Food Strategies
Disclaimer: I am not a doctor, I am not a psychologist, I am not a counselor. The best treatment is intensive therapy or a stay in an eating disorder clinic. If there are any contradictions between myself and a professional, side with the professional.
You have to play hard ball with Ana. She’s a conniving, deceptive little monster, and you have to manage to deceive her without being dishonest with your loved one, which is supremely difficult. I’ll do my best below to help you differentiate between good and bad strategies. I call them “strategies” because this is warfare.
Do
... get your loved one in to see a doctor to get a full work-up and visit a nutritionist. Find out in detail what foods she needs most, and in what ideal quantities. Don’t rely on your own judgment, because a seemingly full-proof food could end up being deadly. For example, a particular anorexic whose intestine lining is thin, underused, and in poor condition can be hurt by apples, which contain pectin.
... explain the value of each food. You’re going to have to get quite well-versed on the subject of nutrition so you can explain that a banana has potassium and that potassium is necessary to ______.
... serve many small snacks instead of meals, since this is less threatening. In recovery programs they space them about two and a half hours apart.
... make a weekly menu that doesn’t change during the first stage of recovery. This will give her a sense of stability, even if the food itself is frightening.
... share a plate with your loved one. Make up a plate for yourself, sit close beside your loved one, and encourage her to eat off your plate. This will make her feel that she didn’t have a meal, but that she only nibbled.
... ask her how much she ate directly after the snack. Sometimes a small bite of sandwich will somehow translate in her mind to be “I ate a whole sandwich.” You need to catch this kind of thinking quickly and cut it off.
... go out with her to buy a special set of dinnerware. Often eating disordered persons will have specific dishes that they use. These are usually small dishes so that she can only eat a little at a time and it looks like a lot, and perhaps quite drab, maybe even chipped. Likewise silverware. We need an alternative that provides her with the same reassuring sense of routine but is far more cheerful. It should always be the same bowl, plate, fork, spoon, ect. Make sure they are big, to make the food look smaller than it is, and also because you’re going to be sharing meals with her. This is a temporary measure until she’s better.
... touch her constantly while eating. This reassures her that she is loved and is being encouraged to eat.
... distract her with animated conversation during snack time to keep her mind off of what she’s doing.
... distract her with anything other than TV and exercise after snack time to keep Ana from berating her. Board games are a good idea.
... choose “safe” foods. Safe foods are foods that aren’t frightening for anorexics and bulimics, which would be extremely, obviously fatty foods. Now, this doesn’t mean that you shouldn’t try to choose foods that are healthy for your loved one. Try to find things that are packed with vitamins and nutrients, even in small quantities. If you can get your loved one to eat fattening foods, then by all means, certainly make the effort.
... be relentlessly cheerful. Since your loved one’s eating is a life-or-death situation, you might feel that it’s intense. She’ll pick up on that, and the pressure might be too much. Be happy about eating with your loved one, and she’ll pick up on that too.
... remove the nutrition labels from all your groceries so Ana can’t make her check calories and fat content.
... ask a nutritionist if you should give your loved one slimfast once a day. Slimfast has a lot of vitamins and nutrients. Make sure though that your loved one understands that you’re only giving her Slimfast because you want her to have a lot of nutrients and you also want her to feel safe, and not because you think she should be on the Slimfast diet.
... encourage “just one more bite.” This war is won calorie by calorie. Don’t say “You have to eat everything on this plate” or “Eat that sandwhich” if she’s kicking and screaming. Cajole her into having one bite, and then praise and ask for another. It’s small, but it matters.
... know when to back off. You do have to be really persistent, and she’s always going to put up a fight when she eats, but there’s a time when you’re not going to get anywhere, and you should know when that time is. If she’s crying and telling you that she wants to eat for you, but she just can’t, no matter how hard she tries, just hold her and tell her you’re not angry at her, then try again just a little later.
... be patient and persistent. If she says she can’t eat something, keep the plate of food on your lap as you sit next to her and talk about it. Try not to put on a lot of pressure, just make it feel safe. I’ve heard of therapists waiting with eating-disordered children for hours upon hours with plates of food, gently and lovingly talking them through Ana’s lies.
Don’t
... try to force feed her. Since most eating disordered persons have been raped or molested, forcing them to put something in their body that they do not want will only further traumatize them. In the event that doctors determine that it’s absolutely necessary to force feed or use a feeding tube, then of course allow this despite the trauma, because you need your loved one to be alive long enough for you to get the chance to help her recover fully. It's the lesser of two evils.
... ask her to eat for you. This will only make her feel more guilty if Ana will not let her eat.
... punish her in any way for not eating. Don’t tell her you’re disappointed in her, don’t physically hurt her, don’t ground her, don’t give her a guilt trip, don't take away privileges.
... choose foods that are impossible for her to eat. You should definitely at least try to get her to eat fattening foods, since fat is what she needs most of all right now, but be aware that these are likely to fail because Ana will punish the anorexic too severely for what she’ll call an unforgivable indulgence.
... trick her. Adding weight-gain formula to her Slimfast may seem like a perfect solution, and believe me it’s a great temptation, but if you’re found out you will have lost the trust you worked so hard to gain. Ana will be able to say “Look, she lies! How then can you trust her when she says that you’re good and lovable?” It's doubtful that you will ever be able to make any kind of headway with her again.
... tell her to just suck it up and eat. She is completely incapable of doing something like that. Imagine that she’s a victim of a cult, and has been thoroughly brainwashed for years. That’s basically what’s happened to her, and it doesn’t just fix itself. She’s not faking this disease to get attention, she’s seriously ill.
... sit down to a family dinner, unless she specifies otherwise. Anorexics and bulimics are terrified of these situations and it will put on added stress. If you want your loved one surrounded by family members as she eats, then have a picnic, eat in front of the fireplace, do something informal where she will not feel that everyone is examining what she’s eating.
.... make her eat something the rest of the family isn’t eating, it’ll make her feel singled out.
... take her out to eat, unless she specifies otherwise. For the same reason as above. If she has a craving for a particular food that’s only available through a restaurant, you might want to order the food to go and either eat in the car or take it home.
.... let her cook for the family. Eating disordered people, and in particular anorexics, always want to take care of everybody else, while denying themselves. She needs to be taken care of right now, not the other way around. Don’t encourage their obsession with sacrificing for everyone else. If they really want to cook, cook alongside them and make it a fun experience that you get the entire family involved in. Urge taste tests.
... tell them they look disgusting and therefore should eat. Clearly, a lot of unappealing things happen to a person’s body with this disease, what with all the bones sticking out everywhere. Heck, I turned a bit ashy and yellow, and my hair was falling out. But insulting her is not the way to go. Besides, you don’t actually mean that they are ugly or disgusting, what you mean is that their emaciation doesn’t look good on them and it frightens you, but in reality they are still beautiful. Try to look at them in terms of what I like to call “potential” beauty. If you feel the need to comment on their emaciation, you might say “You’re beautiful, but your body just looks like it’s in so much pain, and it hurts me sometimes to look at it because of all the pain I see. You’re going to be so much more beautiful when you’re well.” Only say that if you mean it though; these people have a hyper-developed sensitivity to the feelings of others, and they’re likely to sniff out an insincere compliment (even if this one is a bit backhanded.) Again, some specialists say that it’s not a good idea to comment on body at all, but I disagree.
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Email: ericaherron@hotmail.com