Meal Support at the Outpatient Level of Care
Many people are surprised to hear that I often eat with my clients. They think it is odd to ask a client to bring a snack or a meal to a nutrition appointment or silly that we might complete a meal together one-on-one or in a group setting. The reality is that some of the most valuable information about one’s food intake and eating behaviors is gathered by eating with them. During this snack or meal time the food rules, fear foods, and/or eating disorder behaviors can be addressed in the moment in an encouraging and supportive way. Meal time can be very stressful for a person with a poor relationship with food and/or for those individuals with disordered eating or an eating disorder so providing meal support as part of treatment can be a game-changer.
Meal support is common at the residential, partial hospitalization, and intensive outpatient levels of care but is may not be offered as commonly in an outpatient setting. I’ve found that adding meal support as part of the treatment plan at the outpatient level can be monumental to achieving nutrition-related goals. Some outcomes of meal support may include:
- Improved ability to complete a meal or snack
- Acceptance and tolerance of a variety of foods and beverages
- Confidence in portioning and eating appropriate amounts of food for one’s needs
- Practicing normal eating behaviors and while decreasing eating disorder behaviors
- Challenging and reducing food rules and rituals
- Practicing distress tolerance while feeling emotionally supported
- Improved confidence around self-regulated food intake
- Recognition of hunger and fullness cues
- Improved mindfulness at mealtime
Incorporating meal support into practice is useful not only for clinicians but also for the client’s community of support, if appropriate. I recommend that a team approach (dietitian, therapist, support persons, client, etc.) is used in planning and preparing for the meal and that meal support goals and the experience is individualized for each client. For example, person A might set a short term goal to practice eating a meal mindfully with the ultimate goal of identifying hunger and fullness cues while person B may set a short term goal of eating 100% of the meal to help achieve the long term goal of re-nourishing their body. Goals will evolve and change as appropriate throughout the journey. Seek out a registered dietitian that specializes in eating disorder treatment to help identify appropriate meal support goals and to assist in planning meals and giving guidance and tips for before, during and after the meal.
Chrysalis Center offers meal support 3 times a week as part of their Intensive Outpatient Program and once a week for those partaking in outpatient services. Talk to your treatment team if you think this would be beneficial for you!
Courtney is a registered dietitian who specializes in sports nutrition and eating disorder treatment. She incorporates HAES and non-diet principles into her practice. In addition to nutrition consultations, Courtney leads IOP and outpatient meal support group and IOP nutrition group.