Grocery Shopping with Clients Who Have Eating Disorders (February 2021)
Some people find grocery shopping to be a stressful, anxiety provoking experience. For example, those struggling with an eating disorder report that the market can often bring up feelings of confusion about what to buy and how much to buy, feelings of being out of control, and anxiety.
When an individual is in treatment for an eating disorder, part of their work in treatment is grocery shopping with a registered dietitian and having exposure therapy at the market.
Being a private practice registered dietitian, I like to discuss with the client and begin by asking questions to better understand their experience. Some questions that I ask are: what is challenging for them when grocery shopping? What aisles give them anxiety? How do they approach the store?
We discuss this topic for several weeks before even going to the grocery store together or having their meal companion support go with them to the store. A meal companion is a clinician that is trained in eating disorder support and is usually a registered dietitian nutritionist or a mental health provider (LMFT, LCSW) that works with the eating disorder team and follows the lead of what the registered dietitian nutritionist has suggested.
Working on this exposure therapy is beneficial to help the client become closer to immersing back into society with people and daily activities of life. This is important to begin to incorporate once the clinician has developed a relationship and trust with the client. The purpose of this exercise is for the dietitian to also see their client and their relationship to food in action.
As a clinician, I find it helpful to see the reaction and hear the thought process that an individual makes when grocery shopping. I like to challenge my clients to purchase items they normally would not purchase, avoid looking at labels or buying an item based on how something looks, and by suggesting an item. I also like to challenge clients to purchase food in the prepared foods section at the store that has no nutritional information. When amounts to purchase are open ended and there is no “guideline” about serving size, it can be anxiety provoking for people. I also like to pose the question: “If you were at a potluck party, how would you approach it?” Food is put on platters, trays, and has no information with it. I encourage them to approach the grocery store in the same way. We also clarify misconceptions that the clients have regarding macronutrients and what purpose the label serves.
When a client goes to the grocery store with me, a meal companion, on their own, or with someone else, I like to have a client assess their mood and stress level, identify how they are feeling, and explore strategies to help the person get into a different space (listen to relaxing music, call a safe friend, meditate, breathe, or journal). It is also important to assess the persons anxiety after leaving the store and recap how they felt and what they would like to do differently the next time.
Grocery shopping is a practice that I suggest clients to practice regularly, as it’s common to buy food for your home weekly or multiple times per week. This is normal and shows a form of self care that you are worthy and deserving to keep food in your home and able to get to a place of thinking about what you would like to have on your shopping list this week. I also like to challenge clients to be spontaneous and buy food that is not on their list just because it looks appealing to them or they haven’t seen it before. Having this freedom and flexibility is necessary to move closer towards your recovery.