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 a difficult relationship with food and their body due to:

• Living in a weight-focused/fat-phobic society
• Growing up in a family that has a difficult 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 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 model body acceptance
• Improve your relationship with your body and food 
• Identify and work on the emotions that may be driving your eating patterns
• Help you cope with stress and uncomfortable emotions 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 with so many 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. 
‍

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!”

We hear comments like these often. In our experience, people with eating disorders often hold beliefs about food that are shaped by fear more than evidence. 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 people with eating disorders often underestimate (or overestimate) their intake, depending on what their eating disorder looks like. They also often hold inaccurate beliefs about metabolism, what kind of intake is needed for brain functioning and mental health, and generally what kind of intake your body needs to function well. People with eating disorders may be “experts” on calories and diet culture, but they can feel stuck when it comes to their relationship with food and the body.

Even if you do know what to eat, it is a whole other thing to actually be able to consume that food - and keep it up.

If you are also living with other mental health conditions, seeing a dietitian can free up your sessions with your psychologist to work on what sits underneath, such as trauma therapy or skills for coping with depression. 

Eating disorders are complex, and most health professionals are not trained to work with them. Many of our clients have been hurt by well-meaning comments from people who are not trained in this niche area. When building a good care team, ideally your GP, psychologist, psychiatrist and dietitian will all be trained to work specifically with eating disorders and will practise 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 that 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 change, understand your own reasons for wanting things to be different, and work with you to set goals and take steps towards getting better
5. Will help you recognise when the ED is hijacking things by calling your eating disorder out on its BS
6. Get that getting better 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 change or weight changes
10. Will not get frustrated with you if you are unsure whether you are ready to change
11. Understand 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 important that you see a dietitian who uses a neuroaffirming/neuro-informed approach. A neuroaffirming 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.