Taking care of your child with an eating disorder can be incredibly difficult. You can see how much your child is struggling, and want to make sure that you’re doing the best you can to be able to help and support them. Meal supervision is an important part of Family Based Treatment – the evidence-based treatment for young people with eating disorders like Anorexia Nervosa. Here are some tips for meal supervision to support parents new to this treatment.

Before the meal starts – be prepared:

  • Spend some time before each mealtime considering what you would like to get out of the meal and what support you need to make that happen. If you are a two-parent household, have a good discussion together before you get started. What time are we going to have dinner tonight? What is the meal going to be? Is this a nourishing meal that will help restore my child’s health? Is it the right volume? Have we had a good variety of food across the day? Agree on the task very clearly before you get started.
  • Parents should also have a conversation about how they can best be working together as a team. How can we communicate clearly and firmly the importance of the meal, whilst also showing how much we love our son/daughter? Think about your verbal and non-verbal cues for communication. Make sure that even if you have different ways of connecting with your young person, you have the same underlying message being sent.
  • In the early stages of treatment, many young people won’t be ready to participate in the preparation of the meal. You might like to make sure they are distracted whilst the meal is being cooked and plated up with a favourite activity of theirs.

During the meal:

  • It’s very important that your child knows where the meal will be happening – make it known that you’ll be sitting down at the table together for the duration of the meal.
  • Similarly, be very clear about what you’re expecting – for them to finish the meal that has served.
  • Once they know what is expected of the meal, lots of kids say that they really appreciate it when their parents come to the meal armed with lots of interesting, engaging conversation ideas – what happened at school today, favourite TV shows, the great holiday we had.
  • If your child finding the meal difficult, they’ll need lots of encouragement and support to be able to get through the meal. Remember that they’re being asked to do something that absolutely terrifies them. When the brain is starved and you are experiencing significant levels of anxiety, logical reasoning won’t be able to help your child rationalize their behaviour. Try to keep the tone warm, but firm. Some parents find it useful to become a bit like a broken record, with lots of repetition (“I can see it’s hard, but you need to eat it”).
  • As parents, you are the biggest resource your child has for recovery – Be prepared to persist with the meal for as long as you need to.
  • Watch closely for ED behaviours – these include hiding, ‘messy eating’ (crumbing, smearing, wiping their mouth excessively).
  • If your child is getting really stuck, you might like to break up the task and start encouraging them with one part of the meal at a time. You might also devise some logical consequences to follow if the meal can’t happen in the way it needs to. For example, some parents will try the remaining part at the next meal or snack. Others will have a rule about not allowing their child to attend school until breakfast is finished – this can be communicated to the child by reminding them that otherwise you’ll be too worried about how sick and nutritionally compromised they might be.
  • Seeing your child distressed is extremely challenging – it is essential that parents utilize their own emotion regulation strategies for remaining calm throughout the meal. Parents might need a way to signal to one another if they need to step out of the room to breathe for a moment before returning.
  • Finally, consider what is going to be best for any other children in the house. If the meal requires extended time, they might need to be set up with another activity in a safe place. Make sure they aren’t feeling the need to step in and intervene as extra parents.

After the meal:

  • Ensure that there is some sort of positive activity to move into with your child after the meal. For example, card games, a good movie to watch, or a puzzle can be a great way to distract them whilst it’s feeling tough. The best activities are those done together as a family! Siblings can be a great help here.
  • It’s also okay to try to recognize when your child needs company, as opposed to a bit of space – but make sure that they’re feeling safe to be by themselves after the meal.
  • Finally, where you can make sure that you schedule some self-care in for yourselves as parents – it’s important to recharge your batteries to continue to give the loving compassionate care your child needs.

What strategies have you found helpful for meal supervision? Please share your tips for meal supervision in the comments below!

Please contact the Redleaf Practice for further information and support.