Updated: Mar 21, 2020
I was so excited to be invited to be a panelist for the Southern Smash event on April 3rd 2019 at Texas A&M University. I do not get to go back to the school I attended as an undergraduate too often. I thought I’d write a blog post on my “talk” as one of the panelists that spoke at the event. We had a therapist, dietitian (me), psychologist, parent of a child that has had an eating disorder and Amy Sulivan, who tells her story of triumph over her eating disorder. So here is my story I got to tell and how a dietitian (at least my perspective) helps those to overcome their eating disorder:
I’m a graduate of Texas A&M, class of ‘94. Well I actually graduated in 1995. The course work at Texas A&M is a bit rigorous and I needed over 4 years to complete my degree. I’ve been working in Houston for over 20+ years as a dietitian.
At A&M I learned way more about biology, human physiology, chemistry, organic chemistry, biochemistry and nutrition and physiological chemistry than I ever wanted. I’m getting a degree in “just nutrition,” right? I received an amazing education and one thing I learned solidly at A&M is that nutrition is a science not an opinion. One thing to note is that when I went to school I did not have access to the internet and “Dr. Google” (I had to go to the good ‘ol fashioned library on campus) and I definitely did not have access to Netflix and “shockumentary” movies like “What the Health?” etc. I learned that nutrition plays a vital role in the upkeep and repair of the only “house” we will every own: our body. I’ll call this the “hard science.” I did not learn anything about eating disorders though. I did not learn about the devastation they cause on our house, mind, body or soul.
So I went into the field of nutrition thinking I knew how to help people reach health and wellbeing, at least partly through what they chose to eat and how they exercised.
I worked as a clinical dietitian for the first part of my career. I loved working in the intensive care units like surgical, medical, pediatric and neonatal intensive care. I loved the science and intensity and the collaboration with other providers. However in the intensive care units you don’t get to talk much with clients and interact. I’m a pretty extroverted individual.
I had the opportunity to work in a program that focused on weight loss at a large hospital here in Houston. The program was a fasting program (medical weight loss program) and I “helped” thousands of people lose weight. I enjoyed having one on one time with clients, “helping” them with lifestyle changes and teaching classes. I also worked in bariatrics with some prestigious bariatric surgeons. However, I began to find my work not very fulfilling. Why? The longer I worked in this program, the more clients I saw “return” with weight gain that they “successfully” lost. We even had a “joke” in the clinic that these clients came in through our revolving door.
I would say 30-40% would return within 6 months to a year later having gained all their weight back and generally added on additional weight to their “past starting number.”
Even clients that had surgical changes to their stomach, within a few years they would be back in (enrolled in the medical fasting program this time trying to lose the weight they had regained). What was going on? What did I need to do differently to help these clients with permanent weight loss? So I began to learn what I’ll call the “soft science,” how to talk and work with someone from a behavioral perspective. I found that I connected much better with these clients but I continued to remain unfulfilled. So I thought maybe I just need to get out of the corporate world and start my own private practice. I was getting a bit disenfranchised with this weight loss program I was working in. Is there another more effective way to help people? As much as “I helped 1000s lose weight,” I saw “1000s regain that weight back.”
Not very effective, right?
I was invited to work with a local dietitian in her private practice and jumped on the opportunity. Little did I know though that her practice saw basically only clients struggling with and working on recovery from an eating disorder. As I transitioned only to private practice, I still worked part time in the weight loss clinic and then the other days working with clients struggling with eating disorders. One session I was focusing on helping clients “lose weight for health and to feel better about themselves” and then the next day working with clients “care less about how they looked” and/or to “stop trying to lose weight” because of how disordered their thoughts and obsessions about food and exercise escalated. In the eating disorder private practice I would have clients tell me how they thought of food 95% of their day. That doesn’t leave much room to think about anything else!
The more I worked in both fields, the more I came to realize that focusing on helping clients lose weight (medical weight management program) actually could cause or drive eating disorder thoughts and behaviors or cause individuals to really ruin their relationship with food.
One of the biggest gateways to the development of an eating disorder is the focus on diet and exercise to lose weight.
I realized that helping people “lose weight” was actually harming them, not helping them. I also learned as I worked with clients with eating disorders that I could use a mixture of “hard” science and “soft” science that I learned. I help clients understand sound nutrition principles (hard science) through nutrition education but with nutrition therapy (soft science) I help them repair their relationship with food.
So, I had to make a huge paradigm shift: I had to turn away from being a “diet” dietitian and became a “non diet dietitian” with the focus on helping individuals whether they were frustrated with their weight or health or helping them through the throws of an eating disorder. I have never been more fulfilled and gratified in my career.
What I have found is that if you get “too much into the science” you stop informing yourself of what to eat and become a dictator (a know it all), telling your body what it can and can not consume.
Kind of like a micromanager of a large company you own. The internet does not help the cause...stay away from Dr. Google! Remember, nutrition is a science and not an opinion. How many calories to stay under and whether or not you are tired and “have” to hit the gym twice a day to burn of the cookie you ate: you are in dictator mode.
You see, health is about providing balance of nutrition and movement but also maintaining a healthy relationship with food and one’s body.
A relationship involves:
spending time with one another
listening and learning to have a conversation with your body vs a monologue, screaming match or giving your body the “silent treatment.”
a mutual respect: understanding the genetics of our body, how nutrition plays a role in our health, mental health and knowing our bodies need adequate fueling.
working through conflict (anxiety, sickness) vs avoiding or disregarding
knowing when you have too much of a “codependent” relationship with food (emotional eating or comfort eating)
knowing to set healthy boundaries
Just like any relationship that may need repairing (like after you’ve been through diet after diet or recovering from an eating disorder), you have to discover through nutrition education and nutrition therapy how to “get along with food and your body” again. Moving from thinking of food 95% of the day to 25% of the day. We are here to support you on your journey!