Regular Eating—a Cornerstone of Eating Disorder Recovery

If you have been struggling with an eating disorder or disordered eating, step one of recovery requires the establishment of daily regular eating. This is important for people with anorexia, bulimia, binge eating disorder, and ARFID in all body sizes. Regular eating is one of the earliest goals of Cognitive Behavioral Therapy (CBT) for Eating Disorders and is the critical first step on which other skills are built. Setting up regular eating is also essential for parents who are supporting their teens in Family-Based Treatment (FBT). For most people with eating disorders, regular eating is an important first step before moving on to intuitive eating. Read on to learn why.

Most people with eating disorders and disordered eating enter treatment with a pattern of irregular eating. It is common for people to skip meals, delay meals as late in the day as possible, or engage in behaviors such as intermittent fasting. These behaviors make people more vulnerable to episodes of binge eating (and potentially purging). Going long periods of time without eating increases physical hunger and preoccupation with food. When this happens your body protects you by driving you to eat the most energy-dense food it can find, which can lead to a binge.

What is Regular Eating?

Regular eating means eating regularly throughout the day, approximately every three to four hours. This usually requires a meal plan of three meals plus two to three snacks per day. An example:

• Breakfast (within an hour of waking)
• Morning snack (if breakfast and lunch are more than four hours apart)
• Lunch
• Afternoon snack (midway between lunch and dinner)
• Dinner
• Evening snack (if dinner is completed more than three hours before bedtime

Why is Regular Eating Important to Eating Disorder Recovery?

People with anorexia and atypical anorexia, are, by definition, under-nourished. Recovery requires weight gain. Eating regularly throughout the day spreads out the opportunity for episodes of eating so every single episode of eating can be more manageable in quantity. For people with bulimia and binge eating, eating more frequently prevents breakthrough hunger which can be a driver for binge eating. If you allow yourself to get too hungry or run at a deficit all day, you’re more likely to binge eat later in the day.

Many people with avoidant restrictive food intake disorder (ARFID) also need to eat more in terms of volume and so regular eating is equally important. Many people with ARFID also have low interest in eating and inadequate hunger signals. They may graze on snack foods throughout the day but eat few meals. Consistent eating can help to create more regular hunger cues and provide more opportunities for more complete balanced meals.

The goal of regular eating is to form good recovery behaviors upon which eating disorder recovery can build. Regular eating provides a structure. While it may be hard at first—especially if you have been skipping meals or engaging in behaviors such as intermittent fasting—it gets easier with practice and eventually becomes a habit. Over time, your body will become more accustomed to eating at regular times. As well, your hunger cues will likely become more consistent.

Regular eating helps to keep blood sugar levels more stable and can reduce feelings of fatigue, dizziness, irritability, and “hanger.” It also helps to reduce becoming overly hungry and feeling out of control with your eating. It can also improve overall metabolic functioning.

How to Eat Regularly for Recovery

• Make regular eating a priority
• Start by getting the structure and timing of meals and snacks in place—later on, you can work on rounding out the meals and focusing on volume and variety
• Plan meals or snacks in advance. Always know when and what your next meal or snack will be
• Do not go more than four hours without eating
• Set alarms to help remind you
• If you find yourself wanting to eat between planned meals and snacks, consider whether your last meal or snack was insufficient in some way and adjust accordingly going forward
• If you binge or purge, get back on track with the next scheduled mealtime (you may be tempted to skip it)

  

• Carry snacks with you

Worries About Weight Gain

It’s normal to feel scared about implementing regular eating if you have not been eating this way. Many people fear that if they start eating earlier in the day or eat more times per day that they will end up “eating too much” throughout the day. You may be worried about gaining weight with regular eating, but if you do gain weight with regular eating it means you were likely weight suppressed and below your body’s setpoint and needed to gain that weight. Gaining weight can be scary, but it can often improve your life by reducing your preoccupation with food and improving your health.

Help With Regular Eating in California

If you are struggling to establish regular eating, our therapists trained in eating disorders can help you. Contact us here to get started with eating disorder counseling.

Source

Regular Eating for Recovery, Center For Clinical Interventions

About the Author

Lauren Muhlheim, Psy.D., FAED, CEDS is a psychologist, fellow of the Academy for Eating Disorders (AED), and certified eating disorder specialist (CEDS) and approved supervisor for the International Association of Eating Disorder Professionals (IAEDP). She directs Eating Disorder Therapy LA in Los Angeles. She is certified in FBT for adolescent eating disorders and is the author of When Your Teen Has an Eating Disorder. Dr. Muhlheim was previously the Eating Disorder Expert for Verywell. Dr. Muhlheim has held leadership roles in several professional organizations including the AED, IAEDP LA Chapter, and the Los Angeles County Psychological Association. She has previously been an IAEDP core course instructor. She provides training on eating disorders to mental health providers internationally.