Dietetic Support

Why see a dietitian?

Seeing a dietitian involves so much more than getting a meal plan. Many people find that they have developed an unhealthy relationship with food and their body due to:

• Living in a weight-focused/fat-phobic society
• Growing up in a family that has an unhealthy relationship with food and the body
• A pattern of under eating and/or overeating or forgetting to eat due to depression, anxiety, ADHD, PTSD, etc.
• Difficulty with sensory aversions to tastes and textures
• Having gotten stuck in a pattern of overexercising and/or underfuelling (not eating enough compared to the body's needs) which can be common amongst athletes and recreational exercisers
• Misinformation from social media about good/bad foods and weight management
• Negative experiences from health professionals, friends, and family that have internalised fatphobia and that are not up to date with the latest research
• Being an athlete or in another similar high pressure environment with a focus on the body
• Messaging from childhood that there is something wrong with your body
• Complex PTSD leading to the feeling that there is something wrong with your body

The list list goes on.

A good dietitian will work with you to help you: 

• Understand your relationship with food and your body
• Identify the obstacles that prevent you from eating regularly, adequately, a variety of foods, eating socially, and/or eating spontaneously
• Have a better understanding of what and when to eat that is free from diet mentality and is flexible and based on good quality evidence 
• Challenge diet misinformation 
• Set realistic goals and give you the strategies to get there
• Identify your set weight range (the weight your body tends to sit at when adequately nourished) and act as a healthy role model for body acceptance
• Improve your relationship with your body and food 
• Identify and address the underlying emotional issues that may be driving your eating patterns
• Help you manage stress and uncomfortable emotions in a healthy way by providing support and strategies

A dietitian will use all of these strategies with the ultimate goal of assisting you to be healthy and nourished, find your set weight range, and achieve body acceptance and food freedom.         

Furthermore, dietitians are becoming increasingly important in the current epidemic of food “experts” on podcasts and social media platforms that each have a contradictory list of what foods you should and shouldn’t eat to achieve certain health and weight related goals. For more information on the role “health” influencers play in distorting our view of food and the body, see our page on orthorexia. 
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Why see a dietitian that specialises in eating disorders?

“I don’t need to see a dietitian for my eating disorder, I know all the calories and macronutrients in food. I know what to eat, I just can’t do it”

“What do you need to see a dietitian for? You just need to eat!”

Unfortunately, we hear the above comments all too often. In our experience, individuals with disordered eating often hold extremely distorted beliefs about diet and food. This is because when we have a fear of something, we tend to listen to our anxiety more than we do facts. When anxious, we also tend to get more rigid about our thinking and less balanced, flexible, and reasonable.

We find that individuals with disordered eating routinely underestimate (or overestimate) their intake, depending on the nature of their eating disorder. They also tend to have a very distorted view of metabolism, what kind of intake is needed for brain functioning and mental health, and generally what kind of intake is required to have a healthy functioning body. People with eating disorders may be “experts” on calories and diet culture, but they are stuck when it comes to having a healthy relationship with food and the body.

If you are lucky enough to have a healthy enough relationship with food where you do know what to eat, it is a whole other thing to actually be able to consume that food - and keep it up.

For those that have other comorbidities, seeing a dietitian can also free up your sessions with your psychologist to work through your underlying issues, such as trauma therapy or skills to manage your depression. 

Eating disorders are a complex issue that most health professionals are not trained to work in. Many of our clients have been hurt by well-meaning comments from people who are not trained in this niche area. When creating a good treatment team, ideally your GP, psychologist, psychiatrist, and dietitian, will all be trained to work specifically with eating disorders and should practice from a Health at Every Size (HAES) framework

An eating disorder dietitian is different from general dietitians as they;

1. Are aware of eating disorder behaviours, and so can bring up behaviours that you may be doing that you weren’t even aware were part of your eating disorder (eg. excessive looking at recipes, not eating before a certain time in the day, needing to eat alone, etc.)
2. Ask the questions that you will find it hard to bring up, such as discussing purging, laxatives, enemas, binge eating, etc., and do it in a way where you feel understood rather than judged
3. Get it’s hard to be honest. They might need to check in with you a number of times each session, with the knowledge that it’s hard to be honest when you have an eating disorder. This might be because you feel protective of your ED, you’re a people pleaser, don’t want to let others down, etc.
4. Use motivational interviewing skills to help you find motivation for recovery, understand your unique reasons for wanting to recover, and work with you to set goals and develop actionable steps to move you closer to recovery
5. Will help you recognise when the ED is hijacking things by calling your eating disorder out on its BS
6. Get that recovery is so much more than just eating more. They will meet you where you are at while also challenging your eating disorder, helping you to tackle each obstacle at a time
7. Won’t hold weight bias and have the understanding that eating disorders come in all shapes and sizes (including anorexia)
8. Are aware of common triggers and how sneaky the ED can be. They will not praise you for “healthy eating” or exercising, or say that you look “healthy”. Instead, they will use language that is food and body-neutral 
9. Will not presume that you are excited about recovery or weight changes
10. Will not get frustrated with you if you are struggling with readiness to change
11. Understanding the importance of collaborating with a team to check that their understanding of things is correct and to learn ways to better support you
12. Have an understanding of other mental health issues that will impact your relationship with your body and food (such as PTSD, ADHD, depression, OCD), and can help you navigate this

If you identify as neurodivergent, it is also essential that you see a dietitian who uses a neuroaffirming/neuro-informed approach. A neuroaffiming dietitian will not only accommodate your communication or sensory needs in session, but they can support you in the difficult process of untangling your sensory aversions with your ED rules.

Exhale Psychology now provides dietetic support. Book your initial appointment.