Have you eaten in the last 3 hours?

Written By Kate Webbe

I want to talk about Regular Eating.

This is the first place I now start with any client. Recently I completed the DECIDE: Disordered Eating Training for Practitioners by Casey Conroy (Dietician & Naturopath - https://www.funkyforest.com.au/ )

This is where I learnt about two frameworks designed in the eating disorder space that focus on regular eating first.

The first is the RAVES model originally designed by Shane Jeffrey. RAVES stands for:

Regular Eating

Adequate Intake

Variety

Eating Socially

Spontaneity

Now, for some, not all of these will be achievable or even desired. Some neurodivergent people, such as those with ARFID, may not value eating socially or change to what they are eating. Or, like me, they may value those things but find them tricky. I will get into that at a later date.

The RAVES model is intended to be prioritised from R to S - meaning that regular eating is of course more important than being able to be flexible to eat what someone else has made for you. All humans require nutrition but we can Achieve our Required Food Intake Differently, and being able to eat new foods is not essential to eating enough.

The Rule of 3s is another framework that helps assess and address Regular Eating and Adequacy. It was designed by dieticians Marcia Herrin and Maria Larkin. It recommends:

  • 3 main meals a day plus snacks

  • 3 hours between eating

  • 3 macronutrients (fat, carbohydrates, protein) in each meal

Some of you may read that and think ‘easy’. Some of may read that and think ‘well my main meals usually have all the macronutrients so I’m not usually hungry for another 4—5 hours’. And some of you (my ADHDers and my ARFID families) may read that and think ‘wow, that’s a very tall order’.

Honestly when I learnt about it my thoughts were ‘I thought the whole point of eating more at meal times was to go longer between meals’. This is because I find both eating enough and eating regularly difficult, and I hate interruptions to my work day (because I love talking about nutrition yet sometimes I don’t want to stop to eat).

It is now July and I learnt these frameworks in April. I still have not got anywhere close to regular and adequate eating. This has also been complicated by starting ADHD stimulant medication - which has helped with executive functioning (preparing meals, food shopping etc.) but really dampens my appetite during the day.

If you’re wondering ‘where do I start?’ I have a few suggestions.

Firstly if you are supporting a loved one through ARFID or another eating disorder, get support in place for all of you. Sometimes those of us with low appetite appreciate the reminders to eat, but sometimes it feels like a demand we can’t meet. Parents in my clinic will know how deep we discuss what helps their child and what doesn’t seem to help (and how this can change day to day!)

If you are an autonomous adult, then I invite you to join me in reminding yourself to eat every 3-4 hours. For me right now this looks like setting alarms on my watch for every 3 hours to get myself to stop and eat. It’s not always a meal and it’s not always all the macronutrients, but it’s better than nothing or going 6+ hours without eating and then wondering why I suddenly hate everything.

Foods we’ve been enjoying in our house as two low appetite adults now on ADHD stimulant medication:

  • protein-rich pouch yoghurts (we like YoPro) or Up and Go’s

  • baked beans (come in a variety of sizes)

  • leftovers e.g. pasta

  • Milo and milk

  • dinners we usually get our appetite back (the medication wears off and the day’s inadequate intake catches up with us) so I try to make these more substantial e.g. burritos with Mingle seasoned mince with onion, garlic, carrot, capsicum in a tortilla with cheese and sour cream

  • muesli bars (Carman’s have a higher protein content range of bars in different flavours)

  • ham and cheese sandwiches

Please remember that people go hours without food in the day for many different reasons.

If you think you don’t deserve to eat or you’ve eaten ‘too much’ lately - please know you can still eat.

If you or your child lacks an interest in food or finds food unpredictable and demanding - please know there are other strategies for this. Often regular eating is not where I start with ARFID families or myself - we have to start with non-nutrition interventions to support the nervous system and increase capacity for eating. When things are really hard, we have to accept that as long as some nutrition (food or beverage or supplements) is happening every day at some point, that’s ok.

I also know that’s easier said than done. Only last night I found myself commenting on my partner’s long gaps in the day without eating (I have a fear that energy slumps will be purely attributed to needing more ADHD medication which will of course further suppress appetite). But the lack of nutrition counselling before starting stimulant medication is a topic for another blog.

And while of course I never want to encourage underfuelling, I do want to reassure you reading this that the human body is resilient. I was the child who couldn’t eat at school - so I ate more after school, in my home environment. I do of course encourage that if you or your child are going long stretches without eating, reach out for support.

Thank-you for reading, and if you haven’t eaten in the last 3 hours, is there something you could eat or drink now to nourish yourself?

Kate Webbe