Do you have patients that struggle with binge eating associated with binge eating disorder or bulimia nervosa? Are your patients not getting better or is their recovery stagnated?
If so, consider referring to a registered dietitian experienced in treating binge eating. A registered dietitian holds a minimum of a bachelor’s degree in nutritional science accredited or approved by the Accreditation Council for Education from the Academy of Nutrition and Dietetics, has completed an approved and supervised internship and completes on-going continuing education to maintain registration.
You probably already know that your patients who struggle with binge eating disorder or bulimia nervosa already know a lot about food. They may be talking a lot about food, weight, and shape in session. They know how many calories, how much fat, and how many sugar grams are in different foods. They are an expert on the latest diets.
Clients may ask you, “Why do I need to see a dietitian for my recovery if I already know so much about food?”
Not About Food
We know eating disorders are not really about food. They are really about using food and eating disorder behaviors to cope with stress, relationship struggles, worry, and other uncomfortable feelings. However, the eating disorder suffers relationship with food gets so distorted, re-learning how to feed themselves is a must for recovery.
Here are 5 ways that a dietitian can help in binge eating disorder and bulimia nervosa recovery:
1.Gives patients a place to discuss eating patterns and worries around food. Often, if a patient is only receiving therapy for his or her eating disorder, much of the session can be dominated by “food talk” and doesn’t allow for as much therapeutic intervention.
2. Ensures that patients are eating enough food at meals and snacks. Often, people with binge eating engage dietary restriction to “make-up” for binge eating. Or they are simply not hungry for their next meal after binge eating.
Studies also show that food restriction leads to binge eating. Poor nutrition can affect mood and effectiveness of psychotherapy. A registered dietitian can help ensure that your patient is getting adequate nutrition to help reduce binge eating and improve mood.
3. Challenge mistaken beliefs about food. A dietitian can help sort out science from fad when it comes to eating, food, weight, and shape. There are a million messages about food on TV and social media and from well-meaning friends, family members, and co-workers.
On any given day, it seems like the messages about which foods are “good” and which foods are “bad” to eat are moving targets. During the 90s, fat was the culprit. Now, gluten and carbohydrates have a bullet on their head. Not only do we get messages about which foods to eat, but also how to eat them—eat these foods, not these foods; eat 6 small meals a day; don’t eat in between meals. You get the point. There are so many messages out there, it’s no wonder America is plagued with eating problems.
Those who sufferer from an eating disorders feel immense guilt around food choices. Challenging mistaken beliefs about food can reduce feelings of guilt and increase their confidence about food choices, which ultimately help reduce binge eating and the binge-purge cycle.
4. Learn how to eat “binge foods” without fear. A dietitian can help sufferers feel more confident around foods on which they’ve historically binged. Once eating pattern has become less chaotic the dietitian will work on “challenge foods.” Challenge foods are foods that are avoided (because of fear of binge or binge-purge), foods that they regularly binge on, and/or foods that cause a lot of anxiety before or after eating them.
A dietitian can work with clients in several ways such as doing an in-the-office food challenge and practicing eating with others.
5. Intuitive eating. One of the last steps of nutritional therapy for binge eating is teaching people how to listen and respond to their internal cues that their body provides regarding hunger/fullness, food preferences, and much more.
Lastly, finding a dietitian that is experienced in treating eating disorders is a must. When interviewing a registered dietitian with whom to work, consider asking about years of experience treating eating disorders, treatment philosophy, how often to expect to communicate about client’s progress and do they belong to any eating disorder specific professional organizations. To find a registered dietitian go to http://www.eatright.org/find-an-expert.
Alison Pelz is a psychotherapist and has been a registered dietitian for more than 16 years, specializing in the treatment and prevention of body image disturbance, eating disorders, and other fitness and weight-related concerns. She is a certified intuitive eating counselor. Currently, she maintains a private practice in Austin, TX.
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