Written by: Courtenay Vickers RD
Time to read: 6 minutes
What comes up for you when thinking about working with a dietitian? Many people might say they feel anxious, or perhaps express fear that they’re going to be weighed, or maybe they’re worried about getting “lectured” to by the dietitian.
Navigating the journey of recovery from an eating disorder can be overwhelming, but understanding the role of an eating disorders dietitian (ED RD) can help illuminate the path forward. Let’s explore what a dietitian is, what you can expect when working with an ED RD, and practical steps to get connected with one. And, hopefully, leave you feeling less unsure and more confident about getting started with an ED RD.
What is a Registered Dietitian (RD)?
Registered Dietitians are healthcare professionals who provide evidence-based nutrition and food information to help individuals lead sustainable and enjoyable lives. To hold the professional title, a dietitian must:
- Obtain a degree in nutrition from an accredited university.
- Complete a one-year internship with rotations in clinical and community nutrition, and foodservice.
- Pass a national registration exam.
- Register with their provincial dietetic regulatory body.
- Meet annual continuing education requirements.
Dietitians take a holistic approach, focusing on the overall well-being of their clients. In the context of eating disorders, this often involves specialized training and ongoing supervision to address the unique challenges of these conditions.
A note on “nutritionists”: In some provinces, the term nutritionist is a protected title that can only be used by Registered Dietitians. Currently, only applies to Alberta, Quebec, and Nova Scotia. Other titles, such as holistic nutritionist, nutrition coach, etc. can mean different things, but they are NOT the same as an RD. Educational background and ongoing education, level of competence, and regulations can vary drastically.
When an RD says they are eating disorder specialized, this means the RD has specialized training and supervision in addition to their required schooling. Unfortunately, most university nutrition programs have very little to no training on eating disorders, which means many eating disorder-specialized dietitians have gone on to complete many additional trainings and hours in supervision to build their competence and confidence to support those seeking recovery from an eating disorder.
ED RDs are a critical part of the professional care team for ED recovery, alongside a therapist & primary care provider. Many ED RDs have also adopted weight-inclusive, anti-diet, and HAES-aligned perspectives.
The Role of an Eating Disorders Dietitian
Eating disorders dietitians are a vital part of the recovery team, working alongside therapists and primary care providers. Their responsibilities include:
- Conducting comprehensive nutrition assessments and regular follow-ups.
- Developing personalized nutrition care plans.
- Assisting with the implementation of these plans.
- Addressing dysfunctional thoughts and emotions related to eating, food, or body image.
- Collaborating with other healthcare providers and, when appropriate, family members.
What will come up in sessions with an ED RD?
Generally, the top nutrition priorities when working with a dietitian for recovery will be working towards nutritional adequacy and regularity with eating. Along the way there will likely be many other themes to explore and areas to work on, such as:
- Exploration of weight stigma
- Understanding set point theory, metabolism, and energy needs
- Challenging diet culture and internal beliefs about food
- Meal planning and grocery shopping
- Pacing of meals
- Fear foods / trigger foods
- Body image
- Intuitive and mindful eating practices
- Managing gastrointestinal issues and nutrient deficiencies
- …and many other things!
Most ED RDs will be bringing in tons of compassion and validation along the way, and an acknowledgment that the eating disorder is not your fault. Sessions generally should provide you with a supportive environment and a non-judgmental space to explore these complex issues, as you take these brave steps forward in your recovery.
What to Expect in Your Sessions
Initial Sessions
The first few sessions typically involve a nutrition assessment to understand your current nutritional status and recovery needs. This helps set the foundation for your personalized care plan.
Follow-Up Sessions
Subsequent sessions usually start with a check-in, where you can share your progress, challenges, and reflections. Together with your dietitian, you will work on breaking down the next steps toward your nutrition and recovery goals. Sessions can be conducted virtually or in person, depending on your dietitian’s practice setup.
Duration of Treatment
The length of time you will work with a dietitian varies based on individual needs, the availability of the RD, financial considerations, and accessibility. Many individuals see their RD every 1-2 weeks and continue until they can sustainably manage regular and adequate eating patterns, often spanning several months to a year or more.
How to Get Connected with a Dietitian
Free Options
- Referral: Your primary care provider or specialist can refer you to a clinic with a dietitian on the team.
- Family Health Teams, Primary Care Networks, and Community Health Centres: These often have dietitians available and offer free workshops, education programs, and counseling.
- Home & Community Care Services and Hospitals: Ask your case manager or hospital staff about dietitian services.
- Telehealth Services: Call 8-1-1 or visit the website to ask dietitians questions for free.
Finding an Eating Disorder Specialized Dietitian
- National Eating Disorder Information Center (NEDIC) – Find A Provider
- Dietitians of Canada – Find A Dietitian
- EDforRDs – Find A Dietitian
- Association for Size Diversity and Health (ASDAH) – Healthcare Provider Listing
- International Association for Eating Disorder Professionals (IAEDP) – Member Search
- Intuitive Eating Counselor Directory
Tips for accessing and picking your RD
Note – if you are part of a hospital-based program, you generally won’t get a say in who your dietitian is.
- Consider your options based on where you live and financially: In-person vs virtual, Private practice vs a free option, sliding scale and/or direct billing to insurance providers, etc.
- RDs with eating disorder knowledge may or may not highlight the extent of their expertise online, so ask about their knowledge and comfort level of working with EDs
- Some ED RDs will specialize more specifically with a certain type of ED (ex, ARFID or BED). Consider your symptoms and ask the RD if they have additional training/experience with what you’re struggling with.
- Consider what values the dietitian has, and if they are in alignment with yours
- Ask if you can meet with the RD for a free initial call to see if you’re a good fit
- It’s okay to say if you’re nervous!
Working with an eating disorders dietitian can be a transformative step in your recovery journey. By understanding what to expect and how to get connected with the right professional, you can take proactive steps towards a healthier relationship with food and your body. For those living in Nova Scotia, New Brunswick, or Ontario, virtual nutrition counseling options are available through the Aleo Collective.
For more information or to schedule a free discovery call with the dietitian at The Aleo Collective, visit courtenayvickersrd.com and follow on social media at @courtenayvickersrd.
Remember: you are worthy of reaching out for help 💕
