Family meals for eating disorders

Kids with eating disorders are often prescribed family meals as part of treatment because they can help on so many levels. For example, one study found that more frequent family meals, placing a high priority on family meals, and a positive atmosphere at family meals are positively correlated with less disordered eating.

For example, 18.1% of girls who had 1-2 family meals per week engaged in eating disorder behaviors compared with 8.8% of girls who had 3-4 family meals per week. This means that when we double the number of family meals per week, we cut the risk of disordered eating in half. Researchers concluded that family meals have the potential to play an important role changing unhealthy eating behaviors.

A healthy plan

Feeding kids with eating disorders is tough, but family meals help. Here’s how to get started:

1. Make family meals a priority

The first step is to make eating together a priority. Of course, I understand this can be challenging. But the health benefits are clear.

Prioritizing family meals doesn’t have to mean dinnertime. If dinner won’t work, can you all wake up a little earlier and have family breakfasts? Luckily, the type of food you’re serving doesn’t matter. This is about the action of sitting down together to eat. So load up on easy-to-make foods and focus on the gathering rather than the food.

When you prioritize eating together as a family, you are prioritizing the family unit. You are demonstrating the value of human connection as it relates to food. Don’t let our modern lifestyles fool you: humans have always shared food together as a signal of peace, belonging and connection. Our kids’ health depends on these things much more than the latest superfood.

2. Eat together frequently

The word “frequently” will vary from family to family. In FBT treatment, a parent serves all food and eats with a child 5-6 times every day. But even if you aren’t doing FBT, eating together once per day can be therapeutic for a person in eating disorder recovery. Can’t do that? Can you commit to a minimum of two meals together every week?

You may have to adjust schedules. You may have to mix the times of meals. Sometimes, a “meal” may be an afternoon or late-night snack. The idea is to commit to sitting together with food as often as possible for your family.

This will get easier over time. Once you make the commitment and get over the initial panic over how you can possibly achieve your goal, you may find it surprisingly easy to make it happen. If necessary, start a calendar to track your meals together and give yourselves stickers so you can all see how you are doing in meeting your healthy goals of eating food together.

If you can’t get the whole family together, don’t give up! Gather as many members as possible whenever possible. Even if just two people are in the house, they should eat together, not separately.

3. Get it on the table

It’s not easy to think up meals for everyone. Here’s the easiest method I’ve heard of to plan meals. First, let’s define a meal. Your goal is to serve all four of the following: carbohydrates (~50% of the meal), protein, fats, and fruits/veggies. A snack is defined as any two of those. This balance of carbs, protein, vegetable/fruit and fat is essential to a healthy body and mind. And once you get in the rhythm of planning meals this way, things get easier. Here are some examples:

• Buttered pasta, tomato sauce with meat or tofu, salad
• Baked potato with cheese, turkey chili, coleslaw
• Rice, fish, and stir-fry vegetables with sesame oil sauce on top
• Tortillas, beans, ground meat, cheese, and pico de gallo
• Cheeseburgers, broccoli
• Pizza, chicken breast, sliced cucumber

Those are dinner ideas, but this meal balance applies to all meals of the day. So breakfast might be waffles, full-fat yogurt, bacon, and fruit. Lunch can be a turkey sandwich with mayo and cheese, chips, and a tangerine.

Once you get in the swing of planning family meals, you can mix and match your elements. But every meal should have all four elements. You’ll find that full meals will reduce hunger throughout the day. You should all still have 2-3 snacks to keep you going.

4. Create a positive atmosphere at family meals

Of course, kids with eating disorders don’t usually want to have family meals. That makes sense, and it’s a symptom of the eating disorder. You do not need to accommodate the eating disorder’s wishes – nor should you! Serve family meals anyway.

As long as the eating disorder is active, you may find meals are generally unpleasant. This is unfortunate, but the only thing within your control is your behavior. You can’t control your child’s resistance and bad moods, but you can make sure that you are putting in the effort to make family meals positive. Learn how to respond to your child’s food refusal and mealtime tantrums calmly and assertively.

Encourage everyone to think consciously about approaching family meals from a positive mindset. In fact, make this an explicit goal of the family meal.

5. Remove distractions

A family meal won’t improve your family connection and support eating disorder recovery if people are distracted by other things. Unless you’re doing FBT and have been advised to use it as a tool, turn off the TV. Keep phones, tablets, and other distractions off the table – literally. In fact, keep them at least 10 ft away from the table and switch them to airplane mode if they continue to be a distraction.

It’s important to gather around a single dining surface. It could be a dining table, a kitchen island, a coffee table, or a cardboard box. The goal is to have everyone’s plates and glasses sharing the same surface at the same time. This builds the communal concept of family meals. It makes a difference in how each person perceives the value of your shared meal. Some families may enjoy bringing out the fine table linens, dishes, etc. and (finally) use them. They light candles, set the dining room table, and dim the lights a little bit. Then they bring takeout food to the table and dig in.

Remember, it’s not what you eat, but how you eat (communally) that matters. The idea is that you are making a statement: we are a family, and we are sharing food together. Feeding a child with an eating disorder isn’t easy. But more family meals can help kids recover from eating disorders.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder