What is an Eating Disorder Dietitian?

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Being a dietitian for individuals with eating disorders is a privilege. I can’t imagine a more rewarding profession. I am truly thankful to every one of the people who I have had the opportunity to treat over the years. Eating disorder dietitians however, are unlike traditional dietitians. We have often experienced our own struggle with food, which enables us to truly empathize and connect with our clients.

As far back as I can remember into my childhood, I was obsessed with food and nutrition. I was a label reader, a lover of all foods. I loved to prepare food. I loved all the colors, flavors, and textures. I had a great relationship with food, and I was ambivalent about my body. I really didn’t think about it too much. I was a tomboy. I loved to play outside with the neighborhood kids. I was strong. I was an athlete. My body and I got along just fine. All that changed when I was in high school and developed my eating disorder. My eating disorder took away my enjoyment of food and replaced it with negative thoughts, fear, food rituals and unhealthy eating behaviors. It wasn’t my choice. It was an illness that I was afflicted with for 10 long years. Back in the days when I had an eating disorder, treatment was almost non-existent. I was told by my doctor that I wouldn’t be able to have kids in the future unless I ate more. Yep…that was the extent of my treatment. So, in essence, I had to find a way to get better from this illness that I didn’t even know I had at the time. No one formally diagnosed me with anorexia nervosa. In college, when I had bulimia, there was no such diagnosis as bulimia. It wasn’t even in the DSM (Diagnostic and Statistical Manual of Mental Disorders). If there was no diagnosis, there was no protocol for treatment. There basically was no such thing as this mental illness, except I was in the throes of it, as were countless others. There were no treatment teams, no specialists, no courses of study, no self-help books, no support groups. Nothing. Obviously at that time, I had no idea I would eventually be a specialist in the treatment of eating disorders. I was just trying to survive college and keep my grades up. As I got well, and as good eating disorder treatment finally became available, it became obvious that I was going to serve sufferers, like myself, who needed a treatment provider who could empathize with them, who walked in their shoes, who had been in the depths of illness and despair, and who came back to life, better, stronger, and whole.

What do dietitians who specialize in eating disorders actually do? It’s easier to start with what we don’t do. We don’t simply educate about nutrition. We don’t discuss in depth the amount of grams of protein in a piece of chicken (unless it is important to treatment) or the breakdown of types of carbohydrate in a fruited yogurt (unless it’s important to treatment). We don’t place a moral value on certain foods. We don’t believe in “clean” eating. We don’t use fad terms like “macros”. We abhor fad diets.  We believe that “all foods fit”. We don’t force clients to eat, to not eat, to stop behaviors. We believe in “health at every size”. We don’t judge or shame clients for ANYTHING. We are NOT traditional dietitians. We are educated and fully trained, but we know that it takes more than education and training to help someone with an eating disorder. We have to “get it”.

We offer a safe place for people with eating disorders to say things about their food and body that often they have never said to anyone before. We allow them to be authentic. We listen to all the thoughts and feelings they have about their food and their bodies. We let them feel the pain that they have endured throughout their struggle with their illness, and we try to help ease that pain. We validate them and help them understand why they developed this illness and what the eating disordered behaviors represent. We slowly help them dispel the food myths, lessen the fear, recognize and challenge their intrusive critical eating disordered thoughts, and challenge the black and white thinking they have lived by. Slowly and gently, we help them make changes in their eating so that they can live a fuller life, unencumbered by the eating disorder “terrorist” that has invaded their mind. We help them restore their physical health so that they can thrive. We help them learn to accept, to tolerate, and then ultimately to learn to like their body.

It takes skilled professionals to effectively treat someone who suffers from anorexia, bulimia, binge-eating disorder, ARFID, or disordered eating. Fortunately, now there are numerous qualified treatment providers around the country and around the world. There are inpatient and residential treatment centers, day programs, intensive outpatient treatment centers, outpatient clinics, support groups, online resources, books, etc. There are organizations like NEDA, BEDA, Project HEAL, ED Hope, and more, who can assist individuals and families on what to do to get the treatment they need.

We’ve thankfully come a long way from when I was a 15 year old suffering from an eating disorder. If you know someone who is suffering, let them know that treatment is available and that recovery is possible.

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