Hunger and Fullness Cues
Mechanical eating is the gold star method used to re-nourish your child in the beginning of their eating disorder recovery, and is prescribed when your child’s hunger and fullness cues are no longer present. Let’s quickly discuss why your child may lose their hunger and fullness cues.
When your child has an eating disorder, their eating disorder brain constantly tells them things like “we don’t need to eat right now” and “you can’t eat that or x,y,z will happen”. With an eating disorder, these thoughts win. This causes your child to adapt their eating significantly and there is usually a decrease in food consumption. When the body is already low on fuel and the child is ignoring their hunger and fullness cues, the body prioritizes tasks and stops sending these hunger and fullness cues out. Although hunger and fullness cues are nice to have, they are not necessary to have.
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What is Mechanical Eating?
This is where mechanical eating comes into play! The goal of mechanical eating is to restore the hunger and fullness cues in the body in the hopes that your child will eventually be able to return to normal eating. Mechanical eating is also known as “eating on the clock”. It is essentially an eating schedule that must be followed regardless of how your child feels.
Although the amounts of food consumed in a day will differ based on individual patients’ needs, in general mechanical eating plans consist of 3 meals and 3 snacks daily. This pattern ensures that there is never more than 2-4 hours between meals and snacks. This is also known as the rule of 3’s because there should be 3 meals and 3 snacks in a day, generally 3 hours apart! Mechanical eating also includes eating within 1 hour of waking. This wakes up the body and gets the digestive system moving. Try setting an alarm for every meal and snack to ensure consistency in your child’s meal timing.
The Eating Disorder Brain
Let’s circle back to the thought of your child having to eat, regardless of how they are feeling. This includes how they physically and emotionally feel. Your child may complain of feeling nauseous or complain that the eating disorder brain is just too loud to eat! It is extremely important that your child eats through the feelings and emotions. The most common feeling that comes up in mechanical eating with children is the feeling of fullness. Your child may complain of not being hungry and therefore, they do not need to eat. It is important at this time that you help shift your child’s perspective. You may say something “You don’t feel hungry right now because your body isn’t sending out hunger and fullness cues but we need to eat anyway”.
What is a Mechanical Eating Plan?
Your child’s prescribed mechanical eating plan will include 3 meals and 3 snacks. These meals or snacks will be broken down into servings by food group. An example could be that your child’s morning snack must include 1 serving of fruit and 1 serving of protein.
These 3 meals and snacks must also be eaten at predetermined times. For example, breakfast will be everyday at 8 am. Just as the timing of meals is by the clock, so is the amount of time allotted to finish each sitting. For meals, there is 30 minutes allotted for completion and for snacks there is 15 minutes allotted.
If your child does not finish their food within the appropriate time, they will be prescribed a certain amount of a liquid nutritional supplement based on their meal plan. They will have to consume this beverage to “top up” their incomplete meal or snack. The nutritional supplement may be a Boost or Ensure beverage. This “top up” is ensuring your child is both continuing to get adequate nutrition and does not allow the eating disorder brain to win. One way or another, we want them to be getting enough nutrition!
Your Role as the Parent
So, what is your responsibility as a parent in mechanical eating? In the early stages of mechanical eating, parents are responsible for the menu planning, grocery shopping, meal preparation and serving.
Menu Planning
The term menu planning means turning your mechanical eating meal plan into real meals. An example would be taking your child’s afternoon snack plan that states 1 serving of grain and 1 serving of fat and translating that into 1 serving of crackers and 1 serving of cheese. When menu planning, we encourage parents to choose a quiet and stress-free time to do so. This will look different for every family.
We also encourage that meals are always planned at least 3 days or 72 hours in advance. This helps reduce your child’s anxiety around those meals. Some families do weekly menus and some do 3 days menus, depending on their schedule. In the beginning of recovery, we are only concerned with your child getting enough food. Therefore, it is completely okay for you to fill up their meal plan with their safe foods, even if they only have 5 or 10 total safe foods.
Communicating the Menu to Your Child
Once the menu plan is created, we want to ensure that is clearly communicated with your child. We prefer for this information to be posted somewhere in the home. This could look like using a white board attached to your fridge or a piece of paper posted on the wall, whatever is easiest for you. On the posted meal plan, information that should be included is as follows: who is responsible for cooking this meal (must be a parent or guardian), what food is being served, what time the meal will be served and where the meal will be consumed (we encourage the dinner table).
No Negotiations!
Once the menu plan is posted there are no negotiations to be made about the types of food being served. By being responsible for menu planning you are taking that burden off of your child and helping reduce their anxiety. Remember that this is temporary and as recovery progresses your child will be able to regain independence with their eating.
How to Get Help With Mechanical Eating
At Change Creates Change Eating Disorder Care, we have a team of registered dietitians and psychotherapists that can help you navigate mechanical eating with your child, by offering support to both you and your child. If you want to learn more about how we can support you and your child, you can book a free 15-minute consultation call with us.
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