Kids with eating disorders may struggle with transitions, including changes to levels of care, changes to schools and friend groups, and going back to school. These changes can be especially challenging when eating disorder behaviors are used to cope with these transitions.
Below are some ways to help support your child as they return to school, gain more independence and confidence, and reclaim food freedom.
Continue to have three meals with two to three snacks per day, with all food groups present.
Continue to follow the meal plan as provided by a dietitian to ensure that all nutritional needs are met throughout the day. As kids progress through different levels of care, their meal plans may change to reflect their nutrient needs to preserve recovery.
Be flexible with meal and snack times.
Kids with eating disorders should continue to have meals and snacks spaced no more than three hours apart. These times may vary from day to day. For example, breakfast at 9 a.m. on the weekend versus 7 a.m. on a school day—which is OK if their nutritional needs are met.
It is important for kids to have a routine to maintain their recovery and better connect them with their own internal hunger and fullness cues.
Prioritize a minimum of 75% meal and snack completion.
During early recovery from an eating disorder (at the residential and partial hospitalization levels of care), children are expected to eat 100% of the food on their plates. However, as they advance through recovery (at the intensive outpatient and outpatient levels of care) and begin to trust their own internal hunger and fullness cues, it is acceptable for the child to check in with their hunger cues at around 75% of the meal to determine if they are still truly hungry.
Encourage your child to make their own food choices or participate in meal and snack planning.
As kids progress in recovery, involve them in choosing food options and meal planning. You might give them a choice between options A or B for meals or planning and include them during grocery shopping. This could also involve kids choosing preferred snack items to add to a snack basket for their designated snacks to meet their meal plan requirements.
Allow for second portions and eating outside of the meal plan.
As your child begins to lean into their hunger and fullness cues, they might ask for extra food outside their meal plan or seconds at meals. It's important to give those recovering from eating disorders the chance to expand their diet beyond the meal plan to challenge disordered thoughts and diet culture norms. Meal plans provide the minimum nutritional requirements for recovery.
Do not expect perfection or rush recovery.
Recovery from eating disorders is not a straight path. There isn't a perfect way to recover, and each person’s journey takes a different amount of time. Your child will likely need extra support during transitional periods to avoid slips or lapses. There's no shame in needing additional help or returning to a higher level of care to protect health and prevent a full relapse.
While implementing the steps above, keep observing your child’s behaviors during recovery. If at any point your child starts to withdraw, consistently eats only the bare minimum, has limited food variety, begins hiding foods, or argues or negotiates around meal or snack times, contact the treatment team for additional support to prevent relapses.
In addition to therapy for all ages to address eating disorders, Pine Rest also offers an intensive daily program for ages 12 through high school completion. Called a partial hospitalization program, it is tailored to address the unique needs of each child through a combination of medical, psychological and nutritional support, using a holistic approach that combines mindfulness-based movement and food education.
Megan Heath, MEd, RDN, is an eating disorder registered dietitian with experience at all levels of eating disorder care. She has a bachelor's degree in dietetics with a master’s degree in health education and promotion with a concentration in eating disorders. She is currently working on her Certified Eating Disorder Specialist credential to further her eating disorder education. She is passionate about helping those with eating disorders recover and live full, healthy lives.
Courtesy of Pine Rest Christian Mental Health.
