Written by Meghan Kacmarcik, RDN
Book How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach to Rebuilding a Healthy Relationship with Food
Authors Casey Crosbie, RDN, CSSD & Wendy Sterling, MS, RDN, CSSD
Year Published 2018
Target Audience Parents/caretakers of children with eating disorders
Verdict: Very helpful for parents involved in their child’s eating disorder recovery
Written by two dietitians specializing in eating disorder (ED) treatment for children and teens, How to Nourish Your Child Through an Eating Disorder provides some ED-basics groundwork and introduces an approach to eating called the “Plate by Plate” method that’s rooted in family-based therapy (FBT), one of the most well-researched and effective ED treatments for adolescents. The book walks you through the three stages of FBT and the role of the parent/child in each, as well as what parents can expect during each of these phases and tips to handle it.
The authors’ breadth of knowledge is evident in their writing. Before they dive in to the nutritional aspects of recovery, they take a closer look at details of eating disorders that parents may be wondering about (especially if this is their first experience with eating disorder treatment). The authors cover the medical complications of eating disorders, the importance of having a team including an MD, therapist, and dietitian (and a psychiatrist as needed) in place, and how to handle exercise during eating disorder recovery. This provides much-needed background before discussing how to choose, prepare, and serve food which is the focus of the second part of the book.
The majority of the book is spent explaining the plate-by-plate approach, which was developed by Crosbie & Sterling as a simple and adaptable way of feeding your child. The goal is to take away the stress of numbers and exact measurements, which can be a source of stress to parents trying to care for their child in recovery. The idea is to use the plate to visualize portions and adequacy with 50% of the plate as starch, 25% protein, and 25% fruit/vegetable in addition to a source of dairy and fat. The book includes examples of meals and snacks, including photos, as well as questions for parents to ask themselves to ensure their child’s plate is adequate. The photos included in the book to demonstrate portion sizes are incredibly helpful in giving parents a better idea of what portion sizes should look like which can feel particularly challenging after a child’s eating disorder has been guiding those decisions. They also provide guidance in setting limits and expectations with a child who might be upset seeing their portion sizes change. This is a great starting point for parents who are hoping to manage their child’s eating disorder at home versus at an eating disorder treatment center although the strategies discussed in the book could certainly translate to a higher level of care as well.
The authors cover a wide breadth of topics related to recovery, but each chapter is broken down into manageable, bite-sized pieces (no pun intended). They detail the ins and outs of eating disorder recovery in a way that feels clear, straightforward, and compassionate. This book addresses questions that I get from parents frequently in my individual sessions, including how to talk about weight and body image with their kids, how to handle vacations or meals outside the home, vegetarian or vegan eating patterns, and when to start re-introducing challenge foods. It can be difficult to provide parents with guidelines to feeding their child in recovery and the plate-by-plate approach makes this simple and easy to implement for most families.
The authors provide strategies for setting limits and expectations when implementing family-based therapy at home including making the child aware of what the expectation is for meals and implementing a supplement protocol as needed. One thing that is not addressed is how to handle these conversations and situations with teens who have any co-occurring behavioral concerns which is something I see frequently in my own practice. However, the book lays out a foundation helpful in navigating this at home and even having this conversation with a child’s psychologist or psychiatrist who might be able to provide more strategies specific to any behavioral concerns.
The authors share about their own roles as dietitians working with parents and children and how they support both during treatment.
Having a child in eating disorder recovery can be incredibly challenging and exhausting. How to Nourish Your Child Through an Eating Disorder is a compassionate, comprehensive overview of eating disorder recovery for adolescents and teens that answers parent’s questions and equips them with the tools to support their child in recovery. I would recommend it for any parent in this situation or any dietitian working with families and teens.