Module aims:
When remembering the key elements of meal support, just think about the 4 B’s
These are the key take home messages, and we will refer back to these 4 B’s throughout the training.
As a professional or carer supporting someone with an eating disorder during mealtimes, it is your responsibility to:
Once you have done these things you are not responsible for whether someone is eating or not.
It is important to support each other and remember to use person-centred care – what works for one patient may not be the best method for another so engage with the patients and ask how they would like to be supported.
Person-centred care for eating disorders involves tailoring treatment and support to the unique needs, preferences, and values of the individual, acknowledging their experiences and challenges with eating, body image, and related psychological aspects. It ensures that the planning of care is comprehensive, integrated, and sensitive to the life context of the individual, promoting recovery and wellbeing.
| Meal Support IS | Meal Support IS NOT |
| Emotional and practical support from a family member or professional during meals. | Always completely seamless and perfect. |
| Takes practice and commitment to improvement from those providing it. | A battleground between the patient and the person supporting them. |
| A vital part of treatment for eating disorders: prompting patients and holding boundaries helps to tackle the root of the disorder. | Simply sharing a meal with someone. |
| Providing relevant distraction conversation when appropriate during a meal. | Something you get right from the start, after one training session. |
| Helping patients to understand normal eating patterns and meal timings. | A passive process of being only physically present. |
Successful meal support begins even before we get to the dining room. It is important to be prepared in advance of the meal for the best outcome.
The term dietary restraint refers to extreme and sustained attempts to control eating. This takes the form of strict rules about what you can eat, how you should eat, and when. It typically differs from traditional dieting behaviours, which are often temporary and involve more flexible guidelines.
Examples of dietary rules seen in dietary restraint:
Even if these rules do not impact the patient physiologically (i.e. cause weight loss or prevent weight from being recovered), they impair the patient as they maintain anxiety and preoccupation with thoughts and feelings about food and eating. They are not compatible with eating socially which also serves to maintain the eating disorder.
Dietary restriction refers to true undereating. This means taking in less energy than your body needs. This leads to under nourishment and either weight loss or maintenance of a low body weight.
A therapeutic environment supports recovery and mental wellbeing, being safe, calming, and conducive to therapy. It must offer privacy, where appropriate, for individuals to feel secure and respect cultural diversity to ensure inclusiveness. Assessing its suitability can be as simple as asking, ‘Would I be happy to stay here?’ Consultation with patients is essential to ensure the environment meets their therapeutic and cultural needs.
Contracting is an informal process of establishing an action plan and informing the patient what to expect to ensure they are more likely to be able to follow the plan.
During the development of this training, we interviewed experts by experience (patients who have recovered from an eating disorder) to utilise their expert knowledge about meal support. These are some of the things that they found most helpful and unhelpful in the dining room.
