Why Do I Need a Dietitian on My Eating Disorder Treatment Team?

If this is your first time attempting recovery from your eating disorder, a lot of what an eating disorder dietitian will help you with is understanding why your body needs to be fed what it does. For a while now, your mind has convinced you that your body does or doesn't need that or fats are the devil or white bread makes you fat or whatever. None of it's true. Food is just fuel. And every macronutrient (protein, fat, carbohydrate) has a very specific purpose in your body -- you need all of them every day in order to maintain a healthy, functioning body and brain. The dietition you see in eating disorder recovery is an important person on your treatment team.

Simply put, you can do all the therapy in the world but it won't make a dent in your eating disorder until you are eating a balanced diet. Only when you are eating a balanced diet can you brain begin to rebuild itself and start rewiring into more healthy patterns. And if your brain is currently starving, you have to come to the stark realization that no matter how intelligent you are, you are not the one to be making decisions regarding food for the moment. That is why you need a dietitian.

How a Dietitian Helps Your Eating Disorder Recovery

I will always believe that eating disorders are, first and foremost, mental illnesses. So while it is true that the roots of the disorder have absolutely nothing to do with the pasta that I was convinced would make me magically gain fifteen pounds, you cannot ignore the nutritional factor of recovery.

Your dietitian has gone to school for years so as to be able to tell you exactly what that peanut butter and jelly sandwich is doing inside your body and why it is so crucial that you eat it and not compensate. A lot of early work with a dietitian is simply education. Our eating disorders make us believe all sorts of crazy things about food or about what a proper portion is or why we should "eat this, not that." In recovery, knowledge is power. Being able to talk back to your eating disorder with cold, hard facts is tough but crucial. Your dietitian is also there to help you loosen the grip that fears foods may hold over you or ease up on some of the rituals that may surround your eating patterns.

In recovery, knowledge is power. Being able to talk back to your eating disorder with cold, hard facts is tough but crucial. Your dietitian is also there to help you loosen the grip that fear foods may hold over you or ease up on some of the rituals that surround your eating disordered patterns.

Why Does a Dietician in Eating Disorder Recovery Make You a Meal Plan?

There are lots of different ways your body could respond to the refeeding process. In fact, if you have been severely malnourished for any length of time, your body is extremely sensitive and eating too much too quickly can actually be life-threatening. Recovery is not as easy as eating XXXX calories or XX exchanges every day -- if it were, a dietitian would be optional.

I have never been to a treatment facility where any two people are on the exact same meal plan. Your body is going to react differently than anybody else's -- even if your twin sister has a dietitian that told her to do x, y, and z, you can't be sure that you need to follow the same steps. Heck, even if you've done the recovery thing before and are coming back from a relapse, there is no guarantee that what you needed last time is what you need this time.

The first time I did weight restoration, it was fairly easy -- eat extra calories every day and my body gained the weight with no problem. So imagine my shock this summer as my body cranks up the heat into a hypermetabolic state and it is nearly impossible for me to gain weight at any sort of reasonable rate. If I had assumed that the same meal plan that worked three years ago would work this year, I would have been very wrong and very frustrated.

A Dietician in Eating Disorder Recovery Knows What You Need

Your dietitian can help you navigate the choppy waters of figuring out exactly what your body needs to get healthy. This looks different for everybody -- I might need to eat more than you do at points, even if you have more weight to gain. And your dietitian is there to help you understand exactly what combinations of food you need to be eating for optimal health. Just because you can gain weight by eating 18 poptarts a day doesn't mean you should.

It should also be noted here that finding a dietitian with experience in treating eating disorders is extremely important. With the obesity epidemic, many dietitians are helping folks lose weight for health, and even if do need to lose weight to be healthy, you face different challenges than your average Joe. A dietitian without experience in treating eating disorders can just as easily be detrimental to your recovery and further enforce the food rules your eating disorder has created.

At the end of the day, your dietitian is there to get your body back to the healthiest state possible. Only then can you even think about tackling root issues of your eating disorder.

So yes, an eating disorder is a mental illness -- but biology plays a strong role, too. A starving brain absolutely cannot function properly. Proper nutrition in recovery is not just a "good idea" -- it is the building block for all of the other work you do.