Mindful Eating and Disordered Eating
Article orginally appared on Faithfull Eating
Mindful Eating is often promoted and supported in the treatment of eating disorders. It is important to point out though that the majority of research and evidence for mindful eating has been focused on overeating, bulimia and binge eating disorder (BED). Very few studies have looked at mindful eating and anorexia or other restrictive types of eating disorders. (Please note: this article discusses “mindful eating” not to be confused with the broader practice of “mindfulness“. Mindfulness may be taught by experienced eating disorder professionals and used for all types and stages of treatment.)
Mindful Eating involves an intentional awareness of our food choices and paying attention to how we eat (focusing, limiting distractions, listening and trusting our body’s hunger/fullness cues). Professionally I have seen the benefit of clients using mindful eating because it fosters a healthy non-judgmental relationship with food that supports flexibility and variety.
When is Mindful Eating not effective?
Many experienced eating disorder health professionals would agree that mindful eating is not appropriate or effective for people with anorexia in the early stages of treatment. This may also be the case for other restrictive or extreme eating disorder cases. Health professionals need to assess client appropriateness before utilizing a mindful eating plan.
6 S’s to Assess:
- Safety: Have physical health indicators been checked? (ie. blood pressure, heart rate, blood work, electrolytes, etc.) Is there a risk for refeeding syndrome? Does the person need to be medically monitored in an inpatient program or hospital setting? Is the individual self-harming in other ways?
- Supports: Is a full support team in place including a therapist (and/or psychiatrist), medical doctor, and registered dietitian. Is there family or other supports?
- Stability: Are mental and emotional health stable? Is medication needed? Is weight restoration needed? Are basic nutritional needs being met? A meal plan from a Registered Dietitian is often utilized to ensure adequate intake.
- Slowed Digestion: Has food been restricted for a prolonged period of time? If so, digestion can be slowed and fullness reached really quickly with a very small amount of food. In this situation, feeling “uncomfortably full” may be necessary in the refeeding or weight restoration process. Hunger and fullness cues are often not relied on or trusted until nutritional needs are being met and sustained.
- Stress: Can the person tolerate stress? (and to what degree?) Stress and anxiety surrounding food and mealtimes can often create stomach discomfort which can be confused with physical fullness. Initially distraction strategies are often used as a part of meal support because the goal of treatment is to just complete meals. A trained therapist can help clients build resiliency, develop stress tolerance and differentiate between emotional and physical discomfort.
- Stage of Change: Does the person even think their eating disorder is a problem? Are they even contemplating change? If not, mindful eating will not be effective. Remember many people suffering with eating disorders will initially be forced into treatment or forced to seek support but are still in the precontemplation stage of change.
Most importantly when supporting someone with eating disorder recovery remember that there is never one best approach for everyone. Eating disorders are very complicated and individualized treatment is absolutely necessary.