What Is An Eating Disorder?

Eating disorders (EDs) are mental, nutritional and medical illnesses characterized by a poor relationship with food, body image and movement. Individuals with eating disorders often experience pervasive thoughts about food and body image. Over 30 million people in the United States have an eating disorder and EDs have one of the highest mortality rates of any mental health diagnosis. 

The current eating and feeding disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders V (DSM V) are as follows:

  • Anorexia nervosa, with a restricting subtype as well as a binge-purge subtype
  • Bulimia nervosa
  • Binge Eating Disorder
  • Avoidant and Restrictive Food Intake Disorder (ARFID)
  • Other Specified Feeding and Eating Disorders 
  • Pica
  • Rumination disorder

Regardless of whether a person has an “official” eating disorder diagnosis, it is important to get support if there are any signs/symptoms that food and body image is causing a disruption to life. All people deserve recovery and to improve their relationship with food. 

What is Nutrition Therapy?

Nutrition therapy and counseling means working individually with a dietitian who can support a person in achieving long-term nutrition goals while creating an environment that feels comfortable, non-judgmental and empowering. When working with an eating disorder nutritionist, a person will cultivate a balanced and peaceful relationship with food and nutrition so they can re-learn how to trust their body’s innate wisdom. 

Individuals often work with an eating disorder dietitian on a long-term basis. It is incredibly normal for clients to take at least 6 months to see improvements in their relationship with food. Many clients continue to see their eating disorder dietitian for a year or more. 

Why a Nutritionist Is Key to Eating Disorder Recovery

An eating disorder nutritionist plays a key role on a person’s eating disorder treatment team. Firstly, a dietitian supports clients in strategically challenging their eating disorder food rules and thoughts. A dietitian assures their clients are fueling their bodies adequately with enough food. Additionally, a dietitian supports their clients in finding enjoyment out of food. And helps them to gain trust in their bodies to listen to hunger and fullness cues as well as cravings. Lastly, a dietitian also supports clients in exploring how society impacts their relationships with food. Eating disorders do not exist in a vacuum. Oftentimes, clients benefit from discussing cultural implications of their eating disorders. It allows them to dig deeper into their relationship with food and how society and their own experiences have affected it. 

What Can I Expect at the Nutritionist’s Office?

First and foremost, an eating disorder dietitian should create a non-judgmental and safe space for a client to talk about their relationship with food and body. At an initial session, a dietitian should ask open ended questions about a client’s eating disorder recovery story. A dietitian’s role is to provide gentle guidance and feedback, so clients can slowly create more flexibility in your thinking with food.

A client can expect to have conversations about how food impacts their life, their relationship with exercise, how to challenge food/exercise/body image behaviors, and discussions about body image. An eating disorder nutritionist will also give suggestions for “homework assignments,” so clients can continue to explore their relationship with food outside of sessions.

What are other strategies used in nutrition therapy?

Nutrition Education and Counseling

Nutrition information has become a tangled web of misinformation. Part of a dietitian’s role in eating disorder treatment is to support clients in untangling that web and sifting through nutrition facts and myths. This is important because eating disorders often latch onto the food myths, which make nutrition seem scary. This is one way food rules develop. Through nutrition education and counseling, an eating disorder dietitian supports clients in having a better overall understanding of nutrition. 

Provide More Than Just a Meal Plan

When people think of a dietitian, they often think of a person who develops meal plans and tells other people exactly what to eat. However, a dietitian isn’t doing their job if they are solely providing their clients with a meal plan. This prevents clients from learning to trust their innate wisdom of hunger cues, fullness cues and cravings. Instead, a dietitian may choose to support their clients by exploring why they choose to eat certain foods and avoid others. Or how and why certain foods cause stress and anxiety. Or how a client’s relationship with food is negatively impacting their life. Then, the goal is to provide strategies on how to have a better relationship with food.

Sometimes, a dietitian may incorporate a meal plan into their work with a client. However, it is important that this meal plan is not only adequate, but also flexible enough to allow the client to have agency over food decisions. Following a meal plan can be triggering for some clients, so dietitians may also seek to explore this. 

Motivational Work and Support to Inspire

Eating disorder recovery is a long road. Another important role of the dietitian is to support and inspire their clients along the way. An eating disorder dietitian may do this by reminding the client of all the progress they have made throughout their recovery journey thus far. 

Intuitive Eating Counseling 

Intuitive eating – which is allowing oneself to listen to their body’s internal cues of hunger, fullness, rest, cravings and more – is the last stage of recovery in eating disorder treatment. Many clients aim to become intuitive eaters. It is important for clients to work with a dietitian well versed in intuitive eating. Throughout recovery, a dietitian can support their clinicians in exploring the ten principles of intuitive eating. The principles were created by two dietitians, Evelyn Tribole and Elyse Resch, and discussed in detail in their book, Intuitive Eating. The book currently has four editions; the most recent came out in 2020. 

Make Decisions Based on Science

Many people do not know the amount of science dietitians take in order to become registered and licensed. Dietetic undergrad programs include biology, chemistry, biochemistry, mammalian physiology and more. Dietitians have a deep understanding of how the body works and how food fuels metabolism. They use this knowledge to support their clients in understanding why it’s important to fuel adequately and find enjoyment in food. 

 Find a Registered Nutritionists Eating Disorder Treatment

Courage to Nourish offers eating disorder recovery treatment for those in Maryland, Pennsylvania, DC and Virginia. We can also work with clients in California, Colorado, and Arizona as well as several other states. Our physical offices are located in College Park and Columbia, Maryland. We offer convenient virtual appointments for those at a distance. 

You can also visit the NEDA Website and treatment tracker to find providers near you.