, and increased urges for unhealthy behaviors. These experiences often can be followed by more discomfort when we think of what we “should” have done or can do. This shame can keep us stuck in the cycle of using negative coping behaviors such as restriction.

Understanding Why Meal Support Feels So Difficult

Acknowledging how much effort has to go into fueling yourself can be helpful. Beforehand, you must plan the meal, purchase the meal or its ingredients, prepare the food, and plate the food in sufficient amounts. You must use skills to navigate urges and emotions. You must eat the food. Then, you’ll probably process the experience, distract yourself after the meal, and get ready to do it again. It can feel exhausting just thinking of it all!

How Meal Support Helps Break the Cycle

This is where meal support can help. You don’t have to do this alone. Research shows that peer support during therapeutic meals is beneficial in helping to reduce feelings of hopelessness for recovery (1).

The Power of Shared Meals and Peer Support

By seeking support from professionals and sharing the experience in the community with others, we can take steps to heal.

Research on the Benefits of Meal Support

There is sufficient evidence, both anecdotally and through research, that meal support is beneficial for clients of all age groups and all eating disorder diagnoses, as well as those who do not meet the clinical threshold for an eating disorder diagnosis. This means that meal support can be a beneficial first-line treatment approach for a wide variety of people (2). Research shows that regardless of weight restoration, eating behavior is a strong predictor of clinical outcomes in eating disorder recovery (3). Meal support is also associated with decreased need for higher levels of care by helping to facilitate weight restoration when clinically indicated (4).

Facing Discomfort as Part of Recovery

Challenging Eating Disorder Rules and Behaviors

Meal support feels hard because disordered eating behaviors are the default; if we do not take action, the behaviors continue. When you join meal support, you are taking a step to learn new ways to take care of yourself. This can be very uncomfortable, especially when you are instructed to do the opposite of what the eating disorder voice says. This might mean picking up your fork, pulling your plate closer to you, challenging rigid rules about order, taking an appropriately sized bite, or using the appropriate amount of a condiment. Bite by bite, we re-learn the way to nourish our bodies and brains.

Building Strength Through Repeated Exposure

When we consistently expose ourselves safely to the repeated discomfort of consuming regular meals and snacks, it begins to feel less overwhelming. We get stronger, both mentally and physically.

Real Stories of Progress with Eating Disorder Meal Support

One client referenced their meal support experience with a dietitian and the impact that it had on their recovery journey:

“It was a difficult meeting. She had me eating. She was tough. On the other hand, she hugged me and encouraged me. I came out deciding that I was going to eat, even though it will be hard. […] It’s far less than what I’m supposed to eat, but it’s a big and hard step.” (5).

Is it time for you to take the next hard step? If you are interested in participating in meal support groups, please contact [email protected] to get started and reserve your spot.

Citations:

Beukers, L., Berends, T., de Man‑van Ginkel, J. M., van Elburg, A. A., & 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), 519–526. https://doi.org/10.1111/inm.12150 BioMed Central

Ellis, A., Gillespie, K., McCosker, L., Diamond, G., Branjerdporn, G., Woerwag‑Mehta, S., Hudson, C., Machingura, T., & Branjerdporn, G. (2024). Meal support intervention for eating disorders: A mixed‑methods systematic review. Journal of Eating Disorders, 12, Article 47. https://doi.org/10.1186/s40337-024-01002-2 BioMed CentralSpringerLink

Gowers, S. G., Edwards, V. J., Fleminger, S., Massoubre, C., Wallin, U., Canalda, G., … (2002). Treatment aims and philosophy in the treatment of adolescent anorexia nervosa in Europe. European Eating Disorders Review, 10(4), 271–280. https://doi.org/10.1002/erv.466

Kells, M., Davidson, K., Hitchko, L., O’Neil, K., Schubert‑Bob, P., & McCabe, M. (2013). Examining supervised meals in patients with restrictive eating disorders. Applied Nursing Research, 26(2), 76–79. https://doi.org/10.1016/j.apnr.2012.06.003

Elran‑Barak, R., Lewis, Y. D., & Schifter, T. (2022). Women’s perspectives toward their nutritional counseling for eating disorders: A qualitative internet‑based study in Israel. Health Care for Women International, 43(2), 219–238.https://pubmed.ncbi.nlm.nih.gov/34403324/ 

Article by Sarah Nichols RD, LDN, CEDS-C

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