The Role of the RD in Eating Disorder Treatment

The Registered Dietitian (RD) is often part of a multidisciplinary eating disorder treatment team, including doctors, psychiatrists, and therapists. Clients sometimes have the misconception that the only thing an RD will provide during treatment is a meal plan. However, the role of an RD in the treatment of eating disorders involves addressing much more. This role also includes discussing eating behaviors and beliefs in the context of the eating disorder. This is why working with an RD in addition to a therapist or doctor is so important.

Are you thinking about seeing an RD for disordered eating or eating disorder behaviors? Here are a few topics you can expect an RD to address throughout the counseling process:

1. Adequacy: Is the amount of energy taken in during the day adequate to support daily activities - from taking a shower to visiting the gym?

2. Balance: Does intake include every food group in a sufficient amount?

3. Variety: Does intake cover every food in way that vitamin and mineral needs are being met?

4. Autonomy: Is intake based on personal preferences or the expectations of others?

5. Confidence: Is intake based on internal cues or a fixed schedule? Is there ever regret surrounding food choices made? Are daily activities chosen based on what type of food will be available?

6. Legalization: Are there foods that are believed to be "bad" or "good"? What would it take to decriminalize foods so they are no longer in these categories, but instead seen as "supportive to my recovery" or "fueling/energizing for my body"?

7. Affect: Are beliefs about food and nutrition affecting physical and mental health or medication needs?

8. Rules: What misconceptions, harmful rules, or harmful beliefs exist about food and eating?

9. Sensory: How well does the client experience the sensory side of eating - the tastes, smells, and sounds?

10. Support: What activities can be provided to assist with the recovery process, such as cooking classes, therapeutic meal classes, or grocery shopping trips?

As you can see, the RD does much more than serve as the "food police". The RD's role in treating eating disorders and disordered eating cannot by filled by any other discipline, as the RD is truly the expert. If you or someone you know is struggling, encourage them to have the courage to find help.

Katie (Murtha) Davis MS, RD, CSSD, LDN

Owner, RDKate Sports Nutrition Consulting

Board Certified Specialist in Sports Dietetics

The Importance of Inquiry

I have recently finished Geneen Roth’s book Women, Food and God: An Unexpected Path to Almost Everything and it has definitely gotten my wheels turning. I particularly enjoyed her discussion of what it feels like to truly inquire about what you’re feeling- and the process of relating to your feelings, instead of from them.

Roth writes:

“Inquiry is body based; it is not a mental process. You sense what it feels like to be inside your skin, your arms, your legs. You notice the sensation and you notice the location of the sensation. Sensation, location, sensation, location. If, for instance, you are feeling sad, you ask yourself where that feeling is located in your body. You notice a gray heap of ashes in your chest, and up pops the belief that ‘love exists for other people but not for me.’ You become curious about that belief. How old were you when you first learned that? And what were your feelings at the time that never got noticed or felt or understood?

It’s good to ask some questions that allow you to focus on the sensations themselves. You can ask yourself if the feeling has a shape, a temperature, a color. You can ask yourself how it affects you to feel this. And since no feeling is static, you keep noticing the changes that occur in your body as you ask yourself these questions” (Roth, 104-105).

With the stress of everyday life: work, school, family, it is so easy to become detached from the body. We become ‘talking heads’ only thinking instead of really feeling. The exercise of reconnecting with the body and seeing what a particular part of it feels like in a stressful, sad, exciting, or joyful situation can be very eye opening. This allows for an exploration of the body that doesn’t involve food or weight, or self-criticism, simply curiosity. Curiosity that can lead to real self discovery. It also allows for small increments of success. For some, the task of focusing inward on body sensation for five minutes a day may be enough at the beginning, for others it may mean an hour long meditation on each area of the body and the feelings that may be harbored there.

I really love the steps involved the process Roth describes above. Starting with curiosity eliminates judgment; the act of exploration eliminates the ‘talking head’; and the experience of the feeling in the body allows for a refreshing openness and understanding to wash over your heart.

Women, Food and God is a wonderful book full of wisdom and I would definitely recommend it. But, if you don’t have the book, try inquiring about your body and your soul and see what it feels like to reconnect with yourself and the world around you.

Peacefully,

Claire Jolly

Claire Jolly was a summer intern at The Awakening Center. She is a student at Centre College in Ohio.