Nutrition Education Interventions Box 9.3 Nutrition Education Topics Related to Eating Out


• “Portion distortion” and how to manage it (eg, share an entrée, order an appetizer and a salad, put half the food in a take away container)


• Social and self-care skills (eg, asking the server to remove a complimentary bread basket or looking up a menu in advance on the Internet)


• The downside of “saving up” for one or more days in order to “splurge” during a special occasion


• Back-up strategies (eg, bringing a snack in case there is no acceptable food available when needed)


• Assertiveness when experiencing peer pressure about when, what, or where to eat


165


SPECIAL EVENTS


Certain situations are unpredictable and especially stress- ful during eating disorder recovery, even without the added stress of eating. Examples include a first date, meet- ing a significant other’s parents, participating in a wed- ding, a performance, or a reunion. Help patients prepare for the eating-related aspects of these events. In addition, the mental health professional on the team can provide stress management techniques and problem-solving of social stressors that may arise. Body image issues can flare up in advance of an event


in which your patient must stand in front of a group, and the temptations of eating disorder behaviors can be strong. If patients use alcohol in social situations and/or to handle stress, take this into account. Explain that alco- hol alters one’s judgment regarding what and how much to eat, and help patients consider how drinking alcohol may influence their eating plan.


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