For Nutritionists and Registered Dieticians

The Unique Use of the Client/Nutritionist Relationship
in the Treatment of Eating Disorders

Anorexia and bulimia are integrative diseases, adversely affecting a patient's nutritional, emotional, cognitive, behavioral, and social life; all of these elements must be held in mind and considered, if not addressed, by the nutritionist, even within the course of a treatment focused primarily on food and eating. Some eating disordered individuals, in seeking "to learn more effective weight loss techniques" or to "better ways to enhance 'wellness,' typically seek the counsel of a nutritionist first, quite unaware of the potential existence of pathology. Treatment success hinges on the professional's capacity to recognize and diagnose an eating disorder, to bring the client to critical self-awareness, and to make appropriate referrals to therapist and medical doctor in preparation to treat the case in the context of a treatment team. All this requires a deep understanding of the unique nature and requirements of these disorders, these clients, and of the practitioner's personal and professional self. It also requires an empathic therapeutic connection between the clinician and the eating disordered client.

The eating disorder nutrition is as much about establishing self-awareness, self-determination, self-regulation and self-care as it is about food and weight management. In light of the importance of food and eating habits in sustaining the disorder, the introduction of a food plan representing a healthy eating lifestyle provides an invaluable opportunity to bring to awareness, and then to break down, the eating disorder defense arsenal, unearthing anxieties and issues long camouflaged by the disease. Nutritionists not formally educated or prepared to address and manage these issues will benefit from this workshop which will highlight the importance of the role of the nutritionist on the treatment team, in diagnosing both pathology and recovery progress, in clarifying the role of weight to client and family, in including the family in the recovery process, in putting the patient in closer touch with her Self, mind, and body, and in preparing the dietician to manage her own critical and sensitive transference issues.


Workshop objectives

• Understanding full implications of eating disorders for client and family.
• Assuming diagnostic responsibility in recognizing an elusive diagnosis
• The nutritionist's unique use of self in the face of unique and complex disorders
• The nutritionist's role as member of the out -patient treatment team
• Including parents as recovery advocates for child patients
• The Nuts and Bolts of eating disorder treatment; The Nutritionist' Tool Box

A letter from a nutritionist

Hi Abby,
I wanted to let you know that I have started reading Doing What Works and love it so far. It is refreshing to read your thoughts that healing occurs partially through relationship, which feels very inclusive for me as a dietitian. A psychotherapist recently accused me of working outside of my scope of practice simply by taking on patients with a mental illness, saying that nutritionists do more harm than good and have no business within eating disorder treatment. It is helpful and legitimizing to read in your book about the importance of the nutritionist's relationship with the eating disordered client, and of fully understanding the disorder and how it heals. I just wanted to tell you how much I am enjoying your book.
 

Abigail H. Natenshon has been a psychotherapist specializing in eating disorders for four decades. As the director of Eating Disorder Specialists of Illinois: a Clinic Without Walls, she has authored two books, When Your Child Has an Eating Disorder: a Step-by-Step Workbook for Parents and Caregivers and Doing What Works: an Integrative System for the Treatment of Eating Disorders from Diagnosis to Recovery. Natenshon, who is also a Guild Certified Feldenkrais Practitioner, hosts three informative web sites, including www.empoweredparents.com, www.empoweredkidZ.com, and www.treatingeatingdisorders.com.