Eating Disorders - fieldi

20 Recovery Through Nutritional Counseling
responsibility and answers lie within the patient, and the team serves
as her guide and support.
NUTRITIONALCOUNSELING
The following paragraphs offer my philosophy and approach in
nutritional counseling, based on three key considerations: physiology,
emotion, and behavior.
Physiology. What, why, how much, and when she needs to eat is
determined by her nutritional status, such as nutritional
deficiency, blood sugar fluctuations, metabolism, weight,
and genetics.
Emotion. She needs to understand and take responsibility for
why and how she turns to, or away from, food to cope with
intolerable thoughts and feelings.
Behavior. Bingeing, purging, starving, overexercising, using
laxatives, diuretics, diet pills, all of which, over time, have
become routine ways of managing situations, are destructive,
and need to be addressed and exchanged for healthier
behaviors.
What expectations can a person struggling with anorexia or
bulimia have if she sees a nutritionist? She may feel that it’s safer,
more acceptable, or she may see the nutritionist as a tool to help
reach her ultimate goal: being thin, thinner, or hopefully the
thinnest. My goal is to get my patients to be able to eat three to five
times a day without worrying about their weight, to be able to eat
meals when they are hungry, to stop when they are full, and to be able to
trust food. It also involves being free from food obsessions and
accepting oneself at a normal body weight. How do I get them to do
that or at least try to do that?
A few basic lessons apply, which I will describe here. Beyond that,
sessions are adjusted to the patient’s individual needs. Any question
a patient asks has to be answered in order to reach our goal. What
we talk about are the needs of my patients; the number of sessions
required for each lesson can and will often vary.