Normalizing eating behaviors is one of the main goals during eating disorder treatment and recovery, and a process that is particularly challenging. Individuals with eating disorders often have elevated anxiety and describe extreme beliefs about the potential consequences of eating. Many eating-related behaviors are organized around managing fears. Because of this, anticipating eating energy-dense foods may induce significant amounts of distress. Patients often engage in rigid dietary patterns that do not meet their nutritional needs by eliminating important macronutrients such as carbohydrates, fat, and protein and avoiding energy-dense mixed dishes with hidden ingredients.
Exposure to challenging food selections is a useful tool to target eating-related anxiety.
This enables the individual to engage in the task of confronting rather than avoiding their fears and decreasing anxiety over time with the consistent practice of exposure to a variety of foods. Preparing seasonal meals and participating in hands-on meal preparation can enhance exposure and reduce rigidity.
I love our featured recipe this month: Butternut squash and sage lasagna! It is an excellent meal for our patients to practice exposure techniques that confront food-related anxiety. This seasonal dish represents a great way to get a starch, protein, fat, and vegetable in a small volume while incorporating a unique variety of vegetables and cheeses. Enjoy!
“On the other side of fear lies freedom.”
Butternut Squash & Sage Lasagna
- 2 1/2 lbs. butternut squash — (peeled, seeded, cut into 1″ pieces)
- 1/2 cup canned pumpkin
- 2 TBSP extra virgin olive oil
- 3/4 tsp salt
- 3/4 tsp pepper
- 2 tsp fresh thyme leaves — stems removed, finely chopped
- 8 ounces ricotta cheese
- 6 ounces mascarpone cheese
- 2 eggs
- 8 pound part skim milk mozzarella cheese — shredded
- 1/8 tsp. nutmeg
- 1/2 tsp salt
- 2 tsp butter
- 1/4 cup fresh sage – loosely packed, finely chopped
- 2 1/2 cups vegetable stock
- 1 box lasagna noodles (12-16 oz. box)
- 3/4 cup Parmesan cheese – (finely grated)
- Preheat oven to 400.
- Toss squash, oil, salt and pepper, and spread on baking sheet. Bake until light golden and tender, 30 minutes or so; add thyme leaves in, set aside to cool (can be done a day ahead).
- With hand mixer in a large bowl, mix well the ricotta, mascarpone, eggs, mozzarella, nutmeg and salt; set aside (can be done a day ahead).
- In a small sauté pan, melt butter over medium-high heat; when it starts to sizzle, add sage and cook until light gold and slightly crisp, about 3-4 minutes: do not burn! Set aside.
- Cook lasagna noodles in well-salted water according to directions; rinse and set in cool water. If using no-boil noodles, do not cook.
- After squash is cooked, reduce oven temp to 375. Grease a deep 9×13 inch casserole pan.
- In a large stainless bowl mash the squash (can have small lumps for texture) then use hand mixer to blend in stock and sage-butter mixture; mix well.
- Spread about 1 cup of squash filling in each pan, spreading evenly.
- Place an even layer of pasta over each, very slightly overlapping.
- Evenly spread about 1 cup cheese mixture in each pan, then about 2 cups squash mixture. Top with another layer of pasta.
- Repeat layering until all is used up: there should be about a 2:1 ratio of squash to cheese filling.
- Sprinkle Parmesan evenly over last cheese layer.
- Bake until cheese is golden and bubbling, about 40 minutes.
- Let sit for at least 15 minutes before slicing with a serrated knife to serve.
1 piece = 1 starch, 1 pro, 1 veg, 1 fat
Yield: 16 pieces