Eating Disorders - fieldi

Recovery Through Nutritional Counseling 47
her body had coped with her starvation by breaking down muscular
tissue to the point where she qualified as being not just underweight
but malnourished. This was a shock to Sue and motivated
her to eat more, gain weight, and bring her weight up to normal—
without being overweight, her constant fear.
While she was slowly gaining weight, she had to be assured that
she wasn’t overweight, so on a few occasions we spent time repeating
the nutritional assessment. This always reassured her since it
allowed her to follow her body signals: to eat because her body
needed food to function.
As Sue recovered she weighed 160 pounds at a height of 5 feet,
10 inches. Even though she was fixated with the numbers on the
scale and would have liked to lose ten pounds, she was not going
to starve herself to achieve it. Instead, she realized that people have
a certain body weight that is right for them; because she liked the
way she looked, she gave up fighting the numbers on the scale. The
real accomplishment was that she did not feel bad about herself for
not losing those ten pounds. In other words, she no longer had to
be 100 percent perfect.
What truly benefited Sue was her motivation to reach her goal:
to be happy, to exercise normally, and to look good. She trusted me
and used me as a role model. I was able to show her that her goal
was possible once she turned her negative critical thinking into positive
and rewarding thinking. She finally learned to like herself
because of who she is—not because of how thin she is!
Preventing abnormal eating patterns is not an easy task. It represents
a unique and unusual challenge for the dietitian who
needs to have an understanding of the psychodynamics of eating
disorders. This insight will help the dietitian build a relationship
based on evolving trust, a necessary ingredient if the patient is
to feel safe and motivated to meet challenges on her road to
recovery.
These, then, are the ways in which I implement recovery. They are
specific to eating-disordered patients but may be seen as basic concepts
in eating for good health and a sense of well-being, with mind
and body functioning smoothly in response to the ever present
dynamic interplay that represents our body as a whole.