Eating Disorders: Nutrition Education And Therapy - Eating Disorders Treatment

Written by HealthyPlace.com Staff Writer

QUESTIONS TO ASK AND ANSWERS TO LOOK FOR WHEN INTERVIEWING A NUTRITIONIST

Question: Could you describe your basic philosophy in treating eating disorders?

Response: I believe that food is not the problem but a symptom of the problem. I work with long-term goals in mind and don't expect immediate changes in my clients. Over the course of time I will discover and challenge any distorted beliefs and unhealthy eating and exercise practices you have and it will be up to you to change them. I prefer to work in conjunction with a treatment team and stay in close communication with its members. The team usually includes a therapist and may include a psychiatrist, a medical doctor, and a dentist. If you (or proposed client) are not currently in therapy, I will provide feedback on the need for therapy, and if needed, refer you to someone who specializes in the treatment of eating disorders.

Question: How long could I expect to work with you?

Response: The length of time I work with any individual client varies significantly. What I usually do is discuss this with other members of the treatment team, as well as with the client, to determine what the needs are. However, recovery from an eating disorder can take a significant amount of time. I have worked with clients briefly, especially if they have a therapist who is able to address food issues. I have also worked with clients for over two years. I could give you a better indication of the amount of time I would need to work with you after an initial assessment and a few sessions.

Question: Will you tell me exactly what to eat?

Response: Sometimes l develop meal plans for clients. In other cases, after the initial assessment, I find certain clients would be much better off without a specific meal plan. In those cases, I usually suggest other forms of structure to help clients move through their eating disorder.

Question. I want to lose weight. Will you put me on a diet?

Response: This is a somewhat tricky question, because the appropriate response of, "No, I will not put you on a diet, I do not recommend that you try to lose weight now because it is counterproductive to recovery from an eating disorder," will often result in a client choosing not to come back. (A favorable response should include information to the client that most often weight loss and recovery do not go hand in hand.) What I have found in my work with people with eating disorders is that diets often create problems and interfere with recovery. Dieting actually contributes to the development of eating disorders. I have found that "non-hunger eating" is what usually causes people to gain weight, or makes it more difficult for them to reach their set-point weight range.

Question: On what kind of meal plan will you put me (my child, friend, and so on)?

Response: I try to work with a flexible meal plan that does not get caught up in calories or weighing and measuring food. Sometimes clients do better without meal plans. However, we can get specific if we need to do so. What is important is that there are no forbidden foods. This does not mean you have to eat all foods, but we will explore and work on your relationship with different foods and the meaning they have for you.

Question: Do you work with hunger and fullness?

Response: Dealing with hunger and fullness is part of my job. Usually clients who have eating disorders or have a long history of dieting tend to ignore their signals of hunger, and feelings or fullness are highly subjective. What I do is explore with you various signals that come from different areas of your body to determine exactly what hunger, fullness, satiety, and satisfaction mean to you. We can do things like use a graph on which you rate your hunger and your fullness so that we can "fine-tune" your knowledge of and ability to respond to your body's signals.

Question: Do you work in conjunction with a therapist or doctor? How often do you speak with them?

Response: Nutrition is only part of your treatment plan, psychotherapy and medical monitoring is another. If you do not have a professional in those other areas I can refer you to those with whom I work. If you already have your own I will work with them. I believe that communication is important with all of the members of your treatment team. I usually speak with the other treating professionals once a week for a period of time and then, if appropriate, reduce it to once a month. However, if your exercise or eating pattern changes significantly at any given time, I would contact the rest of the treatment team to inform the members and discuss with them what difficulties might be happening in other areas of your life.

Question: Do you now or have you ever received professional super-vision from an eating disorder professional?

Response: Yes, I have received both training and supervision. I also continue to get supervision or consultation periodically.

OTHER INFORMATION TO OBTAIN

• Fees: If you are unable to afford the nutritionist's standard fee, can adjustments be made or a payment schedule be arranged?
• Hours: Is the nutritionist able to schedule you at a convenient time? What is the policy regarding missed appointments?
• Insurance: Does the nutritionist accept insurance and, if so, help submit claims to an insurance company?