One of the most common comments and questions we get about our ordered-eating family-style meals is about whether or not such eating is “normal” and whether it doesn’t represent some rigid food plan flying in the face of “real” recovery. Isn’t intuitive eating, well, intuitively better?
This is an area where I feel the perfect is the enemy of the very, very good. It’s a bit like saying that the goal of recovery from childhood polio is to walk without a limp or crutch, in a way that no one knows you ever had a problem and that, otherwise, your recovery is worthless, even though you may have started out in an iron lung.
Is flexible eating the highest good? If so, why?
Whether or not a child eventually eats “flexibly” depends on many things: non-eating disorder related temperament/personality substrate (some people are just not flexible), food availability, economic factors, cultural food norms, etc. Kartini Clinic has kids eat in a structured way for a year – which in the world of eating disorder outcomes is not long – and then return to eating in a way that is more typical for their family of origin.
I have blogged on this subject before. In case you feel I am making this up, or talking about something that is style rather than substance, please do click on this link. It connects the dots between known brain science and planning meals for patients with anorexia nervosa, courtesy of Dr. Walt Kaye of UCSD.
In my view, frequently, the goal of “normalizing eating patterns and the return of flexibility in eating” is repeated over and over without any deep assessment of what this means. Was the patient flexible to begin with? And what the heck does “normalizing” mean? What does “the norm” mean for a child whose parents are Chinese immigrant vegetarian Buddhists with no money? Or Montana ranchers whose meals are mostly of elk, venison and beef with few vegetables except potatoes and corn? Or the kid whose family norm is fast food (mostly burgers, fries, chicken nuggets and McFlurrys)? Does it even matter (to health) what we eat? Is eating “like everyone else” the most important goal, without which recovery can’t be said to have been achieved? Just because one man eats a bale of hay, does that mean I’m going to eat a bale of hay?
