I was fifteen years old the first time I heard about Exchanges. I was in the process of being admitted to a residential treatment facility for eating disorders called Center for Discovery when the counselor running my intake mentioned Exchanges. I had no idea what she was talking about. Before CFD, the only refeeding system I was familiar with was the Maudsley Method; an approach intended for quickly restoring weight where the parents have entire autonomy over the child’s diet.
The Maudsley Method was introduced to me two years earlier at my first eating disorder program and had been a large part of my outpatient recovery ever since. But while Maudsley was great for getting me to and keeping me at a relatively healthy weight, I still had zero control over what I ate. I was well into my teens, and I had no idea how to feed myself. In fact, before I was introduced to Exchanges, I was starting to wonder if I ever would.
The Exchange System sounded complicated at first, but after a few days and a lot of help from the counselors and other teens at CFD, I got the hang of it. Every evening between dinner and night snack, I’d sit at the kitchen table, my Exchange book in front of me, and plan my three meals and three snacks for the following day.
One of my favorite things about the Exchange System was that it didn’t rely on calories, but rather the six basic food groups. Like many people with eating disorders, I constantly obsessed over calories, so having a meal plan that wasn’t solely centered around them was a refreshing change of pace.
As weeks passed and I grew more confident in my ability to feed myself, I transitioned to planning meals and snacks in the moment instead of the night before. The penultimate stage of the program was eyeballing, or portioning out food without relying on measuring tools, and the final stage was weening myself off Exchanges entirely and eating intuitively. I achieved the latter a couple of months after I discharged from CFD at an intensive outpatient program.
It’s been five years since then, and while my recovery hasn’t always been smooth sailing, I owe a lot to the Exchange System. Without it, I doubt I would have been able to learn how to feed myself sufficiently, trust my instincts around food and portion sizes, and nourish my body and mind. To this day, I still think about Exchanges and everything they have taught me. I even reference them in my books. If Exchanges could help someone like me, who just a few years ago was convinced that my worth was dependent upon a number on a scale, then I’m confident that they can help others as well.