What does “normal” eating look like?
To be clear, "normal" eating is a very subjective phrase and is not meant to describe one specific diet, plan, or program. There are many different ways to consume food and beverages as part of a regular routine. Essentially, "normal" eating means eating that's not connected to disordered thoughts or behaviors.
In many ways, the ideal way to consume food and beverages is by listening to your hunger and satiety cues. These little internal tugs can help you understand when you're hungry, how hungry you are, the types of foods you may want to eat, and when to stop eating. Ideally, people who are in tune with their hunger and satiety cues:
- Eat for pleasure as well as health
- Don't feel the need to restrict or deny themselves certain foods
- Include a nutritious balance of foods in their diet
However, hearing and staying in touch with these internal nudges can be difficult, even for those not in eating disorder recovery. That's why nutritional education and meal planning are such major parts of bulimia nervosa treatment.
Initially, most patients will be placed on eating plans that include distinct meals and snacks to help establish healthier and more consistent eating patterns. This helps instill the idea of intentionality in eating, leaving less room for maladaptive coping behaviors to take over.1 The goal is for patients to become accustomed to eating in a consistent manner and eventually be able to make their own decisions about when and what is right for them to eat.
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Tips for returning to “normal” eating after eating disorder treatment
Getting back into a consistent eating pattern is not easy when recovering from an eating disorder. Many people in bulimia nervosa recovery can feel anxious or uncertain about preparing and eating balanced meals, even with a desire to get better.
Here are some suggestions for how to ensure that you’re providing your body the nourishment and nutrition it needs, while not letting your fears overwhelm you.
Stick with your meal plan
During treatment, most people living with bulimia nervosa are provided with some kind of recovery meal plan. Ideally, these are straightforward, easy-to-follow programs that are tailored to the patient's specific needs. In many cases, patients
continue to use these meal plans into the early stages of post-treatment recovery.
However, without the support of a treatment team, it can be challenging to adhere to any kind of plan, especially during times of stress. If you're struggling with this aspect of recovery, you may want to:
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- Avoid "clean eating" sites: While some of these sites are well-meaning, they often promote unhealthy or unrealistic ideas about food, including restrictive diets and labeling foods as “good” or “bad." Often, these ideas are presented as healthy and inclusive, which can make this content even more dangerous.
- Draw on positive memories: If you're struggling to find joy or pleasure in eating, try incorporating meals that bring back comforting or happy memories. Creating positive associations with food is a great way to build or maintain a healthy relationship with food.
- Plan your meals ahead: Planning your meals for the week can feel overwhelming, but it goes a long way toward alleviating stress in the long run. Planning your week's worth of meals, shopping for them, and preparing them all at once can help ensure you have nutritionally balanced meals available throughout the week, making it much easier to stick to a plan and resist the kind of stress or anxiety that can lead to disordered eating behaviors.
- Meal subscriptions: Some individuals in recovery from bulimia nervosa really benefit from meal delivery services. Not only do they take some of the pressure and anxiety away from meal planning, but they also encourage experimentation with previously feared or restricted foods, while helping someone maintain adequate nutrition.
Boost your food flexibility
While structure is essential for a successful meal plan, it's also important to
leave some room for flexibility and treat moments when you deviate from your plan with grace. Restrictive eating habits have long been tied to binge eating behaviors, and black-and-white thinking, such as labeling foods as "good" or "bad," is another disordered and potentially dangerous habit.
3 Building flexibility—slowly, and safely—is the first step toward truly autonomous and "normal" eating after bulimia nervosa treatment.
You may want to start exploring this idea by making a list of your previously “banned” foods or food groups and working on incorporating them into your recovery meal plan. Situations you used to fear or avoid, such as eating out with friends, can be treated in the same way. You may even have already done some of these exercises during treatment, especially if you participated in
exposure therapy.
Incorporating previously feared foods as regular parts of your diet can decrease the feeling that these foods are dangerous, forbidden, or otherwise triggering. Unless you have a known allergy or medical intolerance, no foods need to be off limits. Working with a therapist or dietitian can help you continue to challenge food rules and fears while maintaining a healthy diet.
Learn how to build adequate and varied meals
While following a meal plan during treatment and the early stages of recovery can provide crucial structure and guidance, many people in recovery from eating disorders eventually want to transition towards incorporating more autonomy and intuition into their meals and snacks.
If you are still working with an eating disorder dietitian or therapist at this stage in your recovery, they can help you gradually transition from a set meal plan to a more flexible and intuitive style of eating. There are also some helpful free resources online from eating disorder specialists that provide advice about how to maintain recovery while no longer relying on a meal plan.
In general, it's good to eat a variety of foods, making sure to get all of the major macronutrients and necessary vitamins and minerals. This can look different for different people depending on nutritional needs, preferences, and allergies. If you have a limited palate, health conditions that are impacted by specific foods, or a history of nutritional deficiencies, it may be helpful to consult with a dietitian or another trained medical professional to ensure you can meet your nutritional needs while managing co-occurring health conditions.2
Ask for meal support
Meal support is another common aspect of bulimia nervosa treatment, and many people benefit from incorporating this idea into their post-treatment recovery, as well. This can be especially helpful if you're having trouble following a meal plan and would like a bit more accountability in your recovery journey.
In treatment, meal support is typically provided by a volunteer or trained professional who simply sits with someone while they eat, helping them feel comfortable and encouraging them in their efforts. If you're looking for this same type of support and connection outside of treatment, consider asking a family member or friend to join you during meal times. This can also help shift the focus away from food and create a more enjoyable experience overall.
Practice self-monitoring
Self-monitoring is a big part of eating disorder recovery. It's the most important goal patients strive for: to feel more comfortable making their own decisions about food and eating.
If you’re struggling to eat regularly, you may want to consider setting alarms as reminders of when you should eat, particularly if you’ve returned to your normal school, work, or home activities.
Journaling is another helpful technique to develop self-monitoring. You should note down if you engage in binging or purging, or experience any unhelpful urges or thoughts, along with what you were doing or thinking at the time. Make sure to record these details while refraining from shame or judgment. This will help you analyze and understand potential triggers and implement alternative coping strategies in the future.
Avoid the scales
Placing extreme value on one's body weight, shape, and size is a defining characteristic of bulimia nervosa. And the physical changes that often come with recovery can be triggering for many, or at the very least, stressful.
For many people in recovery, it may be most beneficial not to weigh themselves during this time. If weight measurements are needed for medical reasons, you can ask for a blind weigh-in, which will relay the appropriate information to your treatment team, without you having to see the number on the scale.
Learning to love your body at any size is a crucial aspect of recovery. Seeing a number on a scale may encourage the desire to lose weight, which can pull you back into disordered eating habits.
Listen to your body
When you’ve been stuck in a cycle of binging and purging, you can lose track of your body’s
natural cues for hunger and satiety. Once you have been following a meal plan and eating regularly for a while, it may be possible to listen to your body to gauge feelings of hunger and fullness.
Tools like the
hunger/satiety scale can be helpful ways to start listening to your internal cues. Food journaling is another good option for getting a sense of your natural eating rhythm. And if you're still seeing your therapist, they can provide more support and ideas around how to start trusting your own body again.
What foods to eat when recovering from bulimia
Eating disorder treatment is a highly personalized endeavor. Everything, from treatment methods to meal plans, should be tailored to an individual patient's specific history and needs. Consulting with an eating disorder dietitian is a great way to understand the specific foods that may be best suited for your recovery journey.
With that said, it's generally important to eat a well-balanced and adequate diet in eating disorder recovery.
Some foods to keep in mind when meal planning include:
1,2,4
- Healthy fats. These come from foods such as avocados, fish and fish oils, nuts, seeds, and olive oil. "Fat" may be an especially scary word in eating disorder recovery, but healthy fats are what help your body absorb many essential vitamins, as well as keep your organs warm and your skin healthy.
- High-protein foods. This includes poultry, beef, and fish, of course, as well as nuts, legumes, eggs, and certain dairy products. Proteins help your body stay strong and healthy, and are the building blocks for healthy nails and hair.
- Carbs. Another scary word for many people recovering from an eating disorder, carbs are actually essential parts of the human diet. They provide the body and brain with a reliable source of energy. Complex carbs, which can be found in legumes, starchy vegetables, and whole grains, are best.
- Fruits and vegetables. Fruits of all kinds, but especially berries, provide many important antioxidants to the body, which help with cellular upkeep and repair. Vegetables are frequently packed with vitamins and nutrients. Both are healthy sources of fiber, which helps regulate digestion.
Finding help in eating disorder recovery
For people in eating disorder recovery, especially those who have struggled with these conditions for a long time, it can feel scary, difficult, and confusing to imagine a "normal" eating routine or relationship with food. Approaching this process gradually, with the support of medical professionals, family, friends, and peers in recovery, can help alleviate these fears and foster a sense of patience and acceptance during the recovery process.
Over time, you may surprise yourself by feeling ready to transition to a more flexible and intuitive style of eating. But it's important to remember that there's no one way to eat "normally" after bulimia recovery. So long as your nutritional needs are being met and you're doing your best to eat consistently and honor your hunger and satiety cues, rather than relying on disordered eating behaviors to inform your eating schedule, you're doing well.
If you find yourself struggling with these concepts, that's okay and perfectly normal. Recovery hardly ever happens in a straight line. Just as it's important to stick to a consistent eating plan, it's important to stick to other routines that help support your mental health. Regularly speaking with a therapist can be a great way to stay on track and deal with any potentially triggering situations.
