In a client-nutritionist relationship, the therapeutic alliance supports the client’s need for behavior change. These changes are to challenge distorted and irrational thinking about food and weight, to explore feelings related to hunger and fullness, metabolism and body image. It is imperative that the client engages in nutritional counseling without any fear of being judged.

The dietitian is responsible for designing a meal plan based on their client’s specific needs. They conduct a thorough assessment based on lab results, menses history, food recall, BMI, % body weight, exercise regimen and an extensive eating disorder history. A full nutrition assessment reveals current dietary intake, eating patterns, beliefs about food and weight, supplement use, who cooks/buys/prepares meals and an overall weight history. It is encouraged for a client to express their emotions, feelings and fears around food and weight and the goals they wish to accomplish. The dietitian is then assigned the task of exploring, challenging and helping the eating distorted client replace the mental distortions that cause and perpetuate specific food and weight related behaviors. This is to allow the client to know that the overall goal is to return food and meals to their normal place as a source of “fuel.”