Why Eating Disorder Recovery Needs Specialized Nutrition Support
Treating an eating disorder takes a very compassionate clinician, who has received extensive specialty training. Without the proper education and care, warning signs or more subtle nuances may be missed. Additionally, if a provider is not eating disorder-informed, messaging or recommendations given may end up doing more harm than good. Especially when it comes to general nutrition advice, recommendations that are well-intended could be extremely dangerous to those battling eating disorders. Recommendations that are made by clinicians who are not eating disorder-informed may even be fatphobic, invalidating and triggering.
Registered Dietitians (RD/RDN) for eating disorders may even be the only provider on a care team who is eating disorder-informed. As eating disorders are so nuanced, individualized, and all-encompassing, a dietitian plays a unique and crucial role. Having training that is both clinical and therapeutic-based, a dietitian may bridge the gap between a team of therapists and physicians.
As a practice of dietitians for eating disorders, we often find ourselves advocating for our clients in a multidisciplinary team, as eating disorder work requires that we get to know our clients on such a deep level.
What Sessions With a Dietitian for Eating Disorders Look Like
Working with a dietitian for eating disorders likely looks very different from sessions with a non-specialized dietitian. The initial assessment is where we gather a complete history – not only medical and familial, but one’s relationship with food, body, and movement over the years. Our team of dietitians want to get to know you on a personal level, as eating disorders are so unique to the individual. Upon assessing current challenges, behaviors, and goals, we will work collaboratively with you to create an individualized plan. As dietitians for eating disorders, we value the input of the rest of your team as well, and typically collaborate with therapists, psychiatrists, and doctors. Our work may include a clear, flexible, and healing-oriented meal plan, body image work, mindfulness practices, and further exploration of rules and habits. Progress looks different for everyone, and this process is supposed to take time.
How Nutrition Therapy Helps Heal Your Relationship With Food
The goal in working with an dietitian for eating disorders is to rebuild your trust in your body, and therefore heal your relationship with food. This may look like rediscovering your individual hunger and fullness cues, and addressing why/how they went offline in the first place. Or breaking a long standing binge/restrict cycle, and incorporating more supportive coping strategies. Also within an dietitian for eating disorder’s scope of practice is body image support, which may go hand in hand with the work you already are doing in therapy. Healing your relationship with food also may include addressing fear foods, unlearning compensatory behaviors, and challenging rules around food, body and movement.
When to Seek Extra Support – And What “Red Flags” to Watch For
We encourage anyone to seek support, not just those who are struggling with an eating disorder. Someone does not need to be hospitalized to be deserving of care. “Red flags” that may indicate an unhealthy relationship with food include:
- Escalating food rules: For example, eliminating entire food groups from one’s diet (ex: carbs, sugar, fats, etc.), restrictions around timing of eating, and labels of “good” and “bad” foods.
- Losing hunger cues: What is often mistaken for “food noise” may just be your body’s normal (and healthy!) signals that you are hungry and it is time to eat. When we no longer get those signals, it may be a sign that hunger has been suppressed for an extended period of time, and the body is going into energy-saving mode.
- Shame around eating: This may look like eating in secret, hiding food, or prefacing meals with phrases like “I need to work this off tomorrow,” “This is bad for me, but it is a cheat day,” or “I know, I have no self control.”
- Anxiety around meals: This anxiety could present as an inability to engage in spontaneous eating times, the need to plan each meal well in advance, canceling plans that revolve around fear foods, or a lack of flexibility when presented with a variety of foods.