Meal Plans

There are many ways to meal plan with a patient that has an eating disorder. This toolkit will discuss some options for meal planning and how to use them with your patient.

Rationale

• Meal plans are prescribed for patients who require a structured nutrition routine to disengage from their eating disorder behaviors and meet their nutrient and energy needs.  
• It is designed to reorient patient to a normalized eating pattern and restore their body’s natural hunger and fullness cues. 
• Meal plans are set at a targeted calorie amount to meet the patient’s energy needs and, when needed, restore weight to their body’s natural biological weight. Calorie amounts are intentionally not included in the meal plan and should not be discussed with the patient. Counting calories is a common eating disorder behavior that we are often working with patients on avoiding. 
• Patients must follow and complete 100% of their meal plan. 
• At follow up visits, assess the patient’s adherence to the meal plan, thoughts and behaviors, weight trends, and make adjustments if nutritional restoration (weight gain) is not progressing as needed. 
• The goal of a meal plan is not to create long-term reliance on a meal plan. Instead a meal plan can be an effective tool to help with nutritional (weight) restoration and returning growth trajectory.
• The length of this process varies from patient to patient, but typically patients with eating disorders can take months or years to fully disengage from eating disorder thoughts and behaviors.

Setting up meal plan

• Once it is confirmed that patient is medically stable and is at the most appropriate level of care available to them, then provide education on:
• The need for nutrition restoration (re-nourishment of the body)
• The need for structured, consistent, and adequate nourishment throughout the day
• The need for caregiver(s) (or trained support) presence and accountability at all meals and snacks (and postprandial if needed)
• Assess which meal plan option will best fit your patient’s needs
• Provide meal plan education

Meal Plan Options

• Plate by plate
• Entrée/side
• Exchange
• Calorie prescribed