I am mainly going to discuss the situation of weight gain with anorexics, but others that need to gain weight for whatever reason can used the meal plan samples.
WHAT IS AN EATING DISORDER?
" Eating disorders are illnesses that affect all aspects of a child's or adolescent's life. Anorexia nervosa is one type of eating disorder that is very difficult for many people to understand. Anorexia nervosa is a serious, potentially life-threatening disorder characterized by self-starvation and excessive weight loss. This disorder often begins during adolescence, frequently around the time of puberty. Children and adolescents with anorexia nervosa have an overwhelming fear of being overweight and an extreme drive to be thin.This will lead them to behaviors that will cause weight loss, including cutting back on what they eat in a way that can lead to being underweight. The young person becomes obsessed with food and dieting. They may also become dangerously thin. No matter how thin they get, they think they are still fat or they may be they may be terrified of becoming fat." Some other methods that the book mentions is that many will exercise excessively to burn off the calories, they may count calories or grams of fat, starve themselves, limit types of food they allow themselves to eat, purging/vomiting their food ( otherwise known as anorexia bulimia sub type), taking laxative,diet pills, avoiding to eat in front of people and making excuses such as " I'm not hungry", " my stomach hurts" and "I don't have time to".
EATING DISORDER FACTS
- At least 1 in 10 people who develop eating disorders are boys
- Most children or adolescents get help for an eating disorder because their parents insist they get help...not because they want to get help
- 20 % of patients with eating disorders will die of their illness
- With treatment, about 75% to 80% of adolescents with an eating disorder will recover.
COMMON MYTHS ABOUT EATING DISORDERS
Boys with eating disorders are always gay...
Homosexual boys do have a higher risk of developing an eating disorder, but both straight and gay boys can have eating disorders.
Barbie and Ken represent ideal body shapes for females and males...
If barbie were a real human being, her proportions would cause her to fall over. Ken's neck would be 8 inches bigger than the average male's. The female models we see in fashion magazines do not represent any meaningful ideal for the majority of females. In face, only 1 in 10,000 females naturally (without dieting) meet model-thin dimensions.
All fat adolescents are unhealthy...
We were all made differently. There are many possible combinations of shapes and sizes that compose a person's body. It is possible for someone to naturally be dense boned, just as likely as it is for someone to naturally be model-thin. Someone could be eating a balanced diet, exercising moderately and still be fat, but they can still be healthy as well.
SYMPTOMS AND RESULTS OF ANOREXIA NERVOSA
Yellow-orange tinged skin
Thinning of the hair or hair that breaks easily
Growth of downy hair on back, stomach, or the side of face
Major weight loss in a short period of time
Failure to gain weight or height normally
Delay on onset puberty
Loss of menstrual periods
Low body temperature
Counting calories and fat
Increasing interest in all things to do with food
Disgust for previously favorite foods
Wearing baggy clothes
Distorted body image
Extreme concern with appearance
So much more.......
HOW TO RECOVER
I like to think that eating and discussions are the cure to anorexia. Food is our medicine. If someone were to just discuss about their problems,but not eat, these eating disorder thoughts would stay with them and everything discussed would go in one ear and out the other. It's just not possible to recover without eating. Our bodies need glucose, without it our brains go a little funky and we can't think straight, we don't think rationally. Without having a clear mind and being able to think things through, we'd still be occupied with the same old thoughts of food, losing weight, and not trying to get fat. It is mandatory that an anorexic gains weight to be able to fully recovery. The more healthy your weight becomes the less chance of relapsing or lapsing. I read a book by Harriet Brown. It's called " Brave Girl Eating" it talks about her family struggles with having an anorexic child. Kitty, the ill child, would be eating around 3000 calories a day, just to gain a small amount. But, when Kitty was eating, even a little bit under 3000 calories, she would start to have the negative thoughts and refuse food, anorexia would talk to her. So this just further proves that eating also helps to get rid of these negative ED thoughts.
Everybody is different and we all need different amounts of food. For example an average 13 year old would probably consume between 1600 and 2500 calories a day.It all depends on age, height, gender, activity level and genes. So when an anorexic child loses a vast quantity of weight, it is expected for them to gain it back. But, the amount of food needed, varies according to how far along they are with their eating disorder. Some one who is at the point of death knocking at their door would probably need a minimum 3000 calories, probably around 5000 to 6000 or so a day. But if you suddenly start feeding someone who has been starving themselves for a while, their body can go into shock; there can be electrolyte imbalances, extreme bloating and constipation, vomiting and the body's rejecting food and heart attacks, which can all lead to death. This is why it's important to start off slowly and work your way up. But if you are at the point of dying, you would probably have to be feed through a tube. So I would say someone should start off with about 800 a day and every 2-3 days add an extra 100-300 calories a day until you reach around 2000. From there you can determine whether you need to increase or continue with 2000. While re-feeding it is important that the anorexic does not exercise. You cannot afford for them to lose more weight. So here are some sample meal plans, all with different amount of calories.
THE STARTER PLAN: 800 CALORIES
BREAKFAST: 1/2 cup of oatmeal cooked in water
SNACK: an ensure regular or plus calories OR a fruit smoothie
LUNCH: a bowl of rice with chicken or some other form of protein such as beans, ham or beef
SNACK: ensure regular, plus calories or a fruit smoothie
DINNER: 1/2 cup of rice, a small amount of chicken, and some steamed vegetables or a bowl of vegetable based soup
Once the body is ready to move onto solids you can move on to this plan
THE NEXT STEP: 1200 CALORIES
Breakfast: one slice of bread with one tbsp of peanut butter and jam
Snack: ensure plus calories
Lunch: 1/2 a ham and cheese sandwich
Snack: 1/2 of a 6 inch tortilla with hummus and grates carrots
Dinner: 1/2 cup of rice with 3oz of chicken, and steamed veggies, plus some milk OR spaghetti and meatballs with a side ceasar salad and some milk
Snack: ensure plus OR fruit smoothie
Once you become more comfortable eating a variety of foods and a larger quantity....
STAGE 3 ACCEPTING NAUGHTY FOODS: 1800 CALORIES
Breakfast: 2 slices of bread with butter, one egg and juice or a fruit salad OR 1 cup of oatmeal cooked with vanilla ensure and 1/4 cup of raisins
Snack: something you love, but would never let yourself eat..."naughty foods" ex. Cookies and milk, Ice cream and fruit, Cheese and crackers, chips, etc.
Lunch: a ham,chicken,tuna,meat,egg or turkey sandwich with either carrot sticks and an apple or a juice box.
Snack: another small quantity of a "naughty food" muffins and milk, but be sure to also include some nutritious foods like frutis and dairy.
Dinner: 1 cup of rice, 1/2 large chicken breast, 1/2 cup of steamed veggies, a side salad and milk or shredded cheese.
Snack: Green smoothie or fruit juice (something light)
STEPPING IT UP A NOTCH: 2500 CALORIES
Breakfast: 2/3 cup of yogurt, 1/2cup of granola, 1/2 cup of fruit
Snack: a granola bar and fruit or smoothie
Lunch: a large bagel with 2-4 Tbsp of peanut butter and banana, an apple, chips or cookies and milk
Snack: veggies and hummus
Dinner: whole wheat pasta with tomato sauce and chicken, or meat sauce or cheese sauce, a side salad with dressing, a slice of garlic bread and a glass of milk (you can also substitude with any other milk alternative)
Snack: cereal and milk OR fruit and nuts
I'M ON THE RIGHT TRACK TO GAINING WEIGHT: 3000-3500 CALORIE ( this is the stage I'm at currently)
Breakfast: 1 cup granola, 1.3 cups of yogurt and 3/4 cup of fruit
Snack: energy bar and milk
Lunch: 2 slices of homemade or store bought vegetable pizza with a side of carrot sticks and fruit (you can sub with juice if you feel too full)
Snack: ensure plus and a muffin or cookies
Dinner: baked sweet potato (tastes really good if you add honey, cinnamon, yogurt and nuts), chicken, steamed vegetables and salad (with dressing)
Snack: Dessert of your choice: my favourite is a large piece of pumpkin pie with a bowl of fruit and some milk
I HAVE A HYPER METABOLISM AND NEED MORE FOOD...nom nom: 5000-6000 CALS
Breakfast: 2 large pancakes with maple syrup, berries, whipped cream or ice cream, and a glass of milk or juice
Snack: 2 cups of Haagen Dazs ice cream, 1/2 cup of whole milk ( blend into a milkshake)
Lunch: 2 large, thick slices of bread with meatballs, cheese and red sauce inside, a side of mango, a glass of milk and fries
Snack: one large bagel with peanut butter and banana with a glass of milk
Dinner: full fat mac and cheese made with full fat cheese, cream or whole milk, served with juice, a side of grapes and carrot sticks
Snack: an ensure plus and a large cookie or other pastry or if you go on the maudsley parents program website they have a recipe sheet with very high calorie desserts.
HEALTHIER VERSION OF 5000-6000 CALORIE PLAN:
Breakfast: oatmeal (1 cup cooked in milk of choice), a mashed banana, 2 Tbsp of almondbutter, raisins or dates,
Snack: large green smoothie ( 2 bananas, 5 dates, 1/2 cup of berries, handful of spinach greens, spirulina powder, 1 Tbsp of chia seeds blend in liquid of choice: almond milk, juic, etc.)
Lunch: 1.5 cups of quinoa, 1-2 cups of steamed vegetables, 5oz grilled marinated tofu, 1 whole avocado, lemon juice
Snack: 2 slices of toast, 1 banana, handful of dark chocolate chunks, 2 tbsp peanut butter (grill sandwich), 1.5 cups of 2% milk
Dinner: 1-2 cups of Roasted vegetables (brussel sprouts, potatoes, gren beans and a bit of oil or butter and seasoning), 5oz steak, 1.5-2 cups of rice, a side smoothie (2 bananas, dates, almond butter, milk, cinnamon)
Dessert: large portion of whatever you want
So I hope this helped some of you and if you have anymore questions please contact me at firstname.lastname@example.org.
Katzman, D., & Pinhas, L. (2005). Help for eating disorders: A parents' guide to symptoms, causes & treatments. Toronto: R. Rose.