A beautiful dietician nutritionist consults at the office

“Sorry, this isn’t really food related. . . ”

“I know this isn’t really about food but. . .”

“This is probably therapist stuff but. . .”

These are phrases I often hear in the early sessions with new clients, and it’s understandable! What exactly does a dietitian do in eating disorder care? Are we the food police? Do we just give meal plans? Are we only supposed to talk about food?

It can be confusing for dietitians too! What’s within our scope? When are we veering too far into the therapy lane? What are we allowed to talk about?

Clients who are just starting out on their recovery journey often have a somewhat rigid view of what a dietitian provides. We give a meal plan, monitor body weight, provide some general nutrition education, and maybe help you plan some meals.

We certainly can do that, and sometimes we do. Although I certainly have many clients I don’t utilize any of those interventions with. Because the reality is we can do so much more than just give you a meal plan and send you on your way. As we all know, eating disorders aren’t really about food, and yet food is such an integral part of an eating disorder. It’s in that intersection that I believe a dietitian’s work really is best utilized, in what I like to think of as food-based therapy. 

How do we know where that work ends and a therapist’s work starts? A simple rule has helped guide me, the dietitians I supervise, and my clients – if it affects what goes on your plate or into your body, then it’s something we can and should talk about.

Wait. A lot of things affect that.

Yes, they do. And we can talk about all of them. What might that look like? Well, it can look a lot of ways. 

We might talk about the origins of some of your nutrition beliefs and judgments and get curious about how your life would be different if those things weren’t true for you. We might discuss diet culture and fat phobia and how they contribute to your eating disorder thoughts and the challenges they present in recovery. We may dive into the purpose of your eating disorder behaviors and consider alternative coping skills. 

Sometimes we discuss worthiness and how all humans have inherent worthiness and are deserving of being nourished and cared for. Or we may discuss all the different aspects of body image, its origins and challenges, and maybe plan exposures to challenge current perceptions. 

As you can see, there may be whole sessions with your dietitian when you don’t even talk about food, sometimes for weeks at a time. Or you may discuss food every week. Just like with everything in recovery, there’s not one right way to do it. Nutrition care, just like your therapy, should be individualized based on what works for you. Your dietitian is an integral member of your team who is there to hold space for you and support you on your recovery journey.

By Taryn McPherson RDN, LD

About the Author

Taryn McPherson RDN, LD

Taryn McPherson is the Director of Nutrition Services at The Hull Institute and also oversees the nutrition department at Keystone Treatment, an eating disorder PHP/IOP program. Taryn has been a Registered Dietitian since 2010, and is a Certified Eating Disorder Specialist and a Certified Intuitive Eating Counselor. Through her compassionate, individualized approach she specializes in helping those struggling with eating disorders and disordered eating find peace with food and their body, and reclaim their life.