Eating Disorders for Parents: Balanced Eating

Eating nutritionally balanced meals and snacks is important for everyone’s mind and body. During the recovery process from an eating disorder, your child will work with a registered dietitian to normalize eating habits. The goal of eating is to keep your child’s body nourished, energized, and strong. Eating in a healthy, but inclusive and balanced way will help your child to concentrate and learn in school, reach and maintain a healthy weight, grow to a maximum height, and stay strong for sports and other physical activities. Healthy eating is not supposed to be a strict diet plan; it is flexible and may differ from person to person. It involves eating regular meals and snacks, along with occasional treats. To eat in a nutritionally balanced way, your child should eat foods from all of the food groups (carbohydrates, proteins, fruits, vegetables, dairy, and fats) as well as some “fun” foods because each group has different benefits for the body and the mind.

Carbohydrates: The carbohydrates in foods like grains and starchy vegetables supply the brain and muscles with energy. They help keep our minds sharp and focused and are needed for physical activity.

Dairy: Vitamin D fortified and calcium–rich dairy foods help to keep our bones strong. The protein in dairy foods also helps keep us full between meals.

Fruits/Veggies: These foods contain many important vitamins and minerals, as well as fiber which is necessary for normal digestion.

Protein: Protein has many important functions in the body from nourishing hair and nails to repairing and building muscles.
Fats: Fats found in oils (such as canola oil or olive oil), nuts, and fish are great for our heart and skin, help us make important hormones and provide energy.

Meal Plans: Meal plans are designed to help your child transition back to healthy eating. During treatment, your child may get a meal plan from the registered dietitian that breaks down each meal into servings of food (called “exchanges”) from the different food groups. Each meal should include exchanges from all or most of the food groups, and the number of exchanges that your child needs (from each food group) will be based on his/her overall caloric needs. The dietitian will help design meals and snacks based on the exchanges on the meal plan that fit your child’s individual needs. Meal plans are not typically used if the family is participating in family–based therapy (FBT).

Snacks: Snacks give your child energy between meals and will prevent him/her from getting overly hungry. Healthy snacks should be made of two or more food groups. In the sample list of snacks below, you can see how the snack ideas are made from different food groups such as the carbohydrate, fat, dairy, fruit, vegetable, and protein groups.

Sample Snack List

• Banana with peanut butter (fruit/protein/fat)
• Grapes and a cheese stick (fruit/dairy/fat)
• Whole milk vanilla yogurt with strawberries (dairy/fruit/fat)
• Cheese and whole grain crackers (dairy/carbohydate/fat)
• Hummus and baby carrots (protein/vegetable/fat)
• Nuts and dried fruit (protein/fruit/fat)

Grocery shopping: Ask your child if he/she is comfortable going grocery shopping with you. Your child may be working with a registered dietitian to set goals for trying new foods or reintroducing foods. If going to the grocery store seems stressful for your child, he/she can create a list of foods with the dietitian beforehand. Once your child is more comfortable with grocery shopping, take time to explore the entire grocery store and look for different brands or new foods to try.

Cooking: Planning your child’s meals and snacks ahead of time can minimize the stress during meal preparation. The dietitian can assist with meal planning and brainstorm about ways to give the best support around meals and snacks.

Hunger and Fullness: Eating when we’re hungry and stopping when we’re full helps our bodies balance energy needs and keeps us comfortable. Throughout the recovery process the dietitian can help your child understand how to tune into the body’s hunger and fullness cues. Learning to both listen to and understand our body’s cues takes time. Using a hunger and fullness scale such as the one below can help young people better understand their bodies. A scale will help your child learn to eat when feeling like a “3” and stop eating when reaching a “7.” If your child is already keeping a food journal, encourage them to talk to a dietitian about whether to include hunger and fullness ratings in the food journal.

Sample Hunger and Fullness Scale:

0 – Starved, feeling faint and weak with hunger

1 – Extremely hungry

2 – Very hungry

3 – Hungry, strong desire to eat

4 – Somewhat hungry

5 – Not hungry nor full

6 – Somewhat full

7 – Full, don’t need to eat more

8 – Very full

9 – Uncomfortably full

10 – Stuffed, painfully full