Recovery Meal Plan

Anorexia Recovery Meal Plan

When beginning the journey to recover from anorexia, it can be really difficult to ascertain what a recovery meal plan should look like. Your weight has possibly more-or-less-stabilised, even though your intake is very low, so it feels hard to judge how much to increase your meal plan by to establish weight gain.

It is important to understand that when we significantly reduce intake, our metabolism slows down to try and compensate so we don’t tend to see a correlated loss in weight. Instead, you may find yourself feeling dizzy, sleeping less (or more), getting constipated or your hair might start falling out – all signs that your body is trying to compensate for the lower intake.

It is also important to be aware of refeeding syndrome, which can occur when more food is introduced rapidly in someone who is malnourished or hasn’t eaten in over ten days. Refeeding syndrome is a medical complication that results from fluid and electrolyte shifts when nutrition is aggressively rehabilitated, e.g. if someone goes from a 1000kcal meal plan to a 3000kcal meal plan at a very low weight and after little to no intake for a longer period of time. It is therefore always advised that you introduce increases at a steady rate over 7-10 days, take a multivitamin and have regular appointments with your GP to monitor bloods and your heart.

When building a recovery meal plan and taking refeeding risk into account, aim to build your meal plan up from current intake by around 200kcal/day until weight gain is established. As much as possible, try not to focus on calories, but instead use them as a minimum guide. So for example breakfast could be two slices toast (carb) + 2 tbsp peanut butter (protein) + yogurt pot (fat) + fruit. Although we know that this is around 500kcal, by focusing on including proper portions of all macronutrients, it becomes more about the food than the numbers.

Step 1: Establishing a Recovery Meal Plan

Increasing intake to a weight-gaining meal plan can be very hard to do on your own due to the amount of anxiety you may feel or a worry that you might overshoot. It is often helpful to work with a dietitian initially to help you build the meal plan up in a way that feels manageable but allows you to keep progressing and moving forward. If you would like to book an appointment to see either Nicky or myself, you can do so by clicking here:

https://thebluebirdcentre.com/book-with-nicky/

https://thebluebirdcentre.com/book-with-maja/

The meal plan below is an example of where to aim for. The goal is to work towards having three meals (that comprise medium portions of carbs, protein, fat and a portion of veg) + 3 snacks (of around 200kcal each). This might not be sufficient for weight gain, but will better ensure you are meeting your minimum daily requirements.

It helps to start with using foods that feel safe. It could be that carbs are particularly scary, but that rice feels a little easier than pasta, for example. If this is the case, then I would suggest starting with a small portion of rice and building that up to a medium portion, before introducing pasta, to help reduce the overall anxiety.

Recovery Meal Plan
Example of a recovery meal plan

Start by creating a meal plan for the week based on current intake. Work out what portion sizes you are currently on based on the guidelines in the example.

Step 2: Building Increases

Once you have your initial meal plan for the week, start looking at how you can build it up, based on the example above. The idea is to make at least one change per day and to ensure that change comes with a total increase as well. Aim for an amount that feels do-able and then stick to that. This could be aiming for 100kcal increases per day or 100kcal increases per week, but make sure you stick to that plan so that you continue to move in the right direction.

Step 3: Monitoring Progress

How do you know if the changes you are making are resulting in weight restoration? Many people find monitoring weight incredibly triggering and seeing numbers change on the scales can cause a huge increase in anxiety. Here are some suggestions in monitoring progress:

  1. Ask your GP to do weekly blind weighing
  2. Without looking at the scales, take a photo and send it to someone who can track progress on your behalf.
  3. Go All In. If you know your intake is in excess of the example meal plan, then there is a greater chance of this resulting in weight restoration without needing to record the weight on the scales

Getting More Support

In recovery, many people refer to the idea that “it takes a village”. Recovery is incredibly difficult, so finding and accepting support can be a key ingredient to your success in implementing those changes.

BEAT is a great charity with a helpline to call, a chatroom and free downloads and resources: https://www.beateatingdisorders.org.uk and MentalHealth UK also has some great resources: https://mentalhealth-uk.org/

There are lots of articles on refeeding syndrome, but here is a link from Patient.info: https://patient.info/healthy-living/refeeding-syndrome.

If you are a parent supporting a child with an eating disorder, Eva Musby has some great resources: https://anorexiafamily.com.

We have a newsletter that we send out roughly on a monthly basis. It covers everything related to eating disorders, so hopefully you can find a few helpful suggestions here. Subscribe to our monthly newsletter: http://thebluebirdcentre.com/subscribe/.

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