Throughout this blog, I have written about meal plans for eating disorder recovery that are based off of the exchange system. I work in an eating disorder treatment center that uses the exchange system for meal plans, have had clients benefit greatly from it, and therefore am a major supporter of its use. There are some other treatment providers, however, who use a calorie counting approach to the meal plans they prescribe.
The common question is, which is the best way to approach a meal plan for eating disorder recovery: the exchange system or calorie counting?
First, let's begin with the definition of a calorie. A calorie is actually a specific amount of energy, or heat, that it takes to raise the temperature of 1 gram of water 1 degree Celsius. The number of calories in a food is a measure of how much potential energy that food contains. One food calorie (as listed on a food label) actually refers to a kilocalorie or 1,000 calories. Technically speaking, one kilocalorie (or one food calorie in that piece of bread from your sandwich at lunch) is the amount of energy (if that piece of bread was burned to ashes in a research lab) needed to raise 1 gram of water from 16 to 17 degrees Celsius.
Somewhere along the line, a calorie became less about the potential energy it can offer our body in order to sustain life, and more about the judgement associated with how many (or how little) calories we consume. In our diet and appearance obsessed culture, we are unfortunately taught to believe that we should feel guilty, shameful, fearful, sinful and weak if we consume a "high calorie" food. Furthermore, we are programmed to believe that we should limit the amount of calories we consume and that we should feel superior, deserving, and worthy if we are successful at it.
Often times, number association, such as calorie counting, can be a huge part of an eating disorder. Because the number of calories we consume has somehow become a measure of self worth and morality, calorie counting (even in the form of a meal plan) can become a method of restriction, control, and obsession that can be a trigger to a slippery slope of eating disorder behaviors. For many people who struggle with an eating disorder, calorie counting, even in the form of a meal plan, is something they need to steer clear of if they want to live a life in recovery.
For those who have a difficult time seeing a calorie for simply what it is, a unit of energy (and fuel for your body), it is probably best to follow a meal plan that is based off of the exchange system (rather than calorie counting). The exchange system can be a fresh start and a new way of looking at eating (as the exchange system places emphasis on learning what a balanced plate of food should look like for you within each of the food groups). It can re-channel some of the negative associations you may have about foods, which you have been calorie counting for so long.
I do find that the majority of the clients I work with prefer to use the exchange system for their meal plans. Despite my bias and experience with using the exchange system, there are some people who have found calorie counting beneficial in recovering from their eating disorder. As far as which method is superior, I suppose that it really depends on the person. For the majority of people suffering from an eating disorder, I would suggest they follow an exchange based meal plan. However, if you are able to let go of the negative associations placed on calories and you are able to use calorie counting as 1) a way to appropriately nourish yourself with a variety of food from all of the food groups 2) a tool to assist you in decreasing rigidity with food 3) a way to help you abstain from engaging in eating disorder behaviors, calorie counting may be helpful in eating disorder recovery.
In the end it's all about what supports (rather than prevents) recovery from your eating disorder.