Meal Support is a term you may have heard of before in regards to eating disorder treatment and recovery. In case it’s a new term: meal support is an opportunity to have a shared meal and sometimes occurs in a group setting or 1:1. 

As a therapist I will often share meals with clients to offer an opportunity for a therapeutic meal with exposure support as we work on introducing avoided or feared food, building skills for resourcing emotional regulation tools, and to allow the accountability for a client to eat a meal when they may not have otherwise done so.  

As a therapist I will often talk about how Eating Disorders don’t really have much to do with food. In the sense that the behaviors with food are on the surface and what we are able to see and tangibly identify has a problem or disordered. The root of Eating Disorders the “why” is usually much deeper underneath the eating behaviors and eating disorder thoughts. It’s complex and involves genetics, beliefs, shame, fear, anxiety, avoidance, and trauma. There is no 1 cause of an Eating Disorder and to make it even more tricky we do have to talk about food.

In fact because eating disorders are multifaceted have a physical, psychological, and spiritual effect we have to care for the whole system. From a physical and biological perspective we have to provide care to that sometimes 1st or at least in tandem because if we don’t it’s like pushing a boulder up hill and wondering why you aren’t moving. That is why having a dual team of a registered dietitian and therapist is so important, because when only one aspect of the disorder is receiving treatment you are always left with a boulder you’re trying to push uphill.

Meal support is one example of the collaborative and holistic model of care exists in eating disorder recovery and is a very beneficial aspect of treatment and recovery. It’s an experiential experience that allows for real time support and benefit during an exposure to a stressful event like eating.

---

Some benefits of a supportive meal are:

1.  Social Support: Eating disorders thrive off of isolation and disordered behavior that develops is usually a desire to eat alone due to anxiety, shame, fear, and/or avoidance.  Having a shared meal with others including peers allows for normalizing eating with others, rebuilding social engagement during meals, and the social accountability to eat a meal even when it is hard.

2. Emotional Support: Meal time can be a time of anxiety and other intense emotions. Meal support allows for the opportunity to receive not just social support but the therapeutic support of real time emotional regulation and safety resourcing.

3. Skill Development: developing the life skills of recovery based eating: normalized eating with others, emotional regulation tools, meal time preparation and meal planning, taking time for meals, and  attunement to hunger/fullness/satiety.

4. Nutritional Guidance: when meal support is provided under the supervision of a registered dietitian nutritional guidance can be provided, normalized meal sizes, hunger fullness, and the intuitive eating skill of gentle nutrition. 

5. Structure: Avoidance and chaotic meal times can be an experience common with disordered eating. Skipping meals because it causes anxiety, having food rules around how often or what times you should be eating, or not prioritizing meals as an act of care can be common behaviors.  Meal support provides structure to build new experiences and beliefs around meals.

6.  Thought Challenging and Reframing: Real time eating disorder thought challenges and reframing.  Eating disorders usually have a lot of thoughts and beliefs that exist around eating and meals. Meal time allows for an opportunity to share, challenge, reframe, and redirect thoughts.