Meal planning in anorexia nervosa recovery

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Treatment for anorexia nervosa (AN) involves a combination of services that help individuals to restore weight if they are weight suppressed, change distorted thinking patterns around weight and body image, and address any co-occurring health issues resulting from the eating disorder. One component of treatment is working with a dietician to develop a healthy anorexia recovery meal plan. It can be difficult to know where to start when planning meals in anorexia nervosa recovery, but there are some tips that can make the process easier.

In this article

What to expect regarding nutrition in anorexia nervosa recovery 

During anorexia nervosa recovery, it is critical to follow a nutritious meal plan that allows for refeeding and correction of any nutritional deficiencies. An appropriate meal plan allows patients with AN to undergo nutritional rehabilitation and reduce eating disorder behaviors. (1)

Here is what to expect when creating nutrition goals during recovery from AN: (1)

  • You will increase your calorie intake to allow for nutritional rehabilitation.
  • You will follow a meal plan that provides adequate nutrition and incorporates all major food groups and micronutrients. 
  • Your dietitian will encourage you to add additional foods to your diet and challenge specific food fears.
  • You may require a multivitamin or multimineral supplement to treat nutritional deficiencies.

Components of an anorexia nervosa recovery meal plan 

Each patient’s meal plan will differ based upon their unique needs and preferences, but there are some general components of an adequate anorexia nervosa recovery meal plan. Meal plans will always include a variety of foods that allow you to obtain the nutrition you need to function your best. 

Experts recommend that patients in recovery from AN consume foods that provide high amounts of protein and essential amino acids. It is also important to consume foods that contain fats, as they provide lipids that are essential for brain functioning. Carbohydrates are also an important part of an adequate meal plan. (1)

A healthy anorexia recovery meal plan can also contain a high amount of calories for some people, as studies have shown that high-caloric refeeding (HCR) is linked to shortened stay among hospitalized patients with AN. (2) While consuming a high amount of calories can seem intimidating to a person struggling with AN, the truth is that larger meal plans in the early stages of anorexia nervosa recovery is linked to better health outcomes over the long-term. (3)

In general, a recovery meal plan for people with AN will contain sufficient calories, combined with standard macronutrient content: (3)

  • 25-35% calories from fat
  • 15-20% calories from protein
  • 50-60% calories from carbohydrates

Beyond these general recommendations, patients in anorexia nervosa recovery typically don’t need special foods. Everyday foods that most families eat can be incorporated into the diet to support healing, rebuild tissue, and correct nutritional deficiencies. (4)

Many people in recovery from AN experience slowed digestion and GI distress during the recovery process, especially at the beginning. Foods that are lower in fiber, including nutritional supplement drinks, can be a helpful strategy to increase caloric intake while minimizing food volume, which reduces digestive discomfort. (6)

Developing an eating plan

Each person’s healthy anorexia recovery meal plan will vary based on individual needs, other medical conditions or allergies, and culturally appropriate foods. Experts recommend that patients in recovery consume three meals and three snacks per day, though some people might find it easier to have fewer, larger meals or more, smaller meals. (4) While in treatment, it is important to work with a registered dietician for an appropriate anorexia nervosa recovery meal plan. A dietician can help you to create a suitable meal plan that includes foods that you like. Your dietician and medical team will monitor your progress and make adjustments to your eating plan as needed.

Tips for meal planning

It can be challenging to increase your food intake during recovery, but support from friends, family, peers, and treatment professionals can help to develop a meal plan and stay consistent with following it. 

If you’re struggling to develop a healthier mindset around eating, the following tips can help you with meal planning:

  • Rather than being concerned about weight, focus on nourishing your body with foods that meet your nutritional needs. (1)
  • Pair fear foods with foods that feel safer and talk to your providers about receiving support during exposures to new or scary foods. (1)
  • Remember that if your meal plan feels impossible at first, it will get easier over time as you physically and mentally adjust to eating regularly. (1)
  • Check in regularly with your goals for recovery to help provide motivation during difficult stages in the process.

At Within, we offer meal plans for all of our clients, and our caring, knowledgeable treatment team will walk alongside you while you do the hard work of recovering. We will help you to develop an eating plan that meets your unique needs, while also providing medical and psychological services to support you along the way.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Marzola, E., Nasser, J.A., Hashim, S.A., Shih, P.B, & Kaye, W.H. (2013). Nutritional rehabilitation in anorexia nervosa: Review of the literature and implications for treatment. BMC Psychiatry, 13, 1-13. https://doi.org/10.1186/1471-244X-13-290
  2. Haas, V., Kohn, M., Korner, T., Cuntz, U., Garber, A.K., Le Grange, D., Voderholzer, U., & Correll, C.U. (2021). Practice-based evidence and clinical guidance to support accelerated re-nutrition of patients with anorexia nervosa. Journal of the American Academy of Child and Adolescent Psychiatry, 60(5), 555-561. https://doi.org/10.1016/j.jaac.2020.09.010
  3. Bargiacchi, A., Clarke, J., Paulsen, A., & Leger, J. (2019). Refeeding in anorexia nervosa. European Journal of Pediatrics, 178, 413-422. https://doi.org/10.1007/s00431-018-3295-7
  4. Roberton, M. (n.d.). Nutrition in recovery from anorexia nervosa. The Victorian Centre for Excellence in Eating Disorders. https://ceed.org.au/wp-content/uploads/2020/04/Nutrition-in-Recovery-from-AN-Sample-Meal-Guides.pdf
  5. Barbosa, M.R.,de Oliveira Penaforte, F.R., & de Sousa Silva, A.F. (2020). Mindfulness, mindful eating and intuitive eating in the approach to obesity and eating disorders. SMAD, Rev Eletrônica Saúde Mental Álcool Drog, 16(3), 118-135. https://dx.doi.org/10.11606/issn.1806-6976.smad.2020.165262
  6. Lauren Muhlheim, P. D. (2021, December 21). Understanding why eating more feels impossible in early recovery. Verywell Mind. Retrieved July 12, 2022, from https://www.verywellmind.com/gastroparesis-and-eating-disorders-5210431

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