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. Eating regular meals is an essential part of treatment for young people admitted to hospital with restrictive eating disorders. However, choosing meals can be stressful for patients and families, while preparing individualized meals can be difficult for hospital staff and may lead to delays or errors. Our hospital replaced daily patient meal selection with a standardized seven-day rotating meal plan. Patients could still exclude a small number of foods they strongly disliked, and these were replaced with nutritionally equivalent alternatives. We compared how often patients needed nutritional supplements before and after this change. The need for supplements, either taken by mouth or through a feeding tube, did not increase after the standardized meal plan was introduced, suggesting that patients were able to complete meals at similar rates despite having fewer choices. These findings suggest that standardized hospital meal plans may simplify care without reducing meal completion during the early stages of treatment. Further research is needed to examine their effects on patient experience, anxiety around mealtimes, and longer-term recovery outcomes.