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Dr. Shaun Riebl, PhD, RDN, Within’s Chief Nutrition Officer, answers some questions that many have had about what meal support entails at Within. Learn about the support patients receive during their time in treatment when it comes to mealtimes, including how we help them cope with anxiety and triggers.
Meal support at Within includes individualized approaches to help you use meals and snacks as opportunities to get one step closer to recovery. Our team provides you with individualized coaching depending on your current emotional state and overall goals.
Meal support is communal and individual. Meal support groups are offered for breakfast, lunch, dinner, and snacks two times a day. Sometimes, individual meal support can be a part of your individual treatment plan and might occur one-on-one with a dietitian, therapist, or care partner.
Ultimately, Within coaches you to become independent with food decisions. Our treatment philosophy is to help patients become autonomous so you can use internal resources to fuel yourself with delicious, nourishing food. Through meal coaching and support, you’ll work through the toughest aspect of treatment and eventually take back the responsibility of nourishing yourself adequately and consistently.
In addition to meal support, Within provides meal delivery when needed to support your recovery.
During treatment, meal support allows you to have a safe place to eat, struggle, and recover.
It helps you to center yourself around your values versus the values of the eating disorder. Sometimes, patients aren’t aware—or maybe were never told—how the eating disorder uses specific eating strategies to temper anxiety. They don’t realize how the eating disorder uses eating strategies to cope with discomfort or uncomfortable body sensations and feelings. Meal support provides you with the opportunity to learn, grow, and ultimately heal.
When providing meal support, Within's teammates will say something versus nothing because if we don’t say something it sends the message that things aren’t that bad when in reality the eating disorder is running the show.
During meal support is when your Within care team will help you overcome eating disorder beliefs, rules, and thoughts.
Yes and no.
As you get meal support during treatment, you lean on others which helps you feel safe and capable of doing things that are intimidating or different. Once back on your own, the transition can be difficult for some, since you don’t have the same support you had before.
As you progress through treatment, you will gradually use more of your own resources (i.e., skills and tools) at meals and snacks and will eventually have opportunities to practice on your own. You may start with just one snack a day on your own, then one snack and one meal a day, then two snacks and one meal, then two snacks and two meals, and so on.
You’ll build up your resilience to a point where you can intuitively support yourself while at the table outside of treatment. You’ll find you no longer have to rely on eating strategies that keep you stuck, oppressed, or bending the knee to society’s unrealistic ideals.
While not every eating occasion will be with someone else post-treatment, the hope is that many meals post-treatment will be with others.
The cause of anxiety around mealtimes can be multifaceted—the environment, company, health, food itself, and more can contribute to feeling anxious around mealtimes. Coping with this anxiety partly depends on the cause—sometimes in order to get relief we need to identify where the discomfort is coming from. When we know the source that can give us direction on what tools or resources to use. Go-to skills we recommend are grounding, deep breathing, and STOPP.
If anxiety is very high and skills aren’t accessible in order to get relief we may need to distract ourselves. We use distraction cautiously since it doesn’t help us ultimately heal, but postpones the discomfort that comes with healing.
Some people worry about being triggered during meal support and don’t want to do it. Meal support Portioning support, encouragement from staff and peers, distraction and connection with peers through that connection comes a healing experience with food. It’s important to remember that being triggered isn’t a bad thing—it can help us cope and function better and we need to be aware of triggers in order to work through them. When we are able to face our anger, frustration, and/or fear from a non-judgmental stance and look at them with wonder we open up the door for healing.
Being triggered at the table during meal support allows us to explore where triggers come from and what function they play. Meal support benefits everyone at the table—you might be struggling in a similar way to someone else and it can help to talk about it and know that you’re not alone in your feelings.
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.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
