Welcome

Individuals with eating disorders frequently employ a meal plan developed with the help of their dietitian. This plan provides structure and supports a person in having the type and amount of food their body needs, divided over consistently timed meals and snacks.

The level of structure provided by a meal plan can vary from a highly detailed exchange-based plan to a more general entrée-sides plan to more of an intuitive eating-based approach. No meal plan style is necessarily better than another; what is important is that it provides the right level of support for that person at that time. As a person’s ability to manage food intake changes, their meal plan is often adjusted as well. Let’s look at some of the different styles of meal plans in a bit more detail.

Most Americans have at least heard of eating disorders. They hit the public’s radar with celebrity news of the 1980s and have faded in and out of media since. More and more people have shared their own stories online and off, and today, more than half of Americans personally know someone with the illness. A staggering 28.8 million people in our country will have an eating disorder in their lifetime.

But awareness is more than knowing that Princess Diana or Taylor Swift or your cousin had an eating disorder. It’s using that information—or any other reason you were introduced to these illnesses—to understand what they mean. Awareness involves learning more about eating disorders so that we can better prevent, identify, and treat them. 

Here are some facts we’d like everyone to know about eating disorders during eating disorders awareness week and beyond.

Eating disorders and icebergs are more alike than one might think. Picture an iceberg floating in a vast ocean: You can only see the tip of the iceberg and have no idea of what is under the surface of the water. Most people look at an eating disorder the same way, only seeing what is on the outside. This generally represents the behavioral parts of an eating disorder – changes in weight and eating patterns, excessive exercise patterns, purging, restricting, bingeing, selective eating, and so on – the things that, for the most part, you can see, measure, and quantify.

The most dangerous parts of an eating disorder (and an iceberg) are what you cannot see. Below the surface of an eating disorder are a host of maladaptive thoughts and mental preoccupations, shame, distress, and often feelings of deep isolation. Parents sometimes say, “Well, she gained her weight back or stopped bingeing, so she must be better.” Unfortunately, that is not usually the case. Despite looking better on the outside, they may still be plagued by eating disorder thoughts and feelings. 

Episode description:

Stacey Brown, RN, joins us in this episode of Peace Meal to reflect on the role of nursing in eating disorder care. She begins by acknowledging the lack of eating disorder education and training in nursing programs; it wasn’t until she began interacting with patients that she fully understood the impact of these illnesses on every body system. Stacey’s experiences have set her on a mission to speak to nurses at all levels about best practices when caring for patients with eating disorders, including developing strong emotional intelligence. She highlights the importance of every care team member and multidisciplinary collaboration to meet a patient’s full range of needs. The episode concludes with Stacey’s words of wisdom for the next generation of eating disorder nurses.

Tell us about yourself!

Hi! My name is Hannah, and I’m a Behavioral Health Specialist at The Emily Program’s South Sound outpatient site in Lacey, Washington. Currently, I am working virtually, assisting the Adult Partial Hospitalization Program (PHP). I have a BA from the University of Montana, where I double majored in Psychology and Women’s, Gender, and Sexuality Studies. In the nearly four years I have worked at The Emily Program, I’ve worked in-person, virtually, and with clients in various levels of care.

Whether in-person or virtually, you’re invited to assess, assess, assess! In school, we clinicians are taught to ask questions—so many questions. We are taught to ask about our patients’ history, their current happenings, and their future hopes and dreams. We are taught to ask about easy things and hard things. We are taught to ask about things that aren’t socially appropriate and would be extremely uncomfortable outside of medical and mental health settings. We are trained to ask questions about substance use, depression, anxiety, suicide, sexual behaviors, and peculiarities of the human body and its functioning.

Yet, so often, we forget to ask questions about one of the things that sustains life: FOOD! We know that to survive, we need to eat. From conception to the moment of death, we are required to consume, in some way, calories that feed and nourish the systems within the body. Why, then, do we shy away from asking questions about this life-giving, life-sustaining human behavior?

Anecdotally, I hear medical and mental health providers say, “We have never had training,” “I don’t know what to ask,” and “I’m not sure what to do if it seems as though there might be a problem.” However, in the same way that we all learned how to ask, respond to, or intervene following questions about suicidal ideation or even substance use, we can all learn to become more comfortable integrating questions about eating disorders into our patient assessments.