SWEDA Somerset & Wessex Eating Disorders Association 18-25 Project

Meal Support


"Serving those affected by Eating Disorders"

Meal support

Meal supporting can be a difficult thing to do and to receive. Some 18-25 people have made some suggestions about what may be useful for meal supporters to know.

It is important to remember that each person you meal support is individual and a meal is a very personal and intimate thing to support someone with an eating disorder in.

Therefore it will be important to ask the person what they find useful and also what they find not helpful so that you have a baseline to work together and move forward from.

Things that help

The Environment

It is important to achieve a balance between "normalising" the environment to minimize stress and to be aware of the specific eating difficulties and needs the person you are supporting have. Generally if the meal supporter is providing support in a relaxed way and behaving naturally it helps to demonstrate that mealtimes are a healthy part of everyday life.

The serving

• This needs to be agreed before the meal as on the spot decisions can be very stressful and upset the meal. It is easier for meals to be served away from the table as this saves the agonising time of wondering how much a portion from a shared dish is. It also can make you self conscious with other people around and watching which may make you stressed and not wanting to eat the right amount. But if everyone else is serving themselves being given a ready prepared plate is patronising. In these cases it can be helpful to have someone who can take their portion that you can copy and know it is safe and allowed. So the meal supporter needs to be eating a similar meal to your own so you can see they suffer no ill effects from eating the meal so why should you?

If there is doubt about what size a portion should be talk to a dietician or nutritionist before you plan your meals so that you are all clear about portions sizes.

Distraction

• Having background noise whether this is music or having the radio on can help relieve the tension in the room. Carrying on with general conversation unrelated to food can also help however the person providing the support needs to know that struggles with food can become very preoccupying and intense so do not try to launch into a demanding conversation requiring continual responses.

• So, keeping a light conversation going away from food and eating disorders and where they do not expect you to keep talking back and are not talking about weight, food diets, calories or exercise

• During the meal :The actual process of eating the meal can make you feel extremely self conscious, so it is important not to draw too much attention to the person needing support. There is nothing worse than feeling watched which is why being distracted is helpful with music and the radio

After the meal

• Be cautious of praising someone for completing a meal. This can provoke different reactions in people and is a very sensitive area.
• It is important that people feel that their efforts are acknowledged and that others appreciate what an achievement it is for them, for some people this can enhance shame guilt and self disgust.

The way in which feedback is given is important so it doesn’t feel patronising. It can be helpful to have an activity planned for after a meal to enable digestion to be a natural process and the focus goes away from reflecting on what you have eaten.

It is helpful when the meal supporter is

• Eating a similar meal to your own so you can see they suffer no ill effects from eating the meal so why should you?
• Having people eating around you is reassuring because you don’t feel the centre of attention.
• Keeping a light conversation going away from food and eating disorders and that they do not expect you to keep talking back
• not talking about weight, food diets, calories or exercise
• being able to directly challenge anorexic thoughts when you

Are struggling, possibly using techniques from CBT (Cognitive Behavioural Therapy)

• Firm in that they don’t let you get away with not eating what you are supposed to and who knows to keep a non intrusive eye on food being hidden.
• being non judgmental
• Confident about portion sizes and can eat the same and reassure you it is not too much.
• Having an agreed time scale before the meal can be helpful with gentle or casual reminders can avoid the endless agonising over eating and prevent meals from dragging on indefinitely

helping you to take responsibility for yourself and your meals.

Things which are not helpful

When the supporter is…

• Not eating or eating salad when you have to eat a full meal of protein potatoes and Veg and a pudding.
• Saying "just eat it" is not helpful because it is not that simple! Or we’d be doing it
• Making food the main focus of the meal time.
• Saying "Don’t you like it," as it seems then that they don’t understand since when was it about if food tasted nice!
• Being singled out from a group and commenting on portion sizes , eating habits even if done casually can be extremely embarrassing.
• Having to respond to conversations in a group situation at any length can feel very awkward as you can feel people are watching and judging what you are eating even if this is not the case.
• Watching you and every mouthful of food you eat.
• Drawing attention to you.
• Rushing you to eat quicker or finish as this adds stress.
• Making it obvious that you are taking longer than other people or that you are finishing last

Reflecting on how it is going

• If you are supporting someone maybe check out how regularly you want to talk about how the meal support is and review what is helpful and what is not helpful and talk about the difficulties that you both have and make a plan to help you work together more.
• Being able to be open and honest is important and will help you build trust with each other. If it is hard to do this you may choose to do some writing to each other and then write about what you would like and need and how it feels to be in your role. You may choose to share this with your supervisor to help you work more effectively with the person you are supporting. If you are being supported you may choose to share your writing with your therapist and or with your meal supporter.
• Behaviours can be challenged. It is hard to do therapeutic work at the table because of all the emotions facing food can evoke.
• Sometimes it can be helpful though painful to have issues addressed around portion sizes and tacking really bizarre eating habits at the time is helpful in the long run, although it feels horrible

It can be necessary to ensure adequate amounts are eaten and to prevent really antisocial habits from becoming established and therefore seem acceptable. This needs to be done in a non confrontational or patronising way as an instruction, it simply makes you feel ashamed and defensive, which reinforces negative self perception. Introducing these casually and in a non judgmental manner by phrasing them as suggestions e.g. "Don’t you think it would be a good idea if…?" can reduce a sense of being controlled and encourage self-respect, because you are being prompted to take responsibility for yourself.

What if I have no meal supporter?

• Work with your dietician to create a meal plan that can work for you.
• If you do not have a dietician find a friend you trust about food and ask them to help you plan what to eat and shop if needed.
• Work out when and where you are going to eat each day, so if you are at Uni or college you may need to take a packed lunch or choose to do the canteen with a safe friend or learning support tutor. So make a meal plan to suit your life, check portion sizes if you worry about this with a State registered dietician or reliable book.
• Some people find writing how they feel before their meal , how they feel during and after their meal as helpful and find their health care professional or friend or family to share this with or keep a private journal for yourself
• Sometimes it is important to have a plan of what you are going to do after your meal, whether that is writing, going for a walk, make a phone call, text a friend, drawing , going to a lecture, listening to music going on the website doing an assignment.
• You may find you can only buy food for one meal at a time and do not feel safe to do a bigger than this shop. Sometimes you can ask a friend to shop with you.

If you find yourself reluctant to eat try writing letters to yourself

• It can be hard to be honest but the only person you trick is yourself.

Somerset & Wessex
Eating Disorders Association
Strode House
10 Leigh Road
STREET
Somerset
BA16 0HA


http://www.swedauk.org
Or email lyn@swedauk.org

We can offer support to students in universities in the South West and to those preparing to go to University who have eating difficulties. Check out the website for our leaflets and what is new. We are in the process of creating an email discussion site for young people 18-25.We have support groups in some Universities and are happy to help you set up groups and raise awareness within your university.