When you start treatment for an eating disorder, one of the essential goals is to learn how to make good food choices. There are two common options: counting calories or using the food exchange system. Each of these options takes a slightly different approach.
There is some debate as to which method is better for people recovering from eating disorders. It's important to look at each method and weigh the pros and cons.
The food exchange system was initially put together by the American Dietetic Association back in 1950. The goal was to give average people quick and easy guidelines so that they would build a nutritious meal. The idea was to categorize food into similar groups. To create a balanced meal, people selected one option from each category.
As our understanding of food and nutrition grew, the food exchange system was revised several times over the decades. The most recent revision was in 2013.
Some feel the food exchange system is the best option for people recovering with eating disorders because it gives them clear and straightforward guidelines to help them balance portions. There is less guesswork involved, and less time struggling over calorie counting (a habit that many people with food disorders are trying to break). Streamlining choices like this can help reduce anxiety about planning meals. Advocates of this system say it helps teach people with food issues what proper portions look like.
Those who criticize the food exchange system feel that the nutritional value of foods found within one category can vary too much. Someone who restricts calories can fall into a pattern of choosing the absolute lowest calorie foods in each group, thus missing their daily targets by a few hundred calories per day. Some argue it's too simplistic and doesn't really teach people to make better decisions.
Some argue that the only way for those with eating disorders to reach their nutritional goals accurately is for them to weigh, count, and add up calories. This is the only way to ensure a person will hit their target calorie goals so that they stand a better chance of hitting their target weight goals.
Learning to count calories accurately can give a patient more control and better prepare them to maintain recovery in any given situation in the future.
Those who oppose calorie counting feel that a person in recovery, particularly in the beginning, may feel more stressed as they watch the calories add up. They may struggle more with open-ended choices about what to eat and get overwhelmed about balancing their meals.
Like with so many things in therapy, a lot depends on the individual. This is something to discuss with your nutritional counselors. You might want to try both ways for a while to see which method works for you.
Sources: Eating Disorder Hope, Healthline
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