The refeeding process occurs when an undernourished individual increases their caloric intake after consuming little to no food for a prolonged period of time. It is a very important step in your child’s eating disorder recovery. During the refeeding process, your child must work hard to combat their eating disorder brain, and they may experience gastrointestinal (GI) discomfort. Keep reading to find out more about our refeeding program for anorexia.
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Top 5 Tips for the Refeeding Process
We know that the refeeding process can be overwhelming and challenging. That is why we have created a list of the top 5 things you should know before your child begins the refeeding process.
1. Start Low
When you start a new job, you don’t just jump right in and you aren’t immediately an expert. Instead, you usually have training so you can familiarize yourself with your new job. Think of the refeeding process as your child’s body beginning a new job. Your child’s body hasn’t been receiving the nutrients it needs in awhile, so it needs to familiarize itself with eating again. This is why your child can’t just jump right in and have a high caloric intake. They need to start low. By this we mean your child should begin the refeeding process by eating just enough to meet their nutritional needs.
2. Go Slow
If your child is tolerating their food intake, then each day they can slowly increase their food intake. Going slow during the refeeding process is important because it reduces your child’s risk of developing refeeding syndrome. Refeeding syndrome can be a dangerous complication of the refeeding process.
3. Restrict Exercise
Our bodies use the energy we get from food to fuel our daily activities – including breathing, walking, and even just basic survival! If your child is exercising during the refeeding process, then your child will need to consume more calories. This makes it much harder for them to meet their nutritional needs. Exercise should be restricted until your child has made enough progress in their recovery to be able to consume enough calories to support physical activity.
Another reason your child should restrict exercise at the start of the refeeding process is because they likely have deficiencies in electrolytes and minerals. This is due to their low caloric intake over an extended period of time. These deficiencies must be addressed by your child’s recovery team before your child begins exercising. If not treated, they may lead to an increased risk of cardiac complications and even death.
Once your child is able to consume an adequate amount of food to support exercise and their electrolyte and mineral deficiencies have been addressed, they can slowly begin to re-introduce exercise. This re-introduction should be done with the support of your child’s recovery team.
4. Limit Fibre Intake
Fibre is a part of food that is not absorbed during the digestion process. When your child suddenly switches from having a low food intake to a higher food intake, their diet will likely go from being low in fibre to being high in fibre.
When your child is in the beginning stages of the refeeding process, they may express that they are experiencing digestive discomfort. They may tell you that they feel very full after meals, and that they are experiencing pain in their stomach, bloating and constipation. These feelings of discomfort can be caused by your child’s sudden switch from a low- to high-fibre diet.
How to Avoid GI Discomfort at the Start of the Refeeding Process
The answer is simple! Your child should limit their dietary fibre intake at the start of the refeeding process. Here is a list of foods that are high in fibre that your child should avoid at the beginning of the refeeding process*:
- Oats
- Legumes: lentils, kidney beans, soy beans
- Almonds
- Avocados
- Apples
- Bananas
- Broccoli
- Carrots
* Please note that this is not an exhaustive list – one of our expert dietitian nutritionists can provide you with a more comprehensive list.
5. Rule of 3’s in Mechanical Eating
If your child has lived with their eating disorder for a long time, it is likely that the eating disorder has turned off their hunger and fullness. Because your child’s body is no longer sending out hunger and fullness cues, your child won’t know when their body needs fuel or has enough fuel – your child will need to eat mechanically instead.
Mechanical eating means your child will need to eat at regular times each day regardless of whether they are hungry or not. The good news is that your child’s hunger and fullness cues will return once they restore regular eating! We recommend following the rule of 3’s at the start of the refeeding process since your child’s hunger and fullness cues will be unreliable, and your child should follow this rule until their hunger and fullness cues are restored.
What is the Rule of 3’s?
The rule of 3’s is based on mechanical eating. The rule of 3’s is basically an eating schedule. Your child should eat 3 meals a day, 3 snacks a day, and eat no more than around 3 hours apart. It is also important that your child eats no more than 1 hour after waking. These principles are important to follow until your child regains their hunger and fullness cues.
Looking for More Support With the Refeeding Process?
We know how difficult the refeeding process can be and we are here for you and your child. If you are interested in learning more about how we can support you and your child throughout eating disorder recovery, click below to book a free, 15-minute consultation call with us.
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