The impact of standardized meal plans for patients hospitalized for anorexia nervosa

Patients hospitalized with Restrictive Eating Disorders (REDs) often face heightened anxiety and challenges around meals. Inconsistent meal delivery and food choice complexity further complicate care. The study evaluated the tolerability of a standardized, no-choice meal plan by assessing nutritional supplement use via oral and nasogastric (NG) tube as proxies for meal completion.

A quality improvement initiative at a pediatric hospital replaced patient-selected meals with a 7-day rotating standardized meal plan. Adolescent patients could exclude up to five "dislike" foods. Electronic medical record (EMR) data from 10 months pre- and 6 months post-implementation (n = 302) were analyzed for rates of supplement via oral and NG tube in the first week of hospitalization.

NG tube use decreased from 22% to 17% of patients and 11% to 6% of patient-days. Oral supplementation increased from 33% to 36% of patients and 18% to 19% patient-days. Changes were not statistically significant.

The standardized meal plan was well tolerated. Future studies should assess psychological impacts and long-term outcomes of removing choice in meals.

This brief provides initial evidence that a standardized meal plan in a hospital setting is well-tolerated and may provide benefits of reducing the psychological burden of choices for adolescents with REDs.