The heart of our book, The Parent's Guide to Eating Disorders, is Marcia's Food Plan, which offers those struggling with an eating disorder a template for returning to normal eating. The plan itself is simple: three meals and two-to-three snacks per day, with meals consisting of a serving each of complex carbohydrates, fruit or vegetable, calcium, protein, fat and (in the case of lunch and dinner) a "fun food," something eaten not for its nutritional value, but because it tastes good and marks an end to the meal.
It is infinitely variable and flexible, and can be adapted for individuals battling anorexia, bulimia, binge-eating disorder, as well as disordered eaters who want to get back to a regular and healthy pattern of eating.
We devote a whole chapter to the Food Plan, breaking it down by component parts, and explaining why these elements are crucial to anyone interested in healthy eating, and we offer sample foods for each category (this is an area that the overwhelmed family or individual can often get stuck on).
All of this is pretty straightforward and simple. The hard part, of course, is mustering the motivation and determination needed to abandon eating disordered behaviors, to take a leap of faith and start using the Food Plan. Here, I've summarized a few of the many tips we give on how to make the Food Plan work:
• Add what's missing: You can either sit down and, using our template as your guide, design a Food Plan for you, your child or loved one. Or, you can start with what you are currently eating, and slowly add what's missing. The latter is the method used by professional nutritionists, and can be easily adapted at home by parents and individuals. It's a less anxiety-producing way to gradually work your way up to full adherence to the Plan.
• Remember the Rule of Threes: Remind yourself or your loved one that the non-negotiables are three meals a day, and for patients who need to gain weight, three snacks a day. The final three is that there should be no more than three hours between a meal and snack.
• The One-Cup Rule: Often kids or adults are unsure about what a "serving size" is. Use a cup measure as a rough guide. It works for most foods, the exception being very rich foods, for example shelled nuts, butter, or peanut butter.
• Normal Serving Sizes Are Normally Served: So what does a normal serving size look like? Here are some visual approximations: a single scoop of ice cream, a standard school lunch tray's individual portions of protein, vegetables and carbs. An apple or a banana. For meat, fish, or poultry, a serving is the size of an outstretched palm or a balled fist.
• No food is forbidden. No food in and of itself, is fattening or forbidden. After the Food Plan is firmly in place, you can experiment by adding to your Plan "fear foods," or foods that in the past have triggered binges. We recommend single-serving packages, especially in the early stages of using the Plan.
Once you've adopted the plan, it's easy, even for kids, to memorize and internalize, and therefore easier to stick to than a more complicated plan. Remember, no matter how hard the going gets, normalizing eating is possible. If you feel the first steps are just too daunting, the help of a registered dietitian or nutritionist who specializes in working with eating disorder patients can help get you started.
Nutritionist Marcia Herrin and Nancy Matsumoto, co-authors of The Parent's Guide to Eating Disorders, Gūrze Books. Marcia is also author of Nutrition Counseling in the Treatment of Eating Disorders.