What to Know & Expect from Meeting with a Dietitian
I interviewed two dietitians in Austin to get a better understanding of what to expect from sessions together, specifically for those seeking support around their disordered eating habits.
Interview #1:
Libby Hill is a lead Registered Dietician (RD) at Nourish, an organization with the central goal of supporting those struggling with their nutrition. Nourish provides accessible & affordable care that aims to treat the whole person.
Lindsay’s interview with Libby:
Who should meet with a dietician?
Everyone - society sets us up for failure in a lot of ways; it becomes challenging to maintain a consistent, mindful relationship with food. I see a lot of individuals who have chronic health conditions such as cardiovascular disease or low blood sugar, and those who feel *out of control* with food.
“The National Eating Disorder Association states that “Approximately 7 in 10 women and girls report a decline in body confidence and increase in beauty and appearance anxiety, which they say is driven by the pressure for perfection from the media and advertising’s unrealistic standard of beauty.” ”
* Can you define “out of control?”
You feel like your relationship with food changes throughout the day, you leave or walk into a food experience feeling guilt or shame, your food decisions are closely tied around body image.
What is the difference between a dietician who focuses their work with individuals struggling with eating disorders vs. a regular dietician?
An eating disorder informed dietician has an increased level of awareness and sensitivity. They are often weight neutral, meaning they focus on behaviors and are curious about you as a whole person-your history, your goals, the barriers to reaching those objectives. We focus on helping to remove numbers from your eating habits, with the ultimate goal of mindful or *intuitive eating.
If weight does not play a role in goal setting, how do you measure success?
Consistency and intake is the ultimate goal; decreased anxious thoughts surrounding eating, challenging foods that didn’t feel accessible before, reducing guilt and shame, and supporting your need to challenge those ED thoughts are all indicators of progress.
What can one expect in an initial session?
In the first session, we will want to get to know your medical history, history with food and diet, you may answer goal oriented questions and what you’d like the focus of our work to be. In sum, my target in our initial session is to receive a larger understanding of your relationship with food in the past, and your goals for the future.
What topics do you typically cover in ongoing sessions?
This is dependent on the goals of each individual; diet recall, looking at room for improvement, addressing barriers to making changes, education on nutrition and the body, myth busting and fact checking are all frequently discussed in sessions.
Can you speak to what family involvement looks like?
For minors, Nourish typically splits the client & the parent in the first session, I might send a weekly update or ask the parent to jump in the last five minutes of the session to give them information
What is a way parents are able to support their child who is struggling with an eating disorder?
Ask your child how they want to be supported; what words are helpful to hear and what phrases should be avoided?
Is there anything else you feel is important to share with those curious about seeing a dietician?
“We’re not selling anything. Our interest is to help figure out what is best for you; we are centered around the goal of establishing a stable relationship with food.”
Interview #2:
Yasmine Mavrakis, RD, works primarily with those who struggle with eating disorders and those who have chronic health conditions. Yasmine is the founder of Mavrakis Nutrition, a practice focused on providing accessible, high quality nutrition care.
Lindsay’s interview with Yasmine:
How common would you say disordered eating is?
“Having a healthy and peaceful relationship with food tends to unfortunately be the minority. We see it across ages, demographics, gender identities, and race. Particularly, we see higher rates of disordered eating in BIPOC and LGBTQ+ communities. (This prevalence is tied to stigmatization, systemic oppression, and discrimination).
“According to the National Eating Disorder Association (NEDA), roughly 30 million Americans struggle with eating disorders. Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals. ”
Can you talk about what the process is like for meal planning with clients?
Each individual is different; although not everyone will require a meal plan, I typically use one of two types of meal planning:
Structure, amount, and frequency of meals.
Recipe & meal prep education & inspiration
I would not recommend weighing or calorie counting in practice; to structure our meals, we might use visual tools such as a dinner plate, learning how to best divide up that plate to ensure balanced components in your meal.
Is there advice you would give to a person struggling to find motivation with consistent meals?
Get curious; check in with yourself on the days you have practiced intuitive eating* and note the relationship you have with yourself, others, your body, your mood, and how engaged & present you’re able to be.
What should someone who is experiencing disordered eating look for in a dietician?
Look for a dietitian who is intuitive eating aligned or Health at Every Size (HAES)
A little bit of information about Intuitive Eating & HAES:
Intuitive eating is based on two main principles surrounding the connection with your mind and body. “[The focus is]...attuning to the physical sensations that arise from within your body to get both your biological and psychological needs met and removing the obstacles and disruptors to attunement, which usually come from the mind in the form of rules, beliefs, and thoughts.” (Tribole, Evelyn).
Health At Every Size (HAES®): The HAES® Principles promote health equity, support ending weight discrimination, and improve access to quality healthcare regardless of size. (“The Health at Every Size® (HAES®) Principles.”)
Any other recommendations for those seeking a dietician?
Ask questions! What is their approach? What should you expect from working with them? If something doesn't feel right, don't be afraid to talk to the dietician more about what’s unhelpful, or explore other dietitians to find the best fit for you.
Yasmine’s recommended Instagram accounts:
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ASDAH, 22 Apr. 2022, https://asdah.org/health-at-every-size-haes-approach/. oes here
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National Eating Disorders Association, 14 July 2021, https://www.nationaleatingdisorders.org/statistics-research-eating-disorders.
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Evelyn Tribole, Intuitive Eating, 17 July 2019, https://www.intuitiveeating.org/definition-of-intuitive-eating/.