Following a meal plan to restore weight, initiate an appropriate meal pattern, and/or increase variety in foods consumed can be a difficult part of eating disorder recovery. Exploring fear foods for the first time and dealing with discomfort from physical fullness may trigger significant anxiety. Though completing meals may feel distressing, it is critical to recovery in that the body receives adequate nutrition and the distorted cognitions around food begin to be neutralized.

By: Sam Wierzbicki

While anxiety and discomfort will undoubtably occur in recovery, cognitive reframes, fact checking, and setting intentions can make it possible to complete especially challenging meals. The seven skills below can be helpful at meal times during the recovery process.

1. Food Is Fuel

“Food is fuel” is a cognitive reframe. Cognitive reframing is a Cognitive Behavioral Therapy technique which targets changing unhelpful thoughts that lead to unhelpful behaviors. For example, if we approach a meal with the thought “this food will make me gain weight” and that idea has led to malnourishment and been developmental in the eating disorder, we can employ the reframe “food is fuel.” Food is energy for the body and is necessary for every cell to function properly. Without an adequate amount of it each day, we face a wide range of health complications. Using “food is fuel” to challenge distorted thoughts, like all cognitive reframes, actually begins to change the brain over time. Each time we practice a reframe, even if it feels forced, new neural pathways are created, and when employed consistently, those new thoughts will populate our head more readily.

2. The Stomach Has No Eyes

“The stomach has no eyes” is a fact check particularly helpful for when we are trying a new fear food. Fact checking is important in recovery as it allows us to determine which of our thoughts are based in fact and which are based in perception. Eating a bowl of macaroni and cheese can feel anxiety provoking if our fear foods include pasta and cheese, but “the stomach has no eyes” tells us that our digestive system will break down, absorb, and utilize macronutrients in the same way. So, while quinoa may feel different to our brains than pasta due to our eating disorder cognitions, the digestive system doesn’t take this into account and will ultimately break down all carbohydrates to the same basic unit, glucose. “The stomach has no eyes” reminds us that our body will utilize any foods we consume, no matter what form they take.

3. Logs On A Fire

“Logs on a fire” is another helpful cognitive reframe we can employ when feeling challenged by how much or how often we need to eat in recovery. “Logs on a fire” is a shorthand way of describing how our metabolism works: the body’s metabolism can be thought of as a campfire which needs to be consistently provided with logs in order to continue to burn. Our metabolism works very similarly. When we don’t give our body adequate nourishment, the fire dies to mere embers. “Logs on a fire” tells us that in order to keep our metabolism at its optimal rate, we need to consistently and adequately fuel our “fire” with food.

4. Meal Island

“Meal Island” is a useful intention to set during meal times when we are experiencing significant external stressors. For example, if we have a final in school or a work deadline that is causing anxiety, it can feel difficult to sit down for a meal. “Meal Island” is a way to stay present in the eating experience and block our intrusive thoughts about outside stress. It may be helpful to engage in conversation with supportive company or play a game as a temporary distraction in order to reach “Meal Island.” Stress reduction techniques such as deep breathing can also be helpful to cultivate this mindset. “Meal Island” asks us to focus on the meal as much as possible so that we can provide our body with the nourishment it needs to deal with the external stressors once the meal ends.

5. Mindful Bites

“Mindful bites” is a mindfulness technique and mealtime intention that allows us to be explorative and objective around our eating experience. “Mindful bites” may be a useful intention when eating a meal that we want to experience differently than we have in the past. In “mindful bites,” we tune into several bites throughout the meal and ask ourselves objective questions about the experience: What textures are present? What flavors are present? What colors do I notice in the food? What sounds do I hear when taking a bite of the food? We ask these questions as a way to be a passive observer of our experience, leaving preferences or food judgements out of the meal. With mindful bites, we collect data about eating experiences which may start to inform our food choices from a neutral perspective.

6. Fact Checking

Fact checking may be employed throughout the entire recovery process, but is especially helpful during meal time. Fact checking is part of cognitive reframing that asks us to question the thoughts in our head that may feel like absolute truths, but are actually just perceptions. For example, when beginning a meal plan that feels like more food than we’ve normally been eating, the thought “two slices of bread at breakfast is too much carbohydrate” may pop up. When we fact check that statement, we logically know that our meal plan is providing us with the amount of macronutrient our body needs to recover. We may ask ourselves what happened in the past when we ate less carbohydrate than this: Did we feel fatigued? Did we have energy to devote to important events or people in our life? When we fact check these perceptions, we may see that our perceptions actually aren’t based in reality and don’t serve to benefit us. This is an important part of changing our eating disorder cognitions and may decrease anxiety at meal time.

7. Pacing

When feeling overwhelmed about a meal, pacing is a helpful skill and intention to set. Pacing allows us to tackle a challenging meal over the course of a set amount of time. Using pacing, we can take the meal bite by bite, effectively breaking down the meal into manageable components. Pacing can also be utilized as a way to practice eating at a normal pace if our eating disorder has manifested in very short or very long meal times. Setting timers every 10 minutes to gauge our pace can help us practice eating at a speed that feels natural and comfortable.

Each meal in eating disorder recovery will likely call on different skills. While these skills will not completely eliminate anxiety related to mealtime, both safer and more challenging meals can feel more manageable. Each time these skills are practiced and the body receives the nutrients it needs, we are one step closer to being recovered.

At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating and body image issues. We offer a variety of programs and services targeted at helping clients overcome fear foods and develop a healthy relationship with food. We offer nutrition counseling with a licensed dietitian, meal support, a Food & Mood Group, and a variety of other groups and resources to help those seeking help for food concerns.

Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below or read more about our philosophy here.

This post was written by BALANCE Dietetic Intern, Sam Wierzbicki.

Sam is a Dietetic Intern and graduate student at New York University, where she is pursuing her Master’s Degree in Clinical Nutrition. Before beginning her graduate degree in nutrition, Sam worked in the educational field as a private academic tutor to children and adolescents. She completed her undergraduate education at Princeton University, majoring in English literature. After completing her dietetic internship, Sam plans to work in the disordered eating space as a HAES and Intuitive Eating aligned Registered Dietitian.

Seven Mealtime Skills Useful in Eating Disorder Recovery