Nutrition Intervention for Eating Disorders: Nutrition Education


127 Legalizing food begins as a concept and a goal, rather


than a behavior. Teach your patient the concept, even if he or she is not yet willing to embrace it. It may takes weeks or more of successful eating experiences before a formerly forbidden food can be eaten without


remorse. Because


American culture reinforces the good/bad dichotomy of food, patients will be challenged by external messages at the same time they are trying to change their internal ones. If your facility encourages or requires patients to eat “risk” foods or “food challenges,” support should be provided before and after for the intense feelings of shame and guilt that may arise, along with the temptations to purge. Some patients will feel shame and guilt not just for eating the food but additionally for enjoying it. Individuals who have restricted themselves from eating


some or many foods may need to relearn which foods they actually like and dislike. They may have convinced them- selves otherwise based on arbitrary or learned food rules or fears. Recovery presents an opportunity to reevaluate food and beverage preferences and to trial different things and determine which to include in daily life, which to include only occasionally, and which to primarily avoid. Although eating disorder treatment may require chal-


lenges and discomfort, ultimate recovery does not require that a person eat or like every food. The important distinc- tions between an appropriate food restriction and an eating disordered one are the conscious, purposeful manner in which the decision is made, rather than an impulsive, com- pulsive, or reactionary manner; and that the motive for the decision is individually determined, rather than based on perceptions of others, mistaken beliefs, or shame.


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