Calories are increasingly on display in restaurants and cafés. Parents, when you are trying to get your child to eat out with you, or with friends, this is an extra hurdle towards freedom from the eating disorder. Our sons and daughters find calories on the menu so very 'triggering'.
Though I despair at all calorie-labelling, today I'm going to be pragmatic: calorie labels on menus in cafés and restaurants are here. So how can parents help their child fully recover from an eating disorder in spite of our society's demonizing of calories?
I'm writing this partly from experience and partly from general principles of exposure and desensitisation to fears (lots more on that in Chapter 9 of my book, in my Bitesize audio collection and in my 'Phase 2' workshop). As always, take what's useful and leave the rest. Use only what makes sense to you, and of course discuss with your eating disorder treatment team.
What's the end goal? Our child can go to any café or restaurant, and pick from the menu any item that titillates their tastebuds. If they notice the calorie labelling, it hardly registers in their mind.
After the meal, they enjoy the gret feeling of having eaten great food in great company. If they feel rather over-full, they groan theatrically and loosen their waistband, all the while finding it all hilarious.
If a few hours later they are hungry again, they satisfy their hunger. They trust their appetite. They may or may not notice that the next day, they may or may not fancy a light meal more than they fancy a rich one.
And they enjoy their usual sports or movement, without any compulsion to 'burn off' the calories.
Plan to 'expose' to the fear of calorie displays, in gradual steps
Fears tend to be overcome by experience, not logic. Most competencies come from repetition. Think 'brain rewiring'. To achieve our goal, our child probably needs to experience, over and over, that nothing bad happens when they eat a higher-calorie item from the menu.
It's rare that our children want to engineer a scary experience by themselves. So we parents need to be their guide, their skilled coach.
Let's use general principles to plan how to do this:
- There is no urgency, so we can take small, gradual steps, building on each previous success. Treat each step as an experiment.
- Did an experimental exposure proves to be 'too much, too soon'? Your child completely freaked out? As happened to me, you got a plate of spaghetti on your lap? Meals were extra-hard for several days after? Then we either put the challenge on hold for a few weeks or months, or we get creative in how to break down the challenge into smaller, smoother steps.
- Usually, we design a challenge to address just one fear at a time: e.g. if our child finds it hard to eat when many people are present, we do the first few restaurant exposures with just the two of us, sitting in a quiet corner.
- We repeat the exposures until our child has no problem with the task: some fears will go with just a couple of exposures, others require more consolidation.
- We don't allow too long between exposures. If we leave big gaps, the fear can build up again. So at first we might repeat every day or two. Then as the task becomes easier we increasingly space out the exposures. Eventually, a 'reminder' or booster once a month might be plenty.
- And as always, our stance is supportive, loving, non-critical (if you don't see why, my Bungee Jump video may help)
Here are some ideas.
If eating in cafés or restaurants is hard for your child (even without calorie considerations) then there's loads of help in Chapter 9 of my book and in my Bitesize audio collection. Let's assume that's now happily sorted.
Start with whatever type of café or restaurant your child finds easiest. Have they already expressed a preference for chains? Maybe they like to (secretly) look up calories, so half the work is already done: they're already exposing themselves to numbers. The challenge, most probably, is to manage big numbers.
You have choices:
- Will you plan the small steps with your child?
- Or will you 'surprise' your child, and be persistent as you support them through the challenge?
Some of our children like to 'own' the process, so it's great to collaborate and plan with them.
On the other hand, some cannot bear to think of anything that will take them out of their comfort zone, so to get any kind of progress, unfortunately we need to 'surprise' them. If we give them too much warning their anxiety just goes up.
You could choose for your child (or support them to choose) a moderately calorific item at first, then return to the same restaurant and each time go up the numbers (of course, only choose dishes which you guess they would like, if they didn't have an eating disorder). As the whole idea is to expose your child to the calorie-labelling, make sure they see the menu (isn't it hilarious / tragic that a dish is labelled to the nearest calorie?)
If the above proves too hard, then problem-solve, be creative (again – with or without your child's collaboration): how can you make the steps smaller and more gradual?
You might practice one of the menu items at home, or order it in as a takeaway. If that's too big a step, then start with small portions and build up every few days, at home.
Your child might find it easier, at first, to view the menu online ahead of the restaurant visit. They may plead for a low-calorie item, and you can use all your skills of compassionate persistence to make a small step towards a higher-calorie choice.
It's common for our children to be overwhelmed by the many choices in a menu. Small steps mean you could do the choosing, or you could give your child a limited choice.
Perhaps it's too big a step for your child to eat the whole plate in the restaurant. Well, maybe it's fine that at first, they eat just a bit. They've still practiced eating something with a high calorie label on the menu, so that's progress.
Think of yourself as a wise mountain guide, as a coach. If this journey needs to be broken down in many small stages, so be it.
Should you explain the process to your child?
It's really understandable that your child should wail, 'Why are you torturing me? I've been eating all my meals without complaint, my weight is good, and now you want me to eat Pastinelli Gourmet in this dumb restaurant and it's even higher in calories than I thought!?'
In my book, in my Bitesize audios, I guide parents on how to nurture connection so our children feel understood and guided through these challenges. There will be an art to how much you explain (using logic and education) and how much you just prompt for the next step in a challenge while giving your child skilled support. A 'template' that may help you is: 'Connect before you Direct' (plenty in my book, my Bitesize audios, and in this short video).
Here's an example:
You're in a quiet corner of a restaurant you've already visited several times. You point at the menu and suggest that today you will both have the 'Pastinelli'.
Your child protests, 'Why are you torturing me? The Pastinelli dish is way too high! Did you see the calories?'
'Yes sweetheart, I really feel for you. It's like torture, when the menu shows those calorie numbers. I can well imagine how that is stressful for you, because up to now you've been pretty cautious around calories. Is that so?' (I'm connecting and checking)
'Too many calories! It stresses me out!'
'Understandably, darling. You're not used to seeing a higher number like the one on the Pastinelli, so your stress goes up . Is that the issue?' (Still connecting and checking)
'Let me pick the Pasdegout Fadasse, like last time. I like that.'
'Sure, you would much prefer the Pasdegout… I'm guessing that if we picked that again, you'd have an easier time.'
(And now you've 'Connected', you could move on to 'Direct'. It's time for action and that may require some level of compassionate persistence. Let's avoid saying 'but':
'And at the same time, honey, I'm thinking of the wonderful life ahead of you where you can enjoy anything in a restaurant, be real chill, even when the menu shows calories. That's what I'd like to work towards. How does that sound?'
'I don't mind seeing the calories, I just don't want a dish with so much.'
Now you can continue looping between Connection and Direction. Hopefully you can problem-solve together to make at least a small step forward today. If your child just can't engage with this challenge, you might make a decision like this:
'Even though it's so difficult for you to imagine you can do this, I really want to help you over this hurdle. So I'm going to order, and I'll support you every step of the way so it feels fine. Now let's change the mood. Let me show you this hilarious cat video.'
Notice I'm not making use of logical explanations. I'm not laboring the point that the scary dish shows only 103 calories more than the Pasdegout, or that the numbers are a load of nonsense anyway. Education and logic are overrated. But if you think that these would help your own child, well you're the expert.
Education at the funfair
You might remind your child how they became bored of a water slide or a funfair ride:
'Remember how it was so scary first time round, and you were screaming and laughing with all the adrenaline? And then you went a second time, and a third, and it became quite dull? That's how fast the brain can decide something isn't scary any more. This is about rewiring, formal new neural connections, so that things that are an effort today become easy, and life will become a lot more fun.'
Can you speed up the process with 'flooding'?
Flooding is when instead of gradual steps, the person is exposed to the whole challenge at once. Sometimes it happens naturally: your child is having a joyful, carefree time with friends. Calories are on the menu, but your child doesn't care, they order the yummy dish they desire, and all goes well.
If so, I suggest you try and recreate this happy situation within a few days to get some repetitions in and consolidate the good work.
Can you decide to 'flood', so as to go faster? Well, you're the expert on your child. Given your son or daughter's anxiety level is likely to shoot up high, it's probably not worth it. What's the rush?
If your child is struggling to eat, to gain weight, if meals are highly anxious affairs, then this is probably not a good time to add to their anxiety (and risk setbacks) with non-urgent challenges?
If early in treatment you really need to eat out, then I suggest you make the food decisions just like to you do at home. You could make sure your child doesn't see the menu, but you and I know that if they really want to see it, they will probably find it online.
I'm thinking of how at first my daughter's easiest restaurants were the Nando's chain. I have no doubt that she was secretly looking up calories ahead of time. Yet she was choosing dishes that were not low in calories. Calorie-labelling was not an issue at this stage (much earlier, we'd had to hide the labelling from food packaging).
For us the biggest challenge turned out to be eating in small restaurants where there was no access to calorie information. (I describe how we worked on that in my book, Chapter 9)
Can you use the calorie-labelling to your advantage?
Am I the only one who, when choosing a sandwich for a long train journey, reads the calorie label… to make sure I'll have enough? I'm not going to pay good money to be stuck in a carriage, feeling hungry.
Calorie-labelling is not so bad, in my view, if sometimes you use it as a minimum.
Imagine you're out with your child at Starbucks, and they're choosing lunch, with your guidance:
Your child: 'Can I have this carrot wrap?'
You: 'Sure, that looks tasty! And what else?'
Your child: 'Errrr, just the wrap?'
You: 'Well, I know you can see the calories, and you know you need at least twice that much for lunch, so what else do you fancy?'
What might resilience to calorie information look like?
Your child is ordering brunch with a friend: 'Oooooh! Look! Pastinelli Gourmet in a Myam Sauce!!!! I love that!'
And the friend groans , 'But have you seen how many calories on that?!'
And your wonderful, recovered, free and joyful child goes, 'Yeah, so what?!'
And the friend says, 'You're right, the diet starts tomorrow! And extra gym time!'
And your darling child feels a flash of empathy for this poor friend who doesn't have an eating disorder, but is trapped in the kind of disordered eating and sad body image that has become society's norm.
Some closing thoughts:
Calorie-labelling is not a new problem: calories are displayed everywhere!
Our children recover from an eating disorder, and move to happy lives, free of fears and of eating rules. Even though calorie information (or misinformation?) has long been available on phones and Fitbits, on packaging, on gym or leisure equipment. Sure, some people fight their eating disorder by avoiding calorie information the best they can. But in today's crazy world, that's a sticking plaster, not a long-term solution.
Learn about Intuitive Eating
Some of my readers may wonder why we'd coach our child to chill around a high-calorie dish, when our governments are so very keen that we should avoid it or follow up with compensatory restriction. You might need to get your head round this so you can guide your child to full recovery from the eating disorder.
To help you with this I suggest you learn from Tribole and Resch about 'Intuitive Eating' (I'm showing you the book but most recently I also enjoyed the audiobook, which is a bit different). To me, it's just 'normal' living — what's the big deal! Perhaps it will provide you with a vision of complete recovery from an eating disorder.
A word of caution: intuitive eating is a great aim, but it may be far too early for your child with an eating disorder. You need a body and brain that deliver reliable hunger and satiety signals, and that takes time. You need a mind that doesn't get in the way, and that takes even longer. My guess is that intuitive eating might never be appropriate for people with some types of ARFID. Check out the article 'Adapting Intuitive Eating for Neurodivergent People', for many good points that are relevant to everyone.
More on intuitive eating, and when it might fit into our child's recovery, in Chapter 10 of my book.
What prompted me to write this post is a new law is in force in England. Restaurants with 250+ staff now have to display calories on their menus. They're allowed, but not obliged, to have an alternative non-calorie menu for customers who request one.
Presumably the logic is that if the nation's health is declining after decades of widespread calorie information, the solution is more calorie information.
This England law has gone ahead in spite of energetic protests by various groups, including BEAT, and of articles by top experts like 'Going too far? How the public health anti-obesity drives could cause harm by promoting eating disorders'.
While many argue against calorie-labelling for the sake of those suffering from — or at risk of — an eating disorder, I think the issue is also alarming for the whole population.
Maybe each of us can do our bit, because we never know what may help. I imagine a loud, sweeping 'grande dame' protest as the waiter brings you the menu: 'Oh sweetheart, not that utterly joyless menu! Is there anything more tragic than calorie-labelling when you're out to enjoy a meal. Be a darling and bring me a proper menu!'
For more help
- On exposure and desensitisation to fear foods and fearful situations: Chapter 9 of my book and quite a few Bitesize audios and my workshop 'Phase 2: the work towards complete recovery'.
- On intuitive eating: Chapter 10 of my book and some Bitesize audios
- On the compassionate skills that will help you support your child through these fears: Chapter 13 and Chapter 14 (and actually, the whole book!) and many Bitesize audios and some of my workshops
- If you're struggling with meals at home, Chapter 7 and Chapter 8 and many Bitesize audios and one of my workshops
I hope the suggestions in this post are helpful and I welcome any more of your ideas in the comments below.