Carb/Pro/Fat
What is the preferred fuel for the brain?
Glucose - from carbs
What is mindful eating?
Recognize and reconnect with hunger/fullness, honor what the body needs.
Why is it necessary to hold boundaries at meal support?
Provide a consistent environment for patients at meal support.
T/F: BMI is a good indicator of someone's health.
False! Many factors contribute to someone's health, BMI alone cannot be used to determine a person's health.
“You look so much healthier now!”
“Don’t worry, you won’t gain weight from just one meal”
How could these comments affect patients with eating concerns?
They could validate the ED's thoughts of others noticing their bodies are changing and invalidate that the patients are struggling with food.
How would you rephrase those? +100 bonus points for each response.
Please list 2 functions of protein
Building blocks of muscle - Growth and Structure, Antibodies - Immune System, Enzymes for Digestion, Increase Satiety and Satisfaction of a meal
What are the 2 recommended percentages for grain/starch from the plate-by-plate approach?
33% and 50%
What is meal support group? What is the goal of it?
Mindful Eating/Meal Support is a group where patients and staff share a supportive meal. The intention is for patients who are struggling to speak to their experience with their food, eating and/or overall emotional state in the moment to allow both peers and staff to problem solve ways in which to support them.
The goal of meal support is to normalize thoughts, feelings, and behaviors around meals and food with support of peers and staff.
Why is it important for those who don't struggle with EDs, to learn about them?
Help support peers, increase understanding of ED, increase awareness
How would you redirect:
“I know chips do not have the most nutritional value, I like to eat them when I know I can pair them with a salad or something with more nutrition”
When you break down chips, they come from potatoes, oil, and salt, all of which the body needs. I like that you are thinking about ways to add variety, focusing on adding vs subtracting is a great way to create balanced meals/snacks.
Please list 3 functions of fat
Aid absorption of fat-soluble vitamins, provide cushion to organs, adds flavor, energy storage, increase satiety and satisfaction of a meal, structure of cell.
How do a scheduled meal time and a 3-meals-3-snacks schedule help restore hunger fullness cues?
Having structured meal/snack times helps the body to recognize that the food/energy intake is stable, convincing the body that it doesn't need to be in survival mode and can actively use energy as needed, restore metabolism, and hunger/fullness cues that majority of patients have been neglecting or lost with unstructured food intake.
Please list 3 ways to provide support during a meal
Provide encouragement, distraction, redirection of ED bx
What are some common misconceptions about eating disorders?
Ex: You can tell someone has an ED by looking at them, EDs only affect certain populations, You can just "stop" having an ED, Anorexia is the "most severe" ED
A patient has completed ~75% of their plate with 15 minutes left of group. They state they are feeling way too full and are not able to work on their meal and further and would like to check out. How would you respond?
Check in with goals set before the meal
Ask what is difficult about completing, validate feelings
Suggest small achievable goals
Pour supplement and encourage
Sit with supplement and keep time boundary
Please create a snack that includes all 3 macronutrients
Trail mix; PB & J; Cheese and crackers, etc.
Please explain the hunger fullness scale. What is the range that we recommend to stay between?
0-2: Overly hungry
3-4: Noticing hunger
5: Neutral
6-7: Noticing fullness
8-10: Overly full
Please list 4 common ED table behaviors
Slow/fast eating pace, Inappropriate portion sizes, Using utensils with handheld foods, Excessive condiment use, Stalling at mealtimes – continuously talking, Hiding food, Picking/cutting food into multiple pieces, Playing with food, Taking food apart – wiping food off, Food avoidance, Excessive ‘food positions’, Water loading during a meal (colored waters/flavored is questioned), Refusing, Inappropriate comments, Over/under portioning
Why is it important for those who struggle with Eating Disorders to have a meal plan?
Normalize eating, provide proper nutrition, incorporate all foods, encourage variety, help establish hunger/fullness cues.
A patient is talking about a previous group they had where a peer processed family trauma. The patient starts discussing how triggered they were and disclosing some of what was shared in group during meal check in. How would you respond?
Redirect the patient to bring it up with that peer in a group setting where the peer is present
Ask the patient to focus on the current meal and set goals
Validate feelings and ask them if they would like support to bring it up in the next group (i.g. let next group leader know they would like to process this)
Please list all components for a balanced meal
Carbohydrates, Protein, Fat, Fruits and Vegetables (Fiber), Dairy
Please list 5 distractions that can impact your hunger fullness cues
- Mood and Emotions
- Dieting, calorie counting, food rules, skipping meals
- Digital distractions: TV, computers, phones
- Access and convenience of food
- Caffeine, gum, and excess fluid/water
- Medication and medical conditions
- Friends' and family's eating habits, environment
Supplements!
Please list how many bottles of ensure do the following meal completion % calls for:
0%, 25%, 50%, 75%, 80-90%
0%- 2 full bottles Ensure
25% 1.5 bottles Ensure
50% 1 bottle Ensure
75% half bottle Ensure
80-90% 1/4 bottle Ensure
Please list 5 effects of ED physically and cognitively
Physical:
Heart arrhythmia, blood pressure and heart rate complications
Abdominal discomfort
Bloating, premature fullness
Poor body temperature regulation
Shakiness, weakness, fatigue, dizziness
Poor growth/wound repair
Cognitive:
Decrease in brain mass
Loss of memory and focus
Increased rigidity
Decreased spontaneity
Insomnia
Increase suicidal ideation, depression sx
A patient is asking for a fork and knife with their meal because they prefer to eat their sandwich in 4 pieces. Pt states that eating the full sandwich is ‘just too overwhelming at this point in their recovery’. What would you suggest?
Validate feeling
Ask if patient is available to share why it is overwhelming
Ask if peers can provide some suggestions or relate to this feeling
Challenge patient to take a bite of their sandwich