“Do I really need to see a dietitian?” or “does my client really need a dietitian?”
I hear these questions from time to time and my amazing favorite (yes, I am allowed favorites) dietitian Sara Upson has certainly heard the converse, “Do I really need to see a therapist….I mean aren’t eating disorders allllll just about food?”
The answer is no and yes. And also no and then yes. Eating disorders aren’t all about the food or all about the feelings. They are all about a lot of things which is why a multidisciplinary approach is the absolute standard of care.
Here are 5 reasons why a dietitian that is skilled and trained at working with eating disorders is an essential part of working with eating disorders and disordered eating:
1. It is the industry standard. When I think of my own care, I want the most evidenced based effective treatment possible. In eating disorder treatment, this includes a multidisciplinary approach involving medical, psychological, and nutrition professionals.
2. Eating disorders come with some unique challenges. Some of these challenges can be life threatening, as professionals we should not take the care of our clients lightly. I didn’t go to medical school or learn about nutrition in my graduate program. Even if I had, it would not be enough knowledge to work with the complexity of eating disorders. Your cousin who got a three hour nutrition certification has probably just enough information to be harmful, the same goes for me. The dietitian I work with has heaps of education (seriously I tease her just a little about how I can never get all the letters at the end of her name just right) and she is constantly furthering this
knowledge through conferences, workshops, and reading.
3. Nutrition is so important! I will keep this part brief because I already told you how woefully inept I am in this area. However, I have seen the importance and difference of working with a nourished brain vs. working with a client who is not getting adequate nutrition. A dietitian skilled at working with eating disorders helps me do my job better and faster. Think about Maslow’s hierarchy of needs ( I added a photo for all of us who feel like Theories of Counseling was soooooo forever ago). Maslow’s theory suggests that if we aren’t getting our fundamental needs met, it is very difficult to achieve higher order needs (okay, he’d maybe say impossible but I am hope focused so…). Simply put I can’t work to build self esteem or coping skills in a client who is malnourished. I can try (oh how I have tried!) but often this results in frustration from everyone involved!
4. My dietitian is the extra set of eyes I need to get the whole perspective. Eating disorders are evil! I don’t say that lightly. I frequently see family members who feel like they don’t even know their loved one anymore. That’s because an eating disorder will take a person and make them act in a way that is completely contradictory to their values. I see it all the time. All. The. Time. Dishonesty. Manipulation. Hurtful words. That’s a blog for another time. All of that to say, it’s common for a person struggling with an eating disorder to not always tell the full truth sometimes even to themselves, especially about food and weight. When things aren’t adding up a dietitian can get in there look at numbers, meal plans, and eating disorder behaviors, which is invaluable to me. You know what this frees me up to do? Therapy. Which I am actually trained to do. My dietitian can tell me during our weekly consultations if there is anything nutritionally significant that I need to know and I can do the same for her therapeutically. Win. Win.
5. My dietitian has become my friend. I spend a lot of time talking about how anti-diet I am. How much I hate this diet culture ridden world we live in. If you can imagine, that doesn’t make me popular at all the parties. But Sara always gets it. Always. We can laugh about how far behind in notes we are. Or Cry. Share our frustrations and lives together. She is one of the few people who gets how hard it is to find office snacks without the calorie amounts listed in bold triggering lettering and she is one of the few people who understands how hard it is to watch an eating disorder destroy an amazing persons life. At the end of the day, my clients need a dietitian and so do I!
I hope, whether you are a therapist working with eating disorders or a person or family member struggling with an eating disorder. You have learned a little more about why a treatment team is essential to recovery!