What is a dietitian’s role in the treatment of eating disorders?

How can Dietitians help individuals with eating disorders?

When I started working as a Dietitian I thought, “How can I help people with eating disorders when it’s about so much more than just food?” 

Eating disorders are psychiatric illnesses and I, therefore, knew that they required psychological intervention. In the absence of going back to university to study psychology, I wondered how I could be of assistance to individuals struggling with disordered eating. Thankfully, I have since been fortunate to work alongside several psychologists who have joined with me to support clients from an integrative approach.

Whilst my clients have benefited from psychological support, I have been able to then address the nutritional and behavioural aspects of an eating disorder. Through this approach, I have come to see the role of the psychologist and that of the dietitian as very different, yet complementary, and both crucial to the successful remission of an eating disorder.

A psychologist’s role typically involves developing a collaborative understanding of the function of an individual’s eating disorder and supporting the development of alternative coping methods.

However, clients aren’t able to effectively participate in such psychological intervention’s when their brains are starved. This is where I truly discovered the value of Dietitians in eating disorder treatment! This journey of discovery is just one of the many reasons why I am so passionate about the role of Dietetics in the treatment of eating disorders and what led to me convening the Dietitians’ Association of Australia National Eating Disorder Workshop last month.

Our role as dietitians in the prevention and treatment of eating disorders is an important one.

If you don’t have a Dietitian on your treatment team, here are five reasons to include one:

  1. Challenging diet culture – Along with being diseases of the mind, eating disorders are “culture-bound syndromes” in that they are at least partly driven by society’s dieting culture. Given that restrictive and prescriptive approaches to eating are often normalised (and even celebrated) in today’s society, a Dietitian can play a crucial role in identifying health behaviours that may appear “healthy” but, in fact, are likely to lead to malnutrition (among other consequences).
  2. Supporting flexible eating – As dietitians, we’re given a bad rap for being the “food police”. Here’s our opportunity to take advantage of that reputations and use it to the advantage of our clients. As accredited and registered experts in nutrition, we can play a powerful role in calling out food myths and reducing modern-day hysteria around eating through drawing upon our food science degrees. We can explain how nutrients work in the body beyond a simplistic view on calories and give our clients the permission they often require in the early stages of recovery to eat the foods they have been taught are “bad”.
  3. Understanding and enhancing health – Dietitians have an extensive understanding of weight science and the impact of food and eating (or not eating) on the human body. Despite what societal ideals will have us believe, we know that thinner is not necessarily healthier. We can assess when weight loss has been health depleting, as opposed to health-enhancing, and link symptoms to nutrient deficiencies resulting from disordered eating. From there, through providing accurate nutritional education, we can aid in the restoration of health and expand our clients’ understanding of health beyond the overly simplistic focus on weight.
  4. Understanding weight – Dietitians can draw upon their expertise of the human body (including the effects of food, digestion, and fluid retention) to unite with clients in combatting the scales. When someone has an eating disorder, their understanding of their body weight has become distorted. Through collaborative weighing, we can assist clients in: broadening their understanding of factors that influence their weight; challenge common weight myths, and disentangle their sense of self-worth from their body weight.
  5. Listening to our bodies – Finally, as experts in eating behaviour, Dietitians can teach clients to tune into their physiological cues, trust their body’s inner wisdom, and eat intuitively. Through doing this, not only do we liberate clients from the prison of dieting, we complement the great work that mental health practitioners do in assisting clients to pay attention to their emotions, utilise them as important sources of information, and take action that is empowering and honours their worth as a human being.

In summary – Dietitians are an important addition to any treatment team tasked with the responsibility of supporting individuals diagnosed with an eating disorder. Above all else, we aid in the reversal of malnutrition and starvation in order for clients to be able to effectively participate in the wonderful therapy that our fellow mental health practitioners provide.

About Kate:
Kate Pollard works full-time as an Accredited Practising Dietitian at Centre for Integrative Health. Kate has a particular interest in working with eating disorders and weight/shape concerns, having completed additional training in Cognitive Behavioural Therapy for Eating Disorders (CBT-E), Family Based Therapy (FBT) and Motivational Interviewing as well as the Health at Every Size (HAES) and the Non-Dieting approaches.