Eating disorder treatment usually consists of input from psychologists, psychiatrists, nurses and/or dietitians. In my experience of treatment for anorexia, there tends to be a focus on my past to look for the cause of my eating disorder and to find out what maintains it and keeps it going, for example perfectionism or anxiety. The only focus on food is on a meal plan set by my dietitian which is not a meal plan that will say dinner is cottage pie and vegetables but instead it will say things like full portion of potato, rice or pasta. It can be difficult to follow a meal plan like this because what if the potato weighs more than the portion size says? It can be confusing for an eating disordered mind but more than that, how do you cook?
As somebody who has suffered from anorexia since early childhood I can say that I do not know how to cook a nutritional meal for myself. My obsession with food has made me an excellent baker but day to day cooking I don’t know where to start. I am the only vegetarian in my family and my Dad cannot eat a lot of the food society consider to be healthy because of his illness and so I cannot even use my parent’s cooking as a guide. On the times I have been doing well with my eating disorder I never really cooked myself a homemade meal because I felt I wasn’t worth the money, time or effort that it would take me to cook the meal. I have never learnt how to feed myself properly. School taught me to bake scones, cakes and stir fry and to this day stir fry is the only meal I can make.
I know that I am not alone in my struggle to cook for myself and I think that this may be a common issue with sufferers of eating disorders, particularly with those who became unwell before adulthood. I think it’s such an important part of recovery, I mean I’ve been in general hospital and seen people have to walk the length of the ward before the OT would allow them to be discharged. People with eating disorders should be helped and supported so that when they go home they are able to cook for themselves, but not just as inpatients, as outpatients too. I imagine an outpatient OT-lead cookery group would help so many people and give people the confidence to cook for themselves at home. It is the ‘simple things’ that would benefit patients, for example, learning basic food preparation like peeling potatoes, chopping a mushroom and cooking/rinsing rice, or how to cook on a budget so that people can learn to cook batches, portion and freeze.
OT cookery sessions would be therapeutic as well as practical. I know that I struggle to cook for myself because I am very rigid, I will stick to rules exactly and cannot cope when things don’t go to plan. Learning how to cook in a ‘normal’ way, for example adding a pinch of this and a handful of that rather than perfectly weighing food would really help me psychologically too.
Out of all seven of my admissions, I have only had OT cookery input once and it was just the one session. We went to the shop and bought some pasta and sauce and then went back to the ward and cooked it and it was helpful to do, although there wasn’t the time to get vegetables and prepare them as the OT was rather busy but it gave me some confidence. I had never really been to the supermarket alone and bought ‘normal’ food to make a meal with. That was one session out of seven hospital admissions and 17 years of anorexia which shows that it does not happen enough. OT cookery sessions should be provided on both an inpatient and outpatient basis.
If food is considered my medicine then surely my treatment should help me with food in practical ways rather than just talking about it.