Nutritional Considerations in Eating Disorder Recovery
A Guide by Emily Rose Martin, ANAD Intern, in collaboration with Matt Stranberg, MS, RDN, LDN, CSSD, CSCS
Recovery is a structured process that affects the body, mind, and relationships. Eating disorders can disrupt how many systems in the body function, including the heart, brain, digestive system, hormones, bones, and muscles. Because of these wide-ranging effects, recovery requires time and consistent care so the body can gradually heal and return to more stable functioning.
Recovery is often most effective when it involves a multidisciplinary approach. This may include support from medical providers, therapists, and dietitians who work together to address both the physical and psychological aspects of the eating disorder. This guide provides general nutrition information to support recovery and is intended to supplement professional treatment. It is not a substitute for medical advice or supervision from a physician or dietitian.
Energy and Fluid Balance
Energy and fluids form the foundation of physical recovery. Food provides the body with energy (calories), which allows organs and body systems to carry out their normal functions. During recovery, the body is often in a rebuilding state. As a result, energy needs may be higher than usual while the body works to repair tissues, restore normal body processes, and rebuild energy stores that may have been depleted during the eating disorder.
Ensuring adequate intake is important for medical stability and is often one of the first steps toward improving physical health.
Functions of Energy (Calories) in Recovery
Energy from food supports many essential processes in the body, including:
- Organ Support: Fuel from food allows vital organs such as the heart, brain, liver, and kidneys to function properly.
- Physical Repair: Adequate energy helps the body repair muscles, organs, and tissues that may have been weakened by prolonged undernourishment.
- Hormonal Balance: Energy supports hormones that regulate metabolism, stress response, temperature regulation, and reproductive health.
- Cognitive Function: Regular energy intake helps maintain stable blood sugar levels, which supports focus, concentration, and memory.
When the body does not receive enough energy over time, it may begin to break down muscle for fuel. This process can increase fatigue, weakness, dizziness, and other medical risks. Eating regularly helps prevent these effects. For many individuals in recovery, this means aiming for three meals and one to three snacks each day. Spacing food throughout the day helps provide a steady source of fuel and prevents long periods without nourishment.
Hydration
Fluids are another important part of recovery. Water and other beverages support many normal body processes, including digestion, circulation, temperature regulation, and the movement of nutrients throughout the body. Drinking fluids consistently throughout the day helps prevent dehydration and supports overall physical functioning. Some general hydration guidelines include:
- Drinking fluids regularly throughout the day rather than consuming large amounts all at once
- Including beverages with meals and snacks when possible
- Choosing a variety of fluids such as water, milk, juice, or tea
- Watching for signs of dehydration, such as dark urine, headaches, dizziness, or fatigue
It may also be helpful to avoid drinking large amounts of fluid immediately before meals, since this can create uncomfortable fullness and make eating more difficult. Most beverages (including water, milk, juice, tea, and other drinks) can contribute to daily hydration.
Macronutrients
Macronutrients are the main nutrients in food that provide energy as well as support normal functioning and recovery. Each macronutrient plays a different role in the body, and they work best when eaten together in meals and snacks to help maintain steady energy levels throughout the day.
Nutrient | Purpose in Recovery |
Carbohydrates | Provide the body’s primary source of energy. They help the brain think clearly and allow the body to carry out everyday activities. |
Protein | Helps rebuild and repair muscles, organs, and other tissues. Protein also supports immune function and the body’s overall healing process. |
Fat | Provides concentrated energy and supports important body functions such as hormone production and the absorption of certain vitamins. Fat also supports the nervous system, hormonal balance, and immune function. |
When meals and snacks include a combination of these nutrients, energy tends to remain more stable and the body is better supported during the recovery process.
Micronutrients and Timing
In addition to macronutrients, the body also requires micronutrients, which include vitamins and minerals. These nutrients play an essential role in maintaining health and supporting recovery. Micronutrients contribute to many important functions in the body including:
- Bone strength
- Immune system function
- Brain and nerve function
- Blood health
- Muscle function
The most effective way to obtain these nutrients is by eating a variety of foods across the week, including foods from different food groups. Please seek guidance from a registered dietitian to ensure nutritional adequacy.
Nutrient Timing
Along with the types of foods eaten, the timing of meals and snacks also plays an important role in recovery. Eating at regular intervals throughout the day helps maintain consistent energy levels and supports more stable blood sugar.
Establishing a regular pattern of meals and snacks can also make daily routines more predictable and reduce long periods without food. When too much time passes between eating intervals, people may experience irritability, fatigue, difficulty concentrating, or feeling physically unwell. For these reasons, regular meal timing is often an important part of nutrition plans used in eating disorder recovery.
Supplements
In some situations, supplements may be recommended to help address specific nutrient needs. These may include vitamins, minerals, or nutrition drinks. While supplements can be helpful tools in certain cases, they are not a replacement for regular meals and snacks. Whenever possible, nutrients are best obtained through a balanced and varied diet.
Supplements should only be used under the guidance of a qualified healthcare provider.
Disclaimer
Everyone’s recovery journey is unique. Energy needs and nutrient requirements can vary based on factors such as age, sex, weight history, medical conditions, and the severity and duration of the eating disorder. Always follow the specific nutrition plan and medical recommendations provided by your treatment team.
For individuals who have experienced moderate to severe malnutrition, significant restriction, or frequent purging, increasing food intake may require careful medical monitoring. In some cases, the body can experience medical complications during the early stages of nutritional rehabilitation (sometimes referred to as refeeding). Because of this, nutrition changes should be guided by a qualified medical professional whenever possible.
