If you or someone you love, such as your child or sibling, has an eating disorder such as anorexia nervosa, bulimia nervosa or Avoidant-restrictive food intake disorder, you know that meal time can be a very stressful time where anxiety is high. I am a therapist provided eating disorder treatment in Columbus, Ohio and today I want to talk about ways to reduce anxiety at meal times for children with eating disorders. These skills can also be applied and used by adults with eating disorders. If you are seeking eating disorder treatment in Columbus, Ohio or anywhere in Ohio, I can help. Schedule a free consultation call today to learn more about eating disorder treatment options for adolescents, teens and young adults.

Whether you or your loved one are in eating disorder treatment, just getting started, or not quite there yet, these grounding skills can help make meal times less stressful and more successful. You can use them yourself or teach them to your loved one with an eating disorder. Anorexia nervosa and ARFID (Avoidant-Restrictive Food Intake Disorder) are particularly prone to increased anxiety and stress around meal and snack times. This can be extremely stressful for everyone at the table or involved in the meal. And this usually means multiple times per day.

First, let’s talk about what eating disorder related meal-time anxiety looks like.

How do I know if my child or loved one’s behavior at the table is caused by eating disorder stress?

The answer: evaluate your child’s history, diagnosis, behavior and circumstances. If your child has historically throughout their life, had anxiety, stress, tears, yelling, refusal to eat, at the table, it is possible they could be related to an ARFID diagnosis. This diagnosis commonly presents at a younger age than Anorexia Nervosa. If your child has not historically had difficulty with meals or stress at meal times, this could be related to a new onset diagnosis of Anorexia Nervosa.

Stress at the table due to ARFID can be induced by presenting foods that a new and not typical for your child. Maybe your child only likes chicken nuggets and French fries and you present a new brand of chicken nuggets because they were out of the usual ones you buy at the store (COVID Supply chain issues-right?!). Your child may be overwhelmed at this small change, triggering a breakdown of tears and anxiety over what seams to you to be a simple change. You insist that they are the same and don’t understand why your child just won’t eat them! This situation invokes stress in you, which your child can feel, and may unintentionally raise their stress level. Children with ARFID can be extremely sensitive to textures and taste variances in food. It typically makes fruits and vegetables difficult to eat due to the high degree of variance in these two factors in fresh, non-manufactured foods.

Now let’s discuss the possibility of stress at meal times due to an eating disorder diagnosis of Anorexia Nervosa.

Anorexia Nervosa causes a fear of weight gain and often times a fear of certain foods that are not perceived by the eating disorder to be “healthy”. This often means stress and anxiety when presented with any foods that are not considered “healthy” or “Safe” by the eating disorder.

The list of “safe” foods is often very small and restricting and typically gets smaller and smaller over time until almost nothing is considered “healthy” or “safe”. Due to the limited foods, anything outside of these can lead to automatic distorted thoughts about weight gain. A person with anorexia nervosa may look at a meal and automatically envision gaining 10 pounds from a single meal. A rational, healthy person knows that is not even possible, but to a child or adolescent with anorexia nervosa, that possibility is very real and guaranteed to happen.

That is some background-now what does this stress and anxiety look like when it comes out?

It can be:

• Crying

• Yelling/Screaming

• Refusal to eat

• Refusal to touch food or engage with food in anyway

• Shutting down, quiet, not talking

• Panic, hyperventilating, fast breathing

• Distress, fidgeting, inability to sit still

• Walking away from table or meal

• Constant distraction, focusing on anything but the meal

• Anger, insults, rude language

• Hitting, throwing things

• Smashing or smearing food

• Avoidance of meal time, refusal to come to table

• Arguing about other things (school, family, siblings) when really stress is coming from food

• Biting nails, lips

• Chewing clothing, hair

• Many others

If you see any of these signs in your child, call Eating Disorder Therapy today to schedule a free consultation call with me, an eating disorder professional. I am here to answer your questions and get your family the eating disorder treatment for adolescents you need.

What to do-

If you think your child has anxiety around meal times, there are some things you can do.

Equip your child with skills to handle anxiety:

1. Deep Breathing

Deep breathing is a quick, in the moment way to reduce anxiety. Your child will benefit from you leading them through a deep breathing exercise and initiating it and doing it yourself.

Some of my favorites are :

• 5 finger breathing (Trace your hand with opposite hand, breathing in through your nose as you go up the finger and out through your mouth as your trace down the other side of the finger)

• Square breathing (trace a square on the table with your hand, breathing in on one side, holding down one side and out through your mouth on the next side, followed by another hold)

• Balloon Breathing (pretend to blow up a balloon, release the balloon by breathing out through your mouth)

2. Grounding

Grounding exercises bring us out of our head and back into the moment. A great quick one to play at meals is I spy. Ask your child to name something red that they can see. Then name something square they can see. Do this until they appear more relaxed. You can also try 5-4-3-2-1, where they name 5 things they can see, 4 things they can touch, 3 things they can hear, 2 things they can smell and 1 thing they could taste. You can also keep a small bottle of essential oils and have them smell a calming sent like lavender or peppermint.

3. Pleasant Distraction

Especially with Anorexia Nervosa, thoughts during meals can be overwhelming and distressing. Having a pleasant distraction during meals can help your child to eat more without being completely distracted by their negative eating disorder thoughts. You can try something like playing Would you Rather or talking about fun facts you find on the internet. You could play word association games or even simple card games like Go Fish, as long as they don’t provide too much distraction and keep your child from eating at all. It will be helpful to provide gentle reminders to keep taking bites between game play. You can also try coloring or fidgets at meals to help with anxiety. Small fidgets that your child can keep in their hand or lap can be really beneficial for reducing meal time stress caused by eating disorders.

The most important and most beneficial thing you can do for your child to reduce stress during meal times is to remain cool, calm and collected, even if you don’t feel that way on the inside. They will respond to your energy. After that, getting professional help from a trained eating disorder professional is the next thing you need to do.

Eating Disorders do not go away on their own- they require help from a professional therapist and a strong support team of parents, loved ones, dietitians and doctors. Inquire on my website today for more information and to get started with your child’s eating disorder treatment today.

Schedule a free consultation call.

This blog is intended to be educational and informational and does not substitute for professional medical and therapeutic help, which is highly recommended when treating an eating disorder. If you would like help treating your child’s eating issues or want to learn more, Schedule a free consultation call today.