During the initial refeeding period of Phase I, families may use the “Magic Plate” technique, which involves the parents taking complete control of all meal planning, grocery shopping, and meal preparation, and the child’s only job is to eat. This technique is a compassionate way of alleviating the anxiety experienced by the child when deciding what or whether to eat. Without the stress of having to make a choice, affected adolescents are able to focus their effort on the present task and accept that eating is what is expected of them. Parents are encouraged to present a united front, thus preventing ED behaviors from emerging during gaps in the treatment plan. According to Lock and Le Grange, parents need to be “not just on the same page, but the same line, the same word and the same letter” so that the adolescent with ED hears only one powerful message from parents: “We know this is hard, but we love you and you have to eat.”

Because there is no approved medication for the treatment of EDs, weight restoration is accomplished using adequate calories from food as medicine in the form of three meals and three snacks per day prepared entirely by the parents.6 Foods that were enjoyed in the past should be reintroduced and overall variety should be increased, including any “fear foods” that may have developed over the course of the disease. Diet foods are discouraged and exercise is temporarily restricted in an effort to shunt all available energy towards weight restoration. Although many practitioners may argue that this approach interferes with the autonomy of the maturing adolescent, FBT recognizes that malnutrition has temporarily impaired the teen’s ability to make sound decisions regarding food, weight, and exercise, but as soon as the malnutrition is resolved, age-appropriate control can and should be returned to the teen.

Denial on the teen’s part regarding the severity of his or her malnutrition symptoms is common in both AN and BN. AN is egosyntonic, meaning that those with this disease cherish it, find comfort in it, and value it as an important part of their personality that they will fight to protect against treatment attempts. BN is considered egodystonic, so while the adolescent may deny the severity of the symptoms, there is less pride and more guilt and shame associated with binge/purge behaviors, making it difficult to seek out help. In both situations, affected teens are unlikely to be ready and willing to take steps towards recovery on their own, and even less likely to do so with a smile. Parents are encouraged to avoid rationalizing, arguing, discussing, or negotiating; they are asked to focus on feeding their child until weight is restored. The goal of Phase I is resignation—the teen has only to be resigned to eat and accept that he or she has no choice.