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 assessing pathology as well as recovery progress; in clarifying the role of weight with 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 clinician to manage her own counter transference issues.

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. Eating disordered individuals typically seek the counsel of a nutritionist first in seeking "to learn more effective weight loss techniques" or to "become fit;” many are quite unaware of the potential existence of pathology. Treatment success hinges on the professional's capacity to recognize disordered eating patterns or diagnose an imminent or existing 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 within a team context.

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 use of self in the face of them. It also requires an empathic and trusting therapeutic connection between the clinician and the eating disordered client, sustaining the client through the tough nutritional demands that are bound to ensue.

The process of putting healing nutritional patterns into place facilitates more than a healthy eating lifestyle. Following the food plan offers opportunities for self-awareness, self-determination, self-regulation and self-care, even beyond affecting food consumption and weight management.  The plan provides behavioral means for breaking down the eating disorder defense arsenal, at the same time unearthing underlying feelings and issues camouflaged by the eating disorder.

Goals and Objectives   The nutritionist or dietician will come away

• With a better understanding of the full implications of eating disorders for client and family.
• Capable of assuming diagnostic responsibility in recognizing an elusive diagnosis.
• Prepared to use oneself uniquely to accommodate the complexity of these disorders.
• Prepared to fulfill her role as member of the multi-disciplinary out -patient treatment team.
• Including parents as recovery advocates for child patients.
• With skills and tools specific to the treatment of eating disorders.

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.    

Sincerely, MB

14 Basic Tenets of Good Nutritional Practice in the Treatment of Eating Disorders