Mealtime Support for Patients with Eating Disorders: A Survey on the Clinical Practice in German Eating Disorders Centers

Mealtime support is a cornerstone of eating disorders (ED) inpatient and day-care treatment but has received only little attention in research so far and no valid recommendations are available for this type of intervention. Thus, the aim of the present study was to gather a comprehensive picture of how mealtime support is currently practiced in Germany. In a nationwide survey, 97 staff members from 66 ED centers across Germany completed a survey-form that covered 4 broad topics: (a) setting, (b) general conditions, (c) specific interventions, and (d) treatment providers' perspective. For the most part, mealtime support is delivered by nurses. Two thirds of the centers provide at least one therapeutically supported meal per day. Most centers offer their patients a kitchen and/or a guided cooking group. Patient eating behavior and amount of food eaten is documented by three quarters of staff members. Most staff members offer some kind of role modeling by eating their own meals at the same table. Food exposure is provided by a minority. Whereas two thirds use sanctions when patients did not achieve their eating goals, only one third use positive reinforcement when patients achieved their goals. Less than one half offer some kind of post-meal support. The results provide important insights into the current practice of mealtime support and will thus inform future studies that examine the efficacy of different types and interventions of mealtime support.