Eating disorders are complex illnesses that require a multifaceted treatment approach. While therapy is essential to address the psychological concerns that play into your disorder, attending to your nutrition is also a crucial part of recovery. Thus, while seeking therapy for your eating disorder, your therapist may refer you to work with a dietician to address the nutritional component of your recovery. Your therapist can then collaborate with your dietician to create a supportive treatment team that is dedicated to coordinating your care.
By engaging in a dysfunctional relationship with food, exercise, and/or body image, individuals with eating disorders often forget how to have a healthy and peaceful relationship with food, or never had one to begin with. Working with a dietician can be very helpful in repairing one’s experience with eating, but can feel extremely scary for someone who has associated food with pain, comfort, or other intense emotions. If you are anxious about meeting with a dietician as part of your recovery process, having an idea about dietitians’ role may provide some direction and relief:
Providing nutritional education – Having an eating disorder entails many distortions about food, exercise, and the workings of the body, particularly weight gain. Dieticians can offer you facts and a realistic perspective of food and nutrients, and their necessity for proper bodily function. They also discuss the role of nutrition related to physical and mental well-being, provide education on different food groups and their purpose in the body, and can help you conceptualize food as fuel, rather than something that is so emotionally-charged. Dieticians can also explain the biology and health risks of eating disorders, as well as health benefits of recovery.
Assessing nutritional needs – Dieticians will evaluate your lab results and vitals, health status (i.e. menstruation, deficiencies, heart function, cholesterol, etc.), medications, whether your weight is safe for you, exercise regimen, dietary intake and patterns, and weight and eating disorder history. They will also evaluate your patterns in buying and preparing food. From this information, your dietician can provide you with an adequate meal, supplement, and/or exercise plan to ensure your physical and mental well-being.
Evaluating eating disorder behaviors – Your dietician can help you monitor and address your disordered behaviors, including chronic dieting, use of compensatory behaviors (purging, excessive exercise, laxative use), eating in secret, and constant body-checking or weighing.
Setting goals for recovery – Your dietician will work with you collaboratively to learn about your specific fears in recovery (i.e. eating certain food groups, gaining weight, binging). Subsequently, together you can create goals regarding food intake and choices, appropriate weight gain or loss, exercise, reduction of compensatory behaviors, and body-checking.
Creating a healthy relationship with food – Dieticians’ goal in eating disorder recovery is to repair the way clients thinks about, feels, acts, and relates to food, eating, exercise, and/or their body image. Your dietician will work with you to help challenge your fears around food, such as by eating a fear food with you in session and processing the experience with you after. Your dietician will also collaborate with you to create a meal plan that allows for adequate food intake, and an exercise regimen, if appropriate. Such a meal plan can help provide a foundation and structure as you try to reclaim a more peaceful relationship with food.
Facilitating attunement to body signals – Individuals who have consistently used eating disorder behaviors may find that they have lost touch with their body signals, in particular those that indicate hunger and fullness. Your dietician can help you connect with and regain trust in these cues and in your body, so you can use them to eventually eat in an intuitive manner. Dieticians can practice mindful eating with you, a process that helps you use all of your senses during the eating process, and can support you in tracking your hunger and fullness and any related feelings after each meal or snack. Your dietician may also suggest types of exercise that can help you reconnect with your body.
Coordinating with other professionals – If you are seeing a therapist, your dietician can connect with this professional (with your permission) and any other clinicians involved in your recovery, so they can collaboratively assess your progress and make recommendations that will benefit your recovery.
Bio: Bahar Moheban, M.A. is a clinical psychology doctoral student and registered psychological assistant in Torrance under the supervision of Dr. Nazanin Moali. She offers psychotherapy in individual and group settings to adults and adolescents with disordered eating and body dissatisfaction. Bahar has experience mentoring individuals in eating disorder recovery and facilitating support groups to improve clients’ body image. She collaborates with other healthcare providers for a multidisciplinary approach to client care. Call Bahar today to book your first consultation.