How does a dietitian work with eating disorders?
Eating disorder diagnoses are increasing each year in Australia, and are estimated to affect 16.3% Australians, when combined with disordered eating [1]. They can impact individuals at any age, gender, body size or socioeconomic group. Eating disorders are a psychiatric illness so you may wonder how a dietitian, who’s expertise is related to food, rather than the mental health component of the illness is able to help.
Studies have shown the best outcomes for individuals suffering from an eating disorder is with a multidisciplinary approach, combining mental health support from a psychologist as well as dietetic support from an Accredited Practicing Dietitian, who has completed specific training in eating disorders. This may explain why you see within Eating Disorder Care Plans Medicare rebates provided for a psychologist as well as a dietitian. The GP and psychiatrist will also form key components of the treatment team.
What can a dietitian do for an individual suffering from an eating disorder?
Dietitians primarily focus on the evidenced based ‘RAVES’ model during treatment, which focuses on various phases of nutritional recovery, including Regularity, Adequacy, Variety, Eating socially and Spontaneity (RAVES). By establishing regular eating, binge eating episodes are reduced, metabolic efficiency is stimulated, and digestive function improves. The dietitian will then focus on what food means to you and its importance, using various approaches such as motivational interviewing or intuitive eating.
Will I be weighed during a dietetic session?
A dietitian’s goal is to help you feel comfortable with seeing the number on the scales, however, can appreciate being weighed may be something very uncomfortable for an individual with an eating disorder. We encourage weight monitoring during sessions as we find exposure over time to be the most useful for reaffirming how eating disorder thoughts around weight and body image are often amplified.
Weight monitoring may become a non-negotiable when medical stability and weight restoration are essential, which your GP, dietitian and psychologist can discuss in more detail with you if necessary.
What if I don’t have an eating disorder?
Eating disorder trained dietitians can still help to provide you with education and tools to improve your overall health and wellbeing by focusing on:
Understanding adequate portion sizes and food choices to ensure a healthy and balanced diet
Identifying patterns of dietary intake which may trigger a ‘binge’ cycle
Identifying and challenging rigid or restrictive food rules
Discussion around unhelpful or disordered thoughts around food in order to develop a more flexible and healthy attitude with food
Appetite signalling; in order to better understand what hunger and fullness means to you
References
[1] Hay, P., Girosi, F., & Mond, J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. J Eat Disord 3(1), 1-7.
Written By: Victoria Andrews - Dietitian