Eating disorder recovery with a HAES Dietitian
Why a HAES dietitian? Eating disorders are both physical and psychological illnesses. These two pieces often overlap. For example, in order to work on the emotional part, it’s important to have adequate nutrition, otherwise the brain cannot function properly. This is just one why recovering from an eating disorder takes a team. This includes a therapist, physician, psychiatrist and last but not least, a registered dietitian. All clinicians on the team are crucial in providing you or your loved one with the tools and techniques needed for recovery.
Since I am a dietitian and all, I’m going to spend some time discussing what makes a dietitian a critical member of the team 🙂
How can a HAES Dietitian help?
First and foremost it is essential to have a Registered Dietitian on your treatment team. A Registered Dietitian is a food and nutrition expert and can help you separate fact from fiction and decrease your anxiety about food. What is the difference between a Registered Dietitian and a HAES friendly Dietitian? HAES stands for Health At Every Size and they are the principles that advocate for respectful and competent care for all NO MATTER their body size or shape. Unfortunately, in our culture it is often believed that you have to look a certain way to have an eating disorder. This is simply untrue. Not only can eating disorders be present and serious at any body shape or size, but also any socioeconomic status, gender, or race. If members of your treatment team are focused on weight loss or suggesting that your eating disorder is not as serious due to your “normal” or higher weight then I would recommend researching a HAES friendly practitioner to work with. For more information read this helpful blog by our own Dana Magee, RD, LD, CLT about HAES.
What is a Registered Dietitian?
A Registered Dietitian has the following credentials:
1. A Bachelor or Master of Science Degree in nutrition:
Dietitians are the only members of the treatment team who have gone to school to specifically learn about nutrition science. (Just as an MD is the only one to have gone to medical school). The eating disorder can have a lot of knowledge about nutrition. However, this knowledge is often false or twisted to make it seem scary. We get information about nutrition from the media, but again, this information is false or twisted to make it seem scary.
So, dietitians can use their background in nutrition science to help clients better understand what may be happening in the body.
This knowledge can often be used to fight back against the eating disorder. For example, the Eating Disorder might say “grains are bad.” But, in reality, grains are the main energy source for the body. They have essential vitamins and minerals. And they make meals more satisfying. When the “grains are bad,” thought pops up, often times it’s useful to use true nutrition knowledge to fight back against that voice. Additionally, dietitians can better properly assess the nutritional needs of a client to assure appropriate intake for adequate nourishment and to repair and restore the body.
2. A HAES Dietitian is a role model:
It’s incredibly important for clients who are struggling with food to eat with a member of their treatment team. This often falls on the dietitian because, well, we’re the ones talking about food. We also have a positive relationship with food we can model for our clients. Challenging and processing “fear foods” in session is definitely intimidating. However, food challenges are essential for recovery. We know that nutritional variety and flexibility is a solid marker for recovery. So doing this in session can be a more supportive way of reintroducing foods that may have been cut out or limited because of the eating disorder.
3. Dietitians Challenge Eating Disordered Food Related Thoughts:
As someone is beginning to form a new, and more positive relationship with food, it’s crucial for eating disorder thoughts to be challenged. The dietitian can easily pinpoint and gently call out both loud and subtle disordered food and body thoughts. The “grains are bad” example I used early. That’s definitely a “loud thought” and may be easier for someone to gently call out and redirect. A thought like “I need to watch my portions” is more subtle. “Watching portions” still implies a level of restriction. Having a positive means giving oneself unconditional permission to eat and trusting the body to provide one with signals. Any external food rule (like “watching portions”) can interfere with these bodily signals and possibly amplify food shame and guilt.
The end goal of eating disorder recovery is intuitive eating. My hope as an eating disorder dietitian is that I can follow my client all the way through recovery and guide them toward intuitive eating. There can be triggers as one starts to listen to the body and allow themselves to eat based on these signals. These triggers include… weight changes, eating less/more of certain foods, comments from other people…etc. A dietitian can support their clients through these triggers and learn how to cope with them.
When choosing your outpatient team, you have the right to ask questions and decide whether or not a potential dietitian or therapist (etc) is going to be a good fit for you.
Here are some questions to ask the dietitian:
What is your experience in working with eating disorders?
Of course, you’ll want to make sure the dietitian has experience in working with eating disorders. Think about it: you wouldn’t ask an oncologist to do surgery on a broken foot. You certainly would run the risk of doing more harm since it’s not their area of medicine. Working with eating disorders is a specialized illness that requires extensive training and supervision.
Are you a HAES Dietitian/ do you practice from a Health At Every Size © framework?
Now that you know what a HAES Dietitian is, make sure that you will be working with a HAES Dietitian.
When recovering from an eating disorder, it’s very important to work with a dietitian who believes in Health at Every Size also known as HAES ©. I love this article by Lisa Pearl on why HAES is a Cornerstone for Recovery. She states “two of the biggest reasons to encourage a HAES® approach is for the prevention of eating disorders and the elimination of weight stigma and its devastating effects on psychological, behavioral and physical health!”
What are your other specialities?
Along with the question regarding HAES, you’ll want to check to see what other specialities the Registered Dietitian (RD) has. Other specialities can certainly be a great thing! If you or your loved one is struggling with another medical diagnosis that involves nutrition (like diabetes or a gut related illness), it can be awesome to find an RD who may have more knowledge in that particular area. Oftentimes, clients who are in recovery for eating disorders have digestive difficulties, food sensitivities, or diabetes so it is helpful to work with a dietitian who is skilled in a variety of nutrition related conditions.
For additional information from a HAES Dietitian:
If you would like to learn more about recovery resources, Health at Every Size treatment, or anything else, please reach out to one of our amazing dietitians. We’d love to talk with you!
Reach us at firstname.lastname@example.org or 240-670-4675.
Blog reviewed and updated February 27, 2020.