Preheat the oven to 375°F (190°C) and grease a loaf pan.

Melt 2 tablespoons of butter in a saucepan, whisk in 2 tablespoons of flour until bubbly, then gradually stir in 2 cups of whole milk until thick. Add 2 cups of cheddar cheese, then fold in the elbow macaroni.

In a bowl, combine 1 pound of ground beef, 1 cup of breadcrumbs, 2 eggs, diced onion, minced garlic, ½ cup of milk, ¼ cup of ketchup, Worcestershire sauce, salt, pepper, and Italian seasoning. Mix gently.

Press half of the meat mixture in the bottom of the greased loaf pan. Layer the mac and cheese on top, then cover it with the remaining meat mixture, sealing well.

Brush the top with ketchup and bake for 55-65 minutes until the internal temperature reaches 160°F (71°C).

Let it rest for 10 minutes before slicing and serving.