In any field of medicine it’s usually best to see a specialist. You wouldn’t see a general surgeon to perform back surgery. You also likely wouldn’t seek out cancer treatment from an infectious disease doctor. Sure they have general knowledge of the spinal cord and vertebrae, or basic cancer treatment and standards of care, but they don’t know the nuances. They didn’t get the specialized training to make the best call and treatment plan.

If that seems like a no-brainer, then it should also make sense that seeing the right types of providers for eating disorder treatment would be no different.

However, there can be many obstacles and emotional blocks for finding the right kind of provider. Perhaps there are no dietitians that specialize in eating disorders that are in-network with your insurance. Maybe you’ve been to a dietitian before and they were not helpful. Perhaps you think you know enough about food and eating, so what else can this person tell you? Maybe you feel a bit embarrassed about working with someone who you feel might judge your eating patterns and habits.

Because of this, it can be difficult to justify the cost of resources (time, energy, money, etc.), making you want to settle for a dietitian closer to home or on your insurance plan. But before you do, please allow me to share with you a few reasons why it’s definitely worth (and frankly necessary) to your recovery to see a specialist.

Reasons why an eating disorder specialized dietitian is different:

1. We’re trained to be keen on discerning disordered eating behaviors from normal influences of diet culture, and red flags for tendencies and behaviors that may erupt into a full-blown eating disorder if not monitored.
2. We “get it” – rather than telling you to “just eat more;” we’re going to meet you where you are while also challenging your eating disorder, and help you to feel empowered to take on food challenges and have a more freeing relationship with food.
3. We’re more aware of normal growth patterns and recognize how important full weight restoration is to recovery. A non-specialized dietitian may not recognize a true weight potential and allow their own weight bias to keep you at a “normal” weight percentile, even though it may not be normal for you – keeping you stuck in your eating disorder.
4. A non-specialized dietitian may praise your eating disorder and other behaviors as “healthy eating” and not know where or how to challenge the eating disorder. A well trained and skilled eating disorder dietitian is going to know where they need to meet you and interpret your readiness for change – where is a weak spot in your eating disorder that is the most low risk option to challenge verses where to back off and allow defenses to come down with time.
5. We’re going to be able to give you a structured meal plan that’s not triggering or just “feels like another diet.”
6. A non-specialized dietitian is not trained on the screening protocols for eating disorders and has strong potential for doing more harm than good. They may not even recognize you have an eating disorder unless you tell them.
7. We’re going to use neutral food and body language during the recovery process. Phrases and words that are unique such as “all foods fit,” “weight neutral approach,” “compassion with curiosity,” “joyful movement,” or “weight rehabilitation.”
8. A specialist has extensive training in their field. Just like a doctor who specializes in surgery or cancer treatment. The knowledge and understanding of food and eating of a non-specialized dietitian is just the basics. A specialist learns and develops specific skills to support someone struggling with an eating disorder. This specialty training is gained over years, supervision, education and direct client care; not a quick course or seminar on “what is an eating disorder?”
9. We understand the importance of collaboration with a team. A specialized dietitian does not work solo when caring for a client in the throws of an eating disorder.
10. A specialized dietitian understands there are often co-occuring conditions or mental health issues that a person with an eating disorder might struggle with. Eighty percent of those struggling with eating disorders also struggle with anxiety, depression, substance abuse, personality disorders or other psychiatric diagnosis, for example. An eating disorder dietitian understands how to balance nutrition guidance and support while also understanding the nuances of how other mental health concerns might be affecting an individual and their food choices. Often food and eating patterns are what are used to cope with difficult emotions or experiences. A specialized dietitian can help untangle the emotions from the food.

What qualifies a dietitian to be a “specialist” or one who is highly trained in eating disorders? One very helpful credential is the Certified Eating Disorders Specialist Registered Dietitians or CEDRD. Click here to read more extensive information. If you do not see that this credential is held by a dietitian you might want to work with, these are some helpful questions to ask before scheduling.

1. Are you or the dietitians in the practice receiving supervision and working towards their certification in eating disorders? To learn more about this prestigious credential, please click here and read more here.
2. What percentage of your clients in your practice have eating disorders? You are looking for at least 50%.
3. What is your nutrition philosophy when you are treating clients with eating disorders? You will want to look for key phrases such as “we follow standards of care and evidence based practices,” “our goal is to support clients to have a healthy relationship with food, movement and their body,” or “we use a combination of interventions such as CBT, FBT, and intuitive eating concepts.”
4. How frequently do you coordinate care with other treatment team members? You are looking for “frequently,” “weekly,” or “generally every other week.”
5. How many continuing education hours do you receive a year that focuses on the treatment of eating disorders?” You are looking for “all my continuing education is focused on the treatment of eating disorders,” “50% or more,” or “a good majority.” Dietitian must obtain 75 hours per 5 years of continuing education. A specialist would receive most likely 10-20 hours a year.

Another good resource is the person who referred you to see a dietitian. This could be your therapist, psychiatrist or medical doctor for example. If they are asking you to see a specialist, there is a strong reason why.

Want to learn more about the reason why seeing a dietitian who specializes in eating disorders is important for the recovery process? Click here.

If you’re struggling with an eating disorder, you’ve likely had a bad experience with some sort of clinician along the way that just didn’t “get it”. Maybe they dismissed your cry for help, couldn’t look past their own weight bias, or overlooked your “normal values” on the growth chart or in your lab work and vitals, effectively making your eating disorder jump for joy and giving it power to minimize your symptoms while leaving you feeling even more miserable and confused than ever.

It doesn’t have to be this way! Establishing a specialized treatment team can be the difference between staying stuck in your eating disorder and reaching 100% recovery. I hope you will find the courage to prioritize you.

If you have more questions, we’re here to help! Give our office a call at (713) 997-9613 to speak to a recovery coach, or go to our website to schedule a discovery call with one of our dietitians to gather more information about what you can expect when working with a dietitian.

Warmly,

Sarah Roth, RDN, LD & Jill Sechi, RDN, LD, CEDRD-S