Plate By Plate Approach In Eating Disorder Recovery

Sharing is caring!

Last updated on September 4th, 2023 at 12:19 am

The plate by plate approach is an eating pattern which focuses using a plate and visual cues to build appropriate meals during eating disorder recovery. 

The plate by plate approach: 

  • Is simple for caregivers and patients
  • Encourages mealtime variety
  • Does not include complicated exchanges
  • Is not focused on portions and serving sizes 

The plate by plate approach offers a simple mealtime solution for many families of patients suffering from an eating disorder. 

In this article explores the pros and cons of the plate by plate method and how it can be used as a tool in eating disorder recovery.

How Does The Plate By Plate Method Work 

The plate by plate approach is designed to be used alongside of family based therapy during eating disorder recovery. 

Steps for the plate by plate approach: 

  1. Use a 9” plate to serve food
  2. Determine if weight restoration is a goal or weight maintenance 
  3. Choose a variety of foods for the meal including carbohydrates, proteins, fats, and fruits and vegetables
  4. Add food to the plate based on plate by plate approach guidelines for weight restoration or weight maintenance 

The plate by plate method is designed to that food does not need to be measured using measuring tools or estimates.  

The only measuring tool used in the plate approach is a plate and visual suggestions for portioning the plate appropriatesly. 

What is An Example of the Plate Recovery Model

According to the plate method, foods placed on the plate at mealtime will have a designated portion of the plate reserved for carbsohydrates, proteins, and fruits and vegetables. Dairy and fats will be served on the side or added to the plate. 

Recommendations for how much of the plate each food group should take up will vary slightly based on whether a person in eating disorder recovery needs to weight restore or just meet their basic energy demands. 

infographic if plate with carbs, fats and fruits and veggies on purple background

The Weight Restoration Plate 

  • 9” plate 
  • ½ plate is carbohydrate (pasta, rice, bread)
  • ¼ plate protein (meat, tofu, beans)
  • ¼ plate fruits and/or vegetables
  • 1 side of fat (butter, oil, peanut butter)
  • 1 cup of dairy 

The Weight Maintenance Plate

  • 9” plate 
  •  ⅓ plate is carbohydrate (pasta, rice, bread)
  • ⅓  plate protein (meat, tofu, beans)
  • ⅓  plate fruits and/or vegetables
  • 1 side of fat (butter, oil, peanut butter)
  • 1 cup of dairy 
infographic of weight maintenance plate by plate phase

Snacking With The Plate Approach

Snacking while using the plate approach should include: 

  • 3 snacks per day
  • 2 food groups (carbs, fats or proteins)

Veggies and/or fruits can be served along with other food groups, but shouldn’t be one of the two primary food groups served as a snack. 

Goals of The Plate Approach

  • Provide a simple approach to mealtime for families of those with eating disorders
  • Allow weight restoration to take place in the home when safe to do so
  • Normalize eating patterns 
  • Distinguishes  meals and snacks  in ED recovery
  • Provide meal support strategies for families 

Pros of the Plate by Plate Method

The plate by plate method is an excellent tool: 

  • To help keep patients at home during recovery
  • Provide a visual tool that doesn’t require measuring 
  • To be used when there is limited access to eating disorder treatment (cost, lifestyle)
  • Can be used as guidance for someone with an ED when there is limited support
  • Does not require calorie counting 
  • Takes away the burden of using exchanges at meal time 

The plate method is easy to use for anyone providing meal support during ED recovery. 

Cons of the Plate by Plate Method

The plate by plate approach is far from a perfect when it comes to re-nourishing during eating disorder recovery.  

Some drawbacks to the plate approach include: 

  • It does not account for individual variation for calorie needs
  • Plate by plate does not account for any physical activity 
  • Plate by plate is not culturally sensitive (for example, cultures that dine family style or have many layers to a meal)
  • It can be difficult to navigate meals that can’t visually be divided on a plate (soups, burritos, lasagna)
  • It does not progressively increase in food quantity,  which might be necessary to prevent refeeding syndrome for those with exteme restriction
  • Weight wil likely fluctuate even after someone is considered “weight restored” which could impact plate recommendations

For many people in eating disorder recovery, a mechanical eating plan that is specific to their unique nutrition needs for recovery will be necessary.

photo of plate with chicken, rice and veggies on purple background

Using The Plate Method in ED Recovery 

The plate method in ED recovery should: 

  • Be used as part of family based therapy (FBT)
  • Be monitored by an eating disorder dietitian
  • Be administered by a caregiver (not the person with an eating disorder) during initial phases 

It is important to consider that the guidelines of the plate method should be seen as minimum recommendations for energy needs.

If a person in recovery desires additional food choices or  still feels hungry after they’ve consumed their plate, they should be encouraged to choose additional foods. 

Extreme hunger is very common in eating disroder recovery and a single plate of food might not be sufficient to meet the needs of the person in recovery.  

Someone in recovery may also be experiencing hypermetabolism which will require a high volume of food to meet their metabolic needs.  Their body may also require overshoot weight to fully heal their bodies from starvation syndrome

plate by plate meal support

Supporting Someone With An Eating Disorder

No matter what strategy you use to meet energy needs during weight restoration with an eating disorder, emotions are likely to be high. 

A person with an eating disorder likely has a loud eating disorder voice and a long list of fear foods which will enduce a lot of panic, anxiety, sadness and potentially rage at the table. 

Goals of plate by plate

Some tools that can be helpful for someone struggling with an eating disorder includ: 

It’s important to consider that recovery also often means grieving the thin ideal.  Check out these recovery tips for staying motivated during this often long and difficult journey.

 
Stop Humoring 
Body Image Bullies!
Whether it’s your great aunt Sally or the itty bitty shitty committee in your own head- messages that threaten how you feel about your body suck.
 
 Subscribe and i’ll send you the ultimate guide for battling the bullies that make us feel like our bodies are something to be “fixed.”
 
You’ll also become a member of my exclusive F*ck Food Rules Friday club only available to subscribers. 
Thank you for subscribing!
Shena Jaramillo. Registered Dietitian
Latest posts by Shena Jaramillo. Registered Dietitian (see all)