Professor Caroline Meyer

A major theme for parents is the management of meal times at home, during home leave and after discharge. The young person is eating at their inpatient unit but in the context of meal times at home, what can be translated from the unit to the home and what strategies may be helpful? These questions were covered at a recent Newbridge Master Class educational event with Professor Caroline Meyer of Warwick University.

Professor Meyer described a study she co-authored. Researchers filmed meal times with 21 families who had a child aged 12 to 18 who was being treated for anorexia. The aim of the research was to explore what strategies parents used and what was effective in terms of the supporting the young person to eat.

Those used repeatedly included direct eating prompts (eg “please eat your pasta”), non-direct eating prompts (“you are doing really well”), physical prompts (presenting the food to be eaten) and providing information or food-related choices. The researchers found that the use of food-related prompts was associated with increased eating. They also found the mother’s sense of self-efficacy (belief she can make a positive difference) was associated with eating.

However, they also found that although direct prompts were successful in the short-term, they became less effective in the longer term. Some interpretations of this important study have suggested that a young person with anorexia is akin to a much younger child in their eating behaviour, requiring more support and reminders throughout each meal. Equally, in the later stages of recovery, strategies need to change to reflect the child’s actual age and their progress through recovery, with control gradually transferring from parent to young person.

The theme of distraction during meal times is also frequently raised. Like many eating disorders units, Newbridge has the radio on during meal times to off-set, to an extent, difficult emotions and the focus on food. Professor Meyer told the Master Class there is relevant research in the field of obesity to support this. Studies have shown that if people eat a meal in front of the television they are likely to eat more than eating without distraction.

There followed a discussion about how distraction could be incorporated at home. The conclusion was that distraction could be helpful, particularly in terms of counteracting stress and anxiety, as long as it didn’t erode the focus on support which is essential (for example, family members watching a TV programme together and failing to prompt and encourage).

Professor Meyer also emphasised that the societal ideal of family meal times is not always helpful. For a young person in the early stages of recovery from an eating disorder, eating a meal with one or two other family members with a little distraction may be more helpful than eating with a larger family group, which can feel more pressurised.

This article appears in the first edition of Moving on and Recovery, a new publication we have produced for people who have left inpatient treatment and are on the journey of recovery. It is relevant for all, not just people treated at Newbridge and if you are a parent or professional and would like copies, please contact us and we would be happy to provide them.

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