As many as 10 million people in the United States struggle with an eating disorder at some point in their lives. Eating disorders are serious mental illnesses that can have devastating physical and emotional consequences on an individual’s life. These complex disorders are caused by a combination of genetic, biological, behavioral, psychological, and social factors.
People with eating disorders often have a distorted view of themselves and their bodies. They may see themselves as overweight even when they are underweight or believe they are not good enough for or unworthy of food. This can lead to a preoccupation with food and weight, as well as extreme behaviors such as starving oneself, binging, purging, and excessive exercise.
Eating disorders can be extremely tough to live with, both for the person with the disorder and for their loved ones. While eating disorders can be difficult to overcome on your own, with the help of medical professionals, you can begin to make progress. If you are ready to begin your recovery journey, strongly consider hiring an eating disorder nutritionist to be a part of your medical team.
There are many ways that the right registered dietitian nutritionist can help you cope with your potentially life-threatening disease, from helping you develop healthy eating habits to helping you deal with complex emotions surrounding food and eating.
The Bottom Line
- What is an eating disorder nutritionist? – A healthcare professional who specializes in the treatment of eating disorders. They work with individuals who are struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, restrictive food intake disorder, and other forms of disordered eating. Nutritionists help their clients to develop healthy eating habits and to make nutritious food choices.
- What are the benefits of working with an eating disorder nutritionist? – A nutritionist will provide patients with a meal plan, nutrition education, and monitor their weight, among other things
- How to get started with an eating disorder nutritionist? – By signing up for an online service, you can start working with an eating disorder nutritionist today.
An Eating Disorder Nutritionist Is More than the Calorie Police
When people hear the word “nutritionist” or “dietitian,” they often think that this healthcare professional’s main goal is to help people lose weight. While some people with eating disorders may need help with weight loss, an eating disorder nutritionist or better yet - registered dietitian - is much more than a calorie counter. Here are some of the many ways you can benefit from working with an eating disorder registered dietitian nutritionist.
Exposure and Skills Work
Many people with eating disorders have both “challenging foods” that they struggle to consume as well as “challenging environments” that they struggle to face. For instance, a challenging environment for someone with an eating disorder may be grocery shopping or eating out at a restaurant. An eating disorder registered dietitian nutritionist will help their patients work through both of these tough scenarios.
Regarding challenging foods, a registered dietitian nutritionist may hold back on incorporating challenging foods into a patient’s meal plan until they are ready. One way that a nutritionist will work through challenging food situations is by having their patients try these foods in a session.
As for challenging food situations, a nutritionist will also strategize around how to manage challenging food situations and help their patient learn helpful ways to cope in these moments. It is not uncommon for dietitians to also accompany their patients on trips to the grocery store and while dining out at a restaurant.
Mindfulness and Appetite Awareness Training
Once a patient is ready, a dietitian or nutritionist will help them move towards a place where they can eat meals without an exact breakdown of calories and portion sizes. Many people with eating disorders have lost their ability to gauge when they are hungry and full, which makes it very difficult for them to eat meals on their own.
To prepare a patient for this step, a nutritionist will do some mindful eating and appetite awareness training. Some of this training will involve keeping a food journal and rating hunger and fullness levels, having mindful eating exercises in a session, and engaging in guided meditation activities.
Motivational Work and Support
It is not uncommon for people with eating disorders to be ambivalent about recovering from their illnesses. Some people living with disordered eating have trouble recognizing that they are ill or realizing the severity of their situation. Others may desperately want to stop their disordered eating behaviors but may be afraid to do so.
It’s important to keep in mind that treatment doesn’t need to wait until someone is “ready.” If you are the loved one of someone with an eating disorder, encourage them to begin treatment as soon as they are aware of the problem.
At the beginning of treatment, an eating disorder nutritionist will often do motivational counseling to help move a patient towards a place where they want to change. While a certain degree of uncertainty and fear is normal with eating disorder patients, an eating disorder nutritionist can help get clients invested in the work ahead.
A good dietitian will determine what motivates their patients and use these tactics to support them through their recovery journey.
Trauma such as bullying, domestic violence, social violence, natural disasters, and social stressors have been linked to disordered eating and eating disorders. Eating disorders can often serve as a coping mechanism to regulate or numb emotions and reduce anxiety.
Trauma survivors often rely on methods that help them regain control or autonomy, and disordered eating is an example of an unhealthy coping mechanism. Other unhealthy coping mechanisms may include substance abuse and self-harm.
Eating disorder patients who have experienced trauma often struggle with food aversions. When the patient is exposed to this “trauma food,” it may trigger a negative response in the patient—this could either be a texture-based or sensory trigger. Alternatively, the food may serve as a reminder of a traumatic event.
A dietitian or nutritionist can help clients develop a safer relationship with these trauma foods and facilitate a path to desensitizing food-related trauma. This is often achieved through prolonged exposure therapy to work on reintroducing these trauma foods to a person’s diet.
More often than not, eating disorders are unhealthy coping mechanisms. Many who suffer from anorexia describe the need to “have control over something” in a world where they otherwise do not. However, individuals with binge eating disorder use food for short-term relief from negative emotions or stressors.
A dietitian can help patients develop healthy coping mechanisms that they can turn to in times of stress or sadness. These solutions may be being around and talking with friends and family, spending time in nature, journaling, doing yoga, reading, creating art, and enjoying the company of a pet, among other things.
How an Eating Disorder Nutritionist or Dietitian Can Help You Make Healthy Lifestyle Choices
You may be wondering, what does an eating disorder nutritionist do? Well, there are many ways that an eating disorder nutritionist can help you slowly introduce healthy lifestyle choices into your day-to-day routine.
One of the most important tasks that an eating disorder nutritionist will help you with is creating a meal plan. A meal plan is a tool that is commonly used in eating disorder recovery to provide a framework for what normal eating looks like. Many people with eating disorders have lost the ability to recognize physical cues of hunger or fullness. Eating mechanically through the use of a meal plan provides the basis for internal food regulation. As time goes on, patients will no longer need to rely on a meal plan, but it is very helpful in the early stages of recovery.
Most people with eating disorders have “challenging foods” or “trauma foods" that they struggle to eat. A dietitian or nutritionist will not force you to introduce these foods into your diet right away; many will rely on an exchange system in their meal plans. An exchange system will include food portion estimates or exchanges from every food group, such as grains, proteins, fruits, dairy, and sweets. If you have any food allergies or aversions, you will have the option to switch out foods with alternative options.
Patients need to understand the significance of healthy eating and proper nutrition. Why is it so important for your body to receive sufficient nutrition? What happens if I don’t consume the foods and nutrients that my body needs?
An eating disorder nutritionist will help walk patients through the nutrients their body needs and why and educate them on how much someone of their size, age, and sex needs to consume to be healthy. They will also help teach patients more about recognizing physical hunger cues, the difference between physical and emotional hunger, the dangers of severe dieting, the need for and limitations of nutritional supplements, and the importance of exercise in a nutritional plan, among other things.
An eating disorder nutritionist will also discuss the health risks associated with malnutrition, which include low blood pressure, thinning of hair, tooth decay, feeling cold often, decreased libido, and endocrine disorders, among other symptoms.
Depending on what members are a part of your treatment team, a registered nutritionist or dietitian may be tasked with monitoring your weight. This type of tracking helps give a general idea of whether or not your current treatment is working or if alternative measures need to be taken.
A lack of progress may be a sign that your treatment may need to be modified for a better response. It also may be a sign that a patient is not following their treatment or meal plan.
Many eating disorder myths are perpetuated by several online sites and books as facts. Almost two-thirds of eating disorder treatment manuals contain information not supported by evidence. For example, one of the most popular myths is that “eating disorders are a choice.” Healthcare professionals know that eating disorders are caused by both genetic and environmental factors and are bio-sociocultural diseases.
Another myth is that “eating disorders only focus on food.” In reality, eating disorders have been linked to perfectionism and obsessiveness, behaviors that can impact grades and sports performances, among other things. An eating disorder nutritionist can help myth bust popular misgivings about eating disorders in your sessions.
Hydration and water intake
People with certain eating disorders may have compromised electrolyte levels due to purging episodes and abuse of medications, including diuretics, diet pills, and laxatives. Other individuals may not be drinking enough water due to fear of weight gain.
Dehydration and electrolyte disorders are not to be underestimated. These conditions can lead to hypokalemia, hypomagnesemia, and even cardiac arrest. Individuals who are purging or dehydrating their bodies through the use of diuretics or laxatives may develop edema. A dietitian or nutritionist can help watch for signs of edema or fluid retention, as either health condition needs urgent medical attention.
What Are the Benefits of Working with an Eating Disorder Nutritionist vs. Going At It Alone?
While it can be tempting to try and recover from your eating disorder on your own, there are many reasons why it’s best to put your condition in the hands of an expert.
Experience and Expertise
Research shows that people with eating disorders are far more likely to recover with professional help. Unless you are unable to afford working with a specialist, willpower, self-help books, and independent work cannot replace the professional guidance of a dietitian, therapist, physician, or member of the national eating disorders association. These healthcare experts have advanced degrees and years of experience helping other individuals like you on the road to recovery.
Another Member of Your Support System
A lot of the changes that you will make throughout recovery are going to feel scary and intimidating. Whether the change is taking a new medication, adopting a meal plan with challenging foods, or considering a higher level of care, your dietitian is going to be by your side every step of the journey.
Through nutrition therapy, your dietitian will also help you develop healthy coping mechanisms for eating certain foods, deal with feelings of fullness, and grapple with anxious thoughts when you do not exercise.
When you are recovering from an eating disorder, there’s no such thing as having too many members of your support system. Having another healthcare professional that you trust by your side as you go through major life changes can go a long way.
Motivation and Accountability
It can take years to recover from certain eating disorders. For instance, one study found that after 22 years of starting their recovery journey, approximately two-thirds of women with anorexia nervosa and bulimia nervosa had recovered. That means that one-third of participants were still very much grappling with their eating disorders two decades after beginning the recovery process.
Your dietitian and nutritionist are there to provide you with motivation and support on your recovery journey but also hold you accountable for your goals. There are going to be days when you need a cheerleader, and there are going to be days when you need tough love and a firm hand.
An eating disorder nutritionist will be there to provide both, depending on what type of support you need at the moment.
What to Ask During Your First Free Consultation with One of Our Eating Disorder Nutritionists
Your first session with a nutritionist near you will be very much like a personal meet and greet. While your nutritionist will be getting to know you, you will also be getting to know your nutritionist. Here are some of the questions you should ask during your first session.
What are your credentials?
Unless you are working with a nutritionist through an online service, you want to double-check to ensure that you are working with a nutritionist who has an advanced degree and has passed a board-certifying exam to practice nutrition. If a nutritionist or dietitian has the letters “RD,” “RDN,” or “CNS” in their title, you will know that you are working with a highly qualified professional.
Have you ever worked with someone who has an eating disorder? If so, for how long?
Not only is it paramount for you to work with a nutritionist who specializes in eating disorders, but you also want to work with a nutritionist who has treated someone with your specific eating disorder. If you have pica or rumination syndrome, find a healthcare professional who specializes in treating those disorders. Do not settle for someone who only treats the most common eating disorders.
If you are going to invest your time, money, and emotional energy in working with a nutritionist, you want to make sure that this is someone who can genuinely help you. It’s also important to get a general idea of what a typical timeline looks like working with this nutritionist.
What is your philosophy and approach?
Before signing up to work with a specific eating disorder nutritionist, you will want to familiarize yourself with their working style. Ask a nutritionist to walk you through what a typical session with them might look like. If this candidate doesn’t seem like someone you can see yourself working with long-term, keep looking for a more compatible nutritionist.
Where do you get support around eating disorder cases you work with?
Ideally, your nutritionist or licensed dietitian will be collaborating with other clinicians and mental health professionals when working with an eating disorder patient.
What is your per session rate?
When working with a nutritionist or dietitian, money will inevitably be a part of the conversation. If you don’t already know what your dietitian’s rate is, make sure to clear this up in your first free session. If this dietitian is not someone you can realistically afford to pay long-term, keep looking for another nutritionist. It’s also worthwhile to ask if your nutritionist or dietitian is covered by your insurance.
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