Assessment: Food/Nutrition-RelatedHistory AVOIDANCE BEHAVIOR


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IDNT defines avoidance behavior as “keeping away from something or someone to postpone an outcome or per- ceived consequence” (1). Eating disorder “rules” usually include avoidance of one or more foods, food preparation methods, and/or food groups. During nutrition assess- ment, ask which foods are avoided and why (see also Beliefs and Attitudes section, later in this chapter). Dur- ing nutrition education and counseling, you will discuss these restrictions in more detail, determine which are valid restrictions (eg, due to food allergies or religious obser- vance), and provide support for relaxing those restrictions that are not beneficial. (See Appendix A for information on restrictive eating styles.) Avoidance behaviors may also include refusal to eat


food prepared by others, refusal to eat food without look- ing up nutrition content, refusal to eat with other people or in public, refusal to eat foods of a specific texture, and refusal to attend social functions where food will be served. Avoidance behaviors should also be evaluated by the mental health professional on the team as they may be symptoms of anxiety, social phobia, obsessive-compulsive disorder, and/or posttraumatic stress disorder (2).


MEALTIME BEHAVIORS


Assess the patient’s “manner of acting, participating, or behaving at mealtime” and how that behavior “influences the patient’s food and beverage intake” (1). Inappropri- ate mealtime behaviors include frequent reheating of food over the course of a meal, inability to sit still for the dura- tion of the meal, excessive cutting or mixing of food on the plate, crying or yelling during mealtime, drawing out


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