1. Don’t offer too much choice. (It sends the person with an ED into a mental spin)
For example: not ‘would you like a yoghurt?’ but ‘what flavour yogurt would you like?’
2.If you’re working with a dietician/meal plan, then stick with this. It will help the sufferer to know in advance what they’re eating and how it has been prepared: but don’t let them get involved, (especially in early stages of recovery).
3. don’t renegotiate food over mealtimes, don’t bribe and don’t blackmail.
4. stick to routines (this will help the sufferer feel less anxious), e.g; when and where you eat. Don’t eat in public in the early stages of recovery unless you’ve planned it in advance.
5. offer lots of encouragement:
‘you’re doing really well.’ ‘I know this is hard, but I’m so proud of you’.
Don’t remind them about the starving children in Africa or make them feel guilty. It might be appropriate to gently remind them of long-term goals, e.g: ‘I know you were saying how good it’ll be to eat with friends when you’re a bit better’.
6. try to stick to non-stressful topics (TV, current events, weather) and keep conversation as normal as possible.
7. model enjoyment of eating and reassure the person that it’s good to eat and they are ok, even if they feel stressed. If you notice unusual behaviour, then gently raise it along with how they feel:
‘I can see you’re struggling with your meat and hiding it under your vegetables. Can you talk to me about why that’s hard?’
8. set times for eating as appropriate, e.g: meals maximum of 30 minutes and a minimum of 15 minutes; snacks a maximum of 15 minutes
9. toilet breaks to be taken before or after meal, food not to be reheated.
10. give the sufferer time to talk after the meal. Activities that might be useful can include: Gentle soothing or motivational music, journaling, arts and crafts, deep breathing, meditation, board games, watching a film.
Ref: British Colombia Children’s hospital. Meal Support, Introduction for Parents, Friends and Caregivers, Auckland Eating Disorder Service, booklet for carers, 2008: full link here