Team Treatment Approach Continued: Nutrition Therapy

• Should your patient be on a structured food plan?
• What percentage of protein, carbohydrates and fats are the most beneficial for his of her unique dietary needs?
• The patient has Type I diabetes - how does this affect dietary needs for an eating disorder patient?
• Does the patient hold erroneous beliefs about food (e.g. carbohydrates are bad for you, eating breakfast makes you more hungry later in the day)?
• Does the patient have a list of "feared foods" that he or she purposefully avoids?

These are just some of the topics about which a registered dietitian or nutrition therapist can provide expertise.In my last few posts, I have discussed the importance of a team approach to eating disorders treatment. Today, let's explore the contributions of nutrition counseling as a part of comprehensive eating disorders treatment.

According to Los Angeles based nutrition therapist and educator Ellen Reiss-Goldfarb, R.D., "the dietitian plays a huge role in getting clients comfortable with eating again, making peace with food, helping them to re-learn how to identify body cues for hunger and fullness and realize that all foods have a role and place in their lives." Reiss-Goldfarb elaborates, "it is vital that someone undergoing treatment for an eating disorder get nutrition support. Finding a nutrition therapist who specializes in eating disorders is best."

While studies show that the use of nutritional counseling in the absence of psychotherapy is contraindicated for some eating disorders patients (Wilson, Grilo & Vitousek, 2007), it is strongly recommended in conjunction with medical and psychological eating disorders treatment.

Knowledgeable nutrition experts include Registered Dietitians, Nutrition Therapists, Certified Nutrition Specialists and Certified Clinical Nutritionists. Be certain that whomever you collaborate with is licensed or properly certified as the use of the term "nutritionist" is not well regulated.

A Registered Dietitian (R.D.) must "have completed academic and experience requirements established by the Commission on Dietetic Registration, including a minimum of a bachelor's degree from an accredited college or university and an accredited pre-professional experience program", explains the American Dietetic Association. "R.D.s must successfully complete a rigorous professional level exam and must maintain ongoing continuing education to maintain their credential. Some R.D.s hold advanced degrees and additional certifications in specialized areas of practice."

A Certified Nutrition Specialist (CNS) holds an advanced degree from an accredited institution in the field of nutrition. The CNS must complete either 1,000 hours of supervised professional experience in nutritional related activities or 4,000 hours of independent experience as a professional nutritionist as a dietitian, nutrition researcher, or public policy nutritionist, and pass an exam for certification.

The American Dietetic Association can help you find a Registered Dietitian in your area (Click here) and the International Association of Eating Disorder Professionals provides a listing of nutrition experts who have experience working with eating disorders.

Source: Wilson, G.T., Grilo, C.M & Vitousek, K.M. (2007). Psychological treatment of Eating Disorders. American Psychologist, 62 (3), 199-216.