There are several beneficial eating disorder outpatient meal support options for individuals stepping down from a higher level of treatment. Meal support sessions can occur individually or in a group setting with a therapist, registered dietitian, or meal support professional. Each of the following models has various strengths and weaknesses, so it is important for an individual to determine which model best suits their personal needs and recovery goals. A few meal support models that have proven to be effective in the outpatient population include the:
- Traditional Model
- Meal Companion Model
- Intuitive Eating Model
Traditional Meal Model
The traditional meal support model is typically provided in higher levels of care, but can also be incorporated into outpatient settings. This model generally includes predetermined meals and snacks depending on an individual’s nutritional needs. In this particular model, individuals are expected to complete the meal or snack in its entirety in order to challenge disordered eating patterns and develop an understanding of hunger and fullness cues. Registered dietitians are particularly well-suited to facilitate this type of meal support because they are educated on the various food rituals that individuals utilize to alleviate meal-related anxiety and can provide appropriate redirection when they observe these rituals occurring.
Strengths:
- Provides a supportive and educational environment
- Meal completion requirements help prevent restrictive behaviors
- Provides an environment for emotional processing when facilitated by a therapist
Weaknesses:
- Potential to create an environment where individuals compare themselves to others
- Potential for heightened levels of food-related anxiety
- Eating disorder behaviors may trigger others during mealtime
Meal Companion Model
This particular model has often been utilized by registered dietitians in order to provide accountability, encourage meal completion, and identify various food rituals. Rather than conducting this particular type of meal support in a group setting, this model generally occurs in an individualized setting wherein an individual meets one-on-one with a meal support professional. This type of meal support is most effective when utilized in tandem with other forms of therapy and can often be beneficial for those who may be stepping down in levels of care.
Strengths:
- Offers individuals a sense of accountability
- Reduces the level of meal-related anxiety by occurring in an individualized setting rather than a group
- Provides feedback regarding food rituals and disordered eating patterns
Weaknesses:
- Multidisciplinary team still required
- Individual may be too undernourished for the model to be effective
- No official training guidelines for meal companions
Intuitive Eating Meal Model
This approach teaches an individual how to create a healthy relationship with food by establishing ways in which to differentiate between physical and emotional feelings. In order for this particular model to be effective, an individual must be nourished and have the ability to recognize their hunger and fullness cues. The ultimate objective of this meal support model is for an individual to learn that their worth is not based on the types of food they consume. This model incorporates mindful eating techniques wherein an individual is required to demonstrate self-awareness regarding their hunger and fullness cues under the guidance of a meal support professional.
Strengths:
- Based on an individual’s personal ability to self regulate
- Can be adapted for children as well as adults
- Helps to reduce an individual’s food-related guilt
Weaknesses:
- Individuals may have different levels of hunger and fullness during group
- Individuals may be triggered by the amount of food eaten by others
- Individual must be adequately nourished in order to participate
