Tag: anti-diet

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Sin, Snacks, and Self-Control: Revelations on the denial of pleasure and reclaiming satisfaction with food

Written by: Raquel Griffin MSW RSW
Time to read: 5 minutes

Sinful snacks, cheat days, and junk food— oh my!! These phrases probably sound pretty familiar; they demonstrate some of the ways in which diet culture’s flavours of puritanism, morality, and virtue are baked into our common discourses surrounding food and eating.

Historically, religion has long shaped the way we think about food and our bodies. Religions issued warnings about gluttony, engaging in fasting practices and avoidances of what could be seen as indulgent. These practices weren’t about weight loss for its own sake or the effects of eating on a person’s size, but about how bodily pleasure was thought to compromise the soul. It was penance: a way of making up for all the times you had screwed up that year, rather than a way of punishing your body for being too large.

Early Protestant Christianity associated bodily pleasure with moral weakness, emphasizing restraint and self-discipline as pathways to spiritual purity. Protestant Christian clergy and leaders like Sylvester Graham and John Harvey Kellogg were pioneers of so-called “healthy eating”, linking bland diets to moral and sexual chastity; this included their own inventions of the Graham Cracker and Cornflakes. Graham believed that all of America’s moral failings could be traced back to “unholy” ways of eating, which could be cured with a strict diet. Graham’s list of “excess” of sinful indulgences included: meat, spices, caffeine, alcohol, and warmed/heated food, to name a few. He even instructed his followers to abstain from dancing (“Footloose” style), to take cold baths, and sleep on hard beds. These practices weren’t merely about health—they were about control and conformity. 

While some of these diets would be seen as overkill today, their legacy persists in modern diet culture’s manifestations, emphasizing individual responsibility which equates thinness with virtue and fatness as a moral failing. In practice, this looks like promoting restrictive eating as a marker of self-worth, abstaining or using “caution” with demonized foods, and pathologizing fatness as inherently diseased and wild. Diet culture’s obsession with categorizing foods as “good” or “bad” not only distorts our relationship with food but also fuels systemic oppression. It marginalizes those who don’t fit its narrow ideals, often targeting women and femmes, racialized folks, queer folks, disabled and those in larger or fat bodies. These standards are rooted not in health but in control—diet culture is a system of oppression, in all its facets.

Reclaiming Pleasure with Intuitive Eating
Intuitive Eating principles offer a roadmap for this reclamation like rejecting the diet mentality, honouring hunger, making peace with food, and discovering the satisfaction factor.

  • Unconditional Permission to Eat
    Instead of viewing food as an enemy, allow yourself to enjoy it— label guilt as such when you notice it. You’ll notice that when you embrace variety and remove restrictions, food eventually loses its “forbidden fruit” allure.
  • Discover the Satisfaction Factor
    Tune into your senses: what flavours, textures, or aromas do you truly enjoy? Eating with intention—savouring each bite and minimizing distractions—can transform meals into moments of joy.
  • Create Joyful Food Memories
    Food doesn’t solely meet physical needs but also serves as a source of emotional and social connection. It brings people together, creates traditions, and tells stories. Recognizing these facets helps us see food as more than calories or nutrients—it’s a part of life’s richness. Make meaningful connections to memories involving food that were joyful. Who were you with? What made the experience special?


Reclaiming pleasure in food is an act of resistance against diet culture and the oppressive systems that sustain it. By rejecting rigidity, embracing flexibility, and reconnecting with ourselves, we can rediscover the joy and pleasure that eating was always meant to bring. A parting invitation: take that treasured creation of Sylvester’s Graham cracker and squish between two of them a warm, toasted marshmallow and melted chocolate square… Mmmm… what a delicious “Fuck you” to diet culture.

References:

Carlton, G. (2022, February 2). Meet sylvester graham, the religious health nut who thought white bread was evil. Retrieved from: https://allthatsinteresting.com/sylvester-graham

Look, M. (2024, February 12). Why was cereal invented? A brief history of corn flakes. Retrieved from: https://history.howstuffworks.com/american-history/why-was-cereal-invented.htm

Harrison, C. (2019). Anti-diet: Reclaim your time, money, well-being, and happiness through intuitive eating. Little Brown: UK.

Harrison, C. (2019, May 20). Episode#196: diet culture’s racist roots with Sabrina Strings. Food Psych. Retrieved from https://christyharrison.com/foodpsych/6/the-racist-roots-of-diet- culture-with-sabrina-strings-sociologist-and-author-of-fearing-the-black-body 

Harrison, C. (2018, August 10). What is diet culture? Retrieved from: https://christyharrison.com/blog/what-is-diet-culture

Smith, A. F. (2009). Eating history: 30 turning points in the making of American cuisine. New York: Columbia University Press.

Strings, S. (2023, May 6). Fatphobia as misogynoir: gender, race & weight stigma. Body Talks Conference, Untrapped Academy. 

Strings, S. (2019). Fearing the black body: the racial origins of fatphobia. New York University Press: New York.

Tribole, E., & Resch, E. (2020). Intuitive eating: A Revolutionary Anti-Diet Approach, 4th ed. St Martin’s Publishing Group: New York.

Tribole, E., & Resch, E. (2017). The intuitive eating workbook: ten principles for nourishing a healthy relationship with food. New Harbinger Publications: Oakland.

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“But What Do I Say?” A Clinician’s Guide to Navigating Conversations About Eating Disorders

Written by: Courtenay Vickers RD
Time to read: 6 minutes

For many healthcare providers, the thought of working with a client who has an eating disorder can be daunting. Questions like What if I say the wrong thing? or What if I make things worse? are common, and this uncertainty can make clinicians hesitate or feel stuck. With some practice and guidance, effective communication and building rapport can be life-changing for that client sitting across from you! 

This blog post offers some helpful strategies for having compassionate conversations with eating disorder clients, integrating self-reflection, examples of what to say and what to avoid, and actionable steps for clinicians to build their confidence in this area.

Before we dig in, an invitation to remain curious rather than judgemental about your current/past self! Wherever you are at on your learning journey, that is ok. And I’m so glad you stumbled upon this post today.

First, what’s the difference between an eating disorder and disordered eating?

It’s important to recognize that there is a difference between an eating disorder and disordered eating when working with clients:

  • Eating Disorders are diagnosable mental health conditions outlined in the DSM, including:
    • Anorexia Nervosa (AN)
    • Bulimia Nervosa (BN)
    • Binge Eating Disorder (BED)
    • Avoidant/Restrictive Food Intake Disorder (ARFID)
    • Other Specified Feeding and Eating Disorders (OSFED)
  • Disordered Eating refers to a broader range of harmful eating patterns or behaviours that don’t meet diagnostic criteria but can still significantly affect physical and emotional health. Disordered eating can be a precursor to an eating disorder. Sometimes disordered eating looks like someone going on a diet, actively pursuing weight loss through dietary restriction, or even being “watchful” of what they eat. It’s not something to ever brush past.

With nearly 2 million Canadians affected by eating disorders—and the second-highest mortality rate among mental health conditions—it’s critical for clinicians to be prepared to address these complex issues with care and sensitivity.

Self-Reflection: Starting with Yourself

Let’s take a moment to do a little self-reflection. You might want to pull out a pad of paper for these questions. Before we get started, it’s important to know that how you approach eating disorder clients can be influenced by your own relationship with food, body image, and assumptions about health. Now, take a moment to reflect on these key questions:

  1. How has your relationship with food and your body influenced how you view and work with clients as a healthcare provider?
  2. Have you ever made assumptions about a person’s health or behaviours based on their weight? How could this affect your care?
  3. How do you interact with patients in larger bodies? Do you notice any differences in how you approach patients in smaller or very thin bodies?

Self-awareness is vital. Recognizing and addressing personal biases is an important step toward creating an environment of trust and support for your clients.

Let’s explore some examples of what to say (and not to say)

Compassionate communication can make a significant difference in how clients feel about their care and recovery. Here are examples of what to avoid saying, along with alternatives that foster trust and understanding:

Instead of: “Just eat!”

Try: “It seems like eating is difficult for you. Tell me more about what challenges come up for you with eating.”

Instead of: “You don’t look like you have an eating disorder.”

Try: “Eating disorders can affect anyone, any age, any gender, any body size. Your experience is valid.”

Instead of: “You’re just going through a phase. Everyone feels insecure about their body sometimes.”

Try: “I imagine what you’re going through is incredibly difficult.”

Instead of: “Your vitals and blood work are fine; you don’t need to worry.”

Try: “Your body is working hard to keep things medically stable right now. I know other behaviours are going on, so let’s explore ways to better support you and reduce harm.”

Instead of: “I wish I had your self-control!”

Try: “The eating disorder is not your fault. It’s a complex brain-based illness, and you deserve to receive supportive care.”

Instead of: “You look healthy/better.”

Try: “How are you feeling about your recovery journey so far?”

Instead of: (silence)

Try: “I’m concerned about your eating. I’m wondering if we can explore your relationship with food a bit more together.”

Instead of: “Don’t worry, you’re not fat! You won’t get fat.”

Try: “I can imagine the idea of gaining weight feels scary for you. That makes sense, given how focused our society and healthcare system are on weight loss. Regardless of your body size, you are deserving and worthy of recovery.”

Instead of: “You have an eating disorder? Sorry, I can’t help you.”

Try: “It sounds like you’re having some real challenges with food and eating. You deserve proper care and support. Are you okay if we talk more about some options to help you?”

Actionable Steps for Clinicians

Working with eating disorder clients doesn’t mean you have to know everything, but there are clear steps you can take to provide meaningful support:

  1. Learn About Eating Disorders
    Expand your knowledge by reading books like Sick Enough by Dr. Jennifer Gaudiani, Life Without Ed by Jenni Schaefer, and The Body Is Not an Apology by Sonya Renee Taylor. Food Psych by Christy Harrison is a wonderful podcast to learn more from. A great Canadian website about eating disorders that we often recommend is the National Eating Disorders Information Centre (NEDIC).
  2. Practice Active Listening
    Listening without judgment or a need to immediately “fix” can be a powerful tool. Validating a client’s feelings and experience can make them feel seen and understood.
  3. Collaborate with a Care Team
    Eating disorder treatment is often multidisciplinary. Work with dietitians, therapists, and medical professionals to ensure comprehensive care. If a client doesn’t have a team, help build a team or consult with other professionals on behalf of your client.
  4. Refer When Necessary
    Know the options for higher levels of care and how to connect clients. If waitlists are long, continue supporting your client with compassion and harm-reduction strategies while they wait.
  5. Advocate for your clients
    Advocacy can make a huge difference, whether it’s within the healthcare system, with family members, or through education about eating disorders in your community.

Building Confidence Through Practice

Feeling confident in conversations about eating disorders takes practice and support. If you want further guidance, consider joining Confident and Competent: Eating Disorder Clinician Consultation Group, starting in February 2025. This program offers group calls, practical skills, and a supportive community to deepen your expertise. Email us at thealeocollective@gmail.com to learn more and get on the waitlist.

Remember, you don’t have to be perfect or have all the answers to make a positive impact. By showing up with compassion, humility, and a willingness to learn, you can help clients feel supported and valued on their recovery journey.

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Taking Up Space: How to honour and connect with our bodies in a fatphobic world

Written by: Dustin LindenSmith

Time to read: 12 minutes

Please allow me to introduce myself: I go by Dustin, my pronouns are he/him, and I’m grateful to live with my wife and three children on a lake situated on the unceded ancestral territory of Mi’kmaqi and the Mi’kmaq people, at Punamu’kwati’jk (”Boonamagwaddy”), known in modern times by its colonialist name of Dartmouth, Nova Scotia (across the harbour from Kjipuktuk (Chebucto), now known as Halifax). I am a White, cisgender man, a stay-at-home dad, a jazz musician, a recovering IT professional, and a peer supporter for people in recovery from eating disorders. I am also currently studying for my Master’s in Counselling Psychology to become a psychotherapist.

I come to this work by way of my own lived experience and my ongoing recovery from childhood trauma and an eating disorder.1 I first started eating for emotional comfort and stress relief at age 7, and I was always known as a “husky” child. I went on my first weight-loss diet in my pre-teens, and by the time I reached high school, I had “dieted my way up to” a very high weight. After another couple of weight-loss cycles followed by longer periods of weight gain, I became very fat by the halfway point of my undergraduate degree. I would go through about eight large swings of weight-cycling from that point until I entered recovery some 30 years later.

What I needed to recover from was an eating disorder. When I entered recovery, I estimated that I had gained and lost the equivalent of four times my adult body weight throughout my life—truly an epic, lifelong cycle of yo-yo dieting. Once I really connected the dots between my childhood trauma and my decades-long, food-based emotional coping habits, I was finally able to stop my weight-cycling behaviours by never starting another weight-loss diet again. However, in the fatphobic, diet-obsessed culture we live in, refusing to go on a diet is itself a quasi-revolutionary, countercultural act.

SOTU (State of the Union) for Fat People Today

First, a word about the word “fat”. People “of size” are reclaiming the word fat as a simple descriptor for our bodies that is stripped of its usual negative and pathologizing connotations. I will use the word as a non-judgmental reference term for people like me who live in larger bodies, and whenever I use the word, I do not imply that there is anything inherently wrong or unhealthy about merely being fat.

Second, our status: our numbers seem to be increasing every year, with the causes being multifactorial, complex, and interrelated with one’s socio-economic, cultural, and intersectional positioning within their community. In healthcare, the medical community certainly treats obesity as inherently pathological, but there is no consensus on how to “solve the problem of obesity” or even how to clearly define what “the problem” is in the first place (recent pharmaceutical developments with GLP-1 inhibitors such as Ozempic notwithstanding).

Third, how fat people might present today is multifaceted, but many of us share similar backgrounds and experiences. For years—likely dating back to our childhoods—many of us have had a dysregulated relationship with food, movement, and our bodies. Many of us have experienced chronic and severe weight cycling throughout our lives as a result of chronic weight-loss dieting, and many of us have experienced adverse childhood experiences that involved trauma, neglect, or abuse. Once more for the people in the back: Fat people are themselves often survivors of trauma and abuse.

A Primer on Anti-Fat Bias and Toxic Diet Culture

Anti-fat bias is rampant in our culture, and it is a force which is colonialist, misogynist, and racist in origin. It arises from holdover imperialist ideas about man’s apparent dominion over our mind and our bodies, and of mind over matter. It clings to the ill-conceived notion that we should all be capable of keeping the body “in line” through the rigours of our own mind and willpower, and this has cultivated a learned distrust within ourselves about our bodies. Many of us have lost faith in our own judgment about what is “the right thing” to do for our bodies.

Fat stigma is shot through our families, popular culture, our society, and in our physical spaces (e.g. restaurants, airplanes, and public seating areas which cannot comfortably accommodate fat people). In healthcare settings, it shows itself through the relentless pursuit of thinness for its own sake (+ the inanity of considering one’s BMI on its own as a diagnostic indicator for anything clinically useful on its own merits). We are also all involved (willingly or not) in a multi-billion-dollar dieting and weight loss industry that is deeply pervasive in our popular culture, news and social media, and within many of our friends and family groups.

Why Are We Fat, Anyway?

With apologies to any medical folks in the crowd, I’d like to start with a disavowal of our collective and cultural drive to be thin in the first place. It is simply not necessary to be thin in order to be happy or healthy, and just like anyone else, fat people deserve to be loved and to feel joy.

There are also well-established links between trauma, adverse childhood experiences (ACEs), and disordered eating behaviours 2. Some of us have that history + a personality type or an entrenched pattern of behaviour that derives emotional comfort or stress relief from eating or overeating, and this has led to weight gain over time.

Dieting for weight loss also contains a painful, intrinsic paradox: people can easily become fat by dieting for weight loss. Dieting has a 95+% failure rate for long-term, sustainable weight loss because of how our biology thwarts long-term weight-loss due to its protective metabolic functions against famine and starvation2. There is almost always an unhealthy rebound effect with dieting and weight-cycling, which can best be described as the result of a restrict*-then*-binge cycle (and not a binge-then-restrict cycle—i.e., the restricting comes first).

Being fat in this culture also brings with it body shame, self-loathing, a lack of self-trust, and pervasive feelings of failure and worthlessness resulting from years of “failing” at weight-loss diets. Shame is a physical manifestation of the existential fear that we might become excluded from our group, and this can often lead to dysfunctional and maladaptive behaviours and relational patterns3.

Many of us also deprive ourselves of food (and/or we have an adversarial relationship with it), and this can result in caloric restriction which then incites binge-eating behaviours. The truth is, *we all deserve to eat—*but not all of us believe that we deserve to eat (and/or not all of us believe that we deserve to eat what we want to eat and when we want to eat it).

In my observation, there are also certain factors that do not usually contribute to our fatness: these are a lack of self-insight, a lack of awareness, a lack of motivation, a lack of information, or a lack of knowledge. What we are missing is something much different than those things.

So What Do We Do Now?

So far, I’ve set some of the context for what it’s really like for fat people to live in a fatphobic world. But what can really do about all of that? I have four concrete things to suggest: (1) changing the way we think (and act) about fatness and our bodies; (2) cleaning up our social media feeds; (3) working on our boundaries; and (4) seeking professional support to work with any or all of the above.

Let’s get into each one in some detail.

1. Changing the way we think (and act) about fatness and our bodies

Here are some ways we can start to adjust our mindset and self-view about our own fatness and how we deserve to show up in the world.

  • cultivating accurate empathy and self-acceptance towards ourselves by working with our shame and forgiving ourselves for our past behaviour with food and movement
  • acknowledging our inherent sense of goodness and self-worth: acknowledging that we are all perfectly good, worthy people and we deserve to exist, to eat, and to take up space in this world—no matter what size we are or what number comes up when we step on a scale or whether we think “society” finds us attractive or whether we’ll find a partner or have a family
  • personal self-development and embodiment work: practicing personal self-development work that gets us into our bodies and cultivates mindfulness and self-acceptance (e.g. journaling, art, writing, crafting, singing, dancing, playing, music, acting, movement, or other embodiment exercises such as sports, yoga, tai chi, swimming, strength training, martial arts, walking, working out, golfing, racquet sports, sports in the water, hiking, camping, bouldering, landscaping, and more)
  • radical self-love: learning how to transform our adversarial relationship with our bodies into what Sonya Renee Taylor calls radical self-love

2. Cleaning up our social media feeds

Extensive research has confirmed that the use of social media has been linked to various poor mental health outcomes (e.g., Gioia et al., 2020; Keles et al., 2020). Here are some suggestions for how to mitigate those harms for yourself:

  • acknowledge SM’s real potential harms to our self-image, body image, and self-worth when we drench ourselves in comparisons with the beauty and health content online
  • initiate some accurate (but compassionate!) self-inquiry about your usage habits and about what you really want to “get” from your social media (e.g., if it’s for entertainment but the end result is that the images you’re exposing yourself to are harming you and making you feel terrible about yourself, is it really giving you what you’re looking for?)
  • revisiting privacy settings, posting/reading frequency, screen time settings
  • unfollowing accounts focused on weight loss, dieting, “clean” eating, excessive exercise, and anything that otherwise appears to promote toxic diet culture or misogynistic beauty standards
  • adding new accounts that pass your new fat-positive vibe check (e.g., the beautiful Black yogini Jessamyn Stanley (@mynameisjessamyn) (and don’t miss this guest reel by @funkingafter50); the ineffably happy Toronto gay bear Lukas (@bearlyfriendly); and the photographer and artist Sugar McD (@shooglet), who has taken some of the most beautiful pictures of fat people experiencing joy that I have ever seen)

3. Working on boundaries

This is the one I have personally found the most difficult; throughout my entire life, I have pre-emptively made self-deprecating fat jokes about myself in social settings in a misguided attempt to make everyone comfortable. I now understand that this habit was causing me more harm than I knew, and it was also giving everyone in my life implicit license to speak disrespectfully about my own weight.

It takes real courage (along with possibly a previously-unknown self-respect) to build up the confidence to start the challenging but worthwhile work of informing the people in your life that you’re no longer willing to put up with a certain type of discussion or judgment about your body weight, your diet, your food choices, or your health.

The best introduction to the topic I can suggest is Aleo’s own Lee Thomas’s 2-part blog post on this topic. When you’re ready to go deeper, I recommend looking at Black psychotherapist Nedra Glover Tawwab’s excellent work (e.g., her website, her Instagram, her book, and her workbook are all excellent resources).

4. Professional support

One of the sweetest gifts you can give yourself is the gift of professional support for what you’re struggling with. If you want to take a fresh new approach to your recovery, working with anti-diet, anti-oppressive practitioners such as the ones you will find at The Aleo Collective would be a great start. Lee and Raquel are MSWs; Courtenay is a Registered Dietitian, and I am a Peer Supporter who works with people in recovery from disordered eating and self-image issues.

  1. i.e., Binge-Eating Disorder (BED); see APA, 2022, p. 392 ↩︎
  2. Bakalar et al., 2018; Brewerton, 2022; Hemmingsson et al., 2014; Schiff et al., 2021 ↩︎
  3. Freire, 2020; Spreckley et al., 2021 ↩︎
  4. Doran & Lewis, 2012; Noll & Fredrickson, 1998 ↩︎

References

American Psychiatric Association [APA]. (2022). Diagnostic and Statistical Manual of Mental Disorders, 5th ed., text rev. (DSM-5-TR). https://doi.org/10.1176/appi.books.9780890425787

Bakalar, J. L., Barmine, M., Druskin, L., Olsen, C. H., Quinlan, J., Sbrocco, T., & Tanofsky‐Kraff, M. (2018). Childhood adverse life events, disordered eating, and body mass index in US Military service members. International Journal of Eating Disorders, 51(5), 465–469. https://doi.org/10.1002/eat.22851

Brewerton, T. D. (2022). Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span. 1–20. https://doi.org/10.1186/s40337-022-00696-6

Doran, J., & Lewis, C. A. (2012). Components of Shame and Eating Disturbance Among Clinical and Non-clinical Populations: Shame and Eating Disturbance. European Eating Disorders Review, 20(4), 265–270. https://doi.org/10.1002/erv.1142

Freire, R. (2020). Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition, 69, 110549. https://doi.org/10.1016/j.nut.2019.07.001

Gioia, F., Griffiths, M. D., & Boursier, V. (2020). Adolescents’ Body Shame and Social Networking Sites: The Mediating Effect of Body Image Control in Photos. Sex Roles, 83(11–12), 773–785. https://doi.org/10.1007/s11199-020-01142-0

Hemmingsson, E., Johansson, K., & Reynisdottir, S. (2014). Effects of childhood abuse on adult obesity: A systematic review and meta-analysis. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 15(11), 882–893. https://doi.org/10.1111/obr.12216

Keles, B., McCrae, N., & Grealish, A. (2020). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25(1), 79–93. https://doi.org/10.1080/02673843.2019.1590851

Noll, S. M., & Fredrickson, B. L. (1998). A Mediational Model Linking Self-Objectification, Body Shame, and Disordered Eating. Psychology of Women Quarterly, 22(4), 623–636. https://doi.org/10.1111/j.1471-6402.1998.tb00181.x

Schiff, M., Helton, J., & Fu, J. (2021). Adverse childhood experiences and obesity over time. Public Health Nutrition, 24(11), 3205–3209. https://doi.org/10.1017/S1368980021001804

Spreckley, M., Seidell, J., & Halberstadt, J. (2021). Perspectives into the experience of successful, substantial long-term weight-loss maintenance: A systematic review. International Journal of Qualitative Studies on Health and Well-Being, 16(1), 1862481. https://doi.org/10.1080/17482631.2020.1862481

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What to Expect When Working with an Eating Disorder Dietitian

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 💕

Posted on

Reclaiming Your Birthright (Part 1)

An Introduction to Intuitive Eating: Rejecting the Diet Mentality

Posted by: Raquel Griffin

Time to read: 5 minutes

“I just want to eat normally”. In my experience teasing this statement out with folks, I typically learn that what they mean is they don’t want to feel so preoccupied with food, or worried, or scared. They are tired from being at war with food and with their bodies. Many of them want Intuitive Eating, but it feels far off, out-of-reach, out of their capacity.

But, what if I invited you to consider that we’re born Intuitive Eaters? Of course, there are always going to be exceptions to most things, but generally speaking we come out of the womb with much of our intuition (evolutionary and survival responses) when it comes to eating. However, what happens often is that internal wisdom becomes polluted by external factors like diet culture. We learn to disconnect from our bodies and deny our needs and wants. Intuitive Eating is about reclaiming our birthright by shifting focus away from external factors rooted in diet culture and rebuilding trust with our internal wisdom and intuition.

This blogpost is the first entry of a series, an Introduction to Intuitive Eating. To summarize, Intuitive Eating:

  • Its philosophy is rooted in an anti-diet positioning and is aligned with the concepts of Health At Every Size and weight inclusivity.
  • It is comprised of 10 principles that are dynamic in nature (not sequential steps, though the positions of #1 and #10 are intentional)
  • Interoception is the foundational skill of reference; it is the ability to perceive physical sensations that originate from inside the body. 
  • It has a solid footing in research in numerous ways: 
    (a) evidence for the ineffectiveness and damage of diets or intentional weight loss
    (b) is an evidence based approach that demonstrates the benefits of intuitive eaters (220+ studies and counting)
    (c) has a validated assessment tool. 

In this post, I want to focus on explaining the anti-diet positioning of Intuitive Eating, which is related to the first principle of Intuitive Eating, and I’ll pull in some research pieces to corroborate that stance.

The first principle is the most important, Reject the Diet Mentality, where right away things get real specific on why an anti-diet approach can be a helpful cornerstone in your relationship with food repair. Diets do not work, and by this I mean weight loss that can be experienced from dieting is not long lasting. On top of that, the ineffectiveness of dieting is not a neutral quality: diets can cause a lot of harm and damage on our health in a variety of ways.

Dieting and intentional weight loss have been have showing their hand in research for a while now. You can see a non-exhaustive list of some of this research at the end of this post. Way back in 2007 a team of researchers came together to conduct a meta-analysis of all the long term weight loss studies they could find to assess whether long-term weight loss was actually a thing. The results from this meta-analysis, and other research studies since, report a 5-year maximum window where approximately 95% of people will not only regain the weight they did lose from dieting initially, but up to 2/3 of people will actually regain MORE weight than they lost. Let’s recognize for a moment what that means: dieting is more likely to make you fatter in the long-run. Now, this is not meant to demonstrate colluding with diet culture, but instead to point out the ridiculousness of a product that worsens the very “issue” it claims to resolve. Imagine purchasing a water bottle that not only is ineffective in quenching your thirst, but instead actually makes you thirstier. Pretty ineffective product, eh?

So, the diet is the problem itself, yet we are convinced by diet culture that WE are the problem. We are somehow at fault. When the weight inevitably comes back we blame ourselves and try the next diet or “lifestyle change”, and the next, and the next. This often results in weight-cycling: the pattern of weight loss and regain that occurs with chronic dieting. Weight cycling is seldom controlled for in many large studies that associate weight with health issues; this is a major oversight because weight cycling itself is an independent risk factor for many health conditions including: cardiovascular disease, inflammation, high blood pressure, and insulin resistance. And what do you know, these health issues often are blamed on one’s weight or fatness, resulting in various prescriptions of the very thing that could be contributing to these health issues = intentional weight loss via dieting and exercise.

In future posts for this series on an introduction to Intuitive Eating, I’ll share more on how the concepts of Health at Every Size and Weight Inclusivity have overlaps with an an-diet approach, some of the benefits of Intuitive Eating that research has shown, Interoception, and more. For now, my hope is maybe reading this has helped you begin to consider a different perspective toward the normalized attempts to shrink our bodies via some rendition of eating less. If you’re feeling exhausted from the never ending pursuit of weight loss, or feeling obsessed with food or eating, know that exploring Intuitive Eating could bring more peace and ease to your food and body relationship. It has the potential to reconnect (or introduce) you to your birthright.

Research references (for dieting being ineffective), a non-exhaustive list:

Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, (10) 9. DOI: 10.1186/1475-2891-10-9

Dulloo, A. G., Jacquet, J., & Montani, J. (2011). How dieting makes some fatter: from a perspective of human body composition autoregulation. Proceedings of the Nutrition Society, 71, 379–389. doi:10.1017/S0029665112000225

Field, A. E., Austin, S. B., Taylor, C. B., Malspeis, S., Rosner, B., Rockett, H. R., et. al. (2003). Relation between dieting and weight change among preadolescents and adolescents. Pediatrics, 112, 900– 906.

Fothergill, E., Guo, J., Howard, L., Kerns, J. C.,  Knuth, N. D., Brychta, R., et. al. (2016). Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity biology and integrated physiology. doi:10.1002/oby.21538

Mann, T., Tomiyama, A. J., Westling, E., Lew, A., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, The American Psychological Association, 62(3), 220-233. doi: 10.1037/0003-066X.62.3.220

Montani, J., Schutz, Y., & Dulloo, A. G. (2015). Dieting and weight cycling as risk factors for cardiometabolic diseases: Who is really at risk? World Obesity, (1), 7–18. doi: 10.1111/obr.12251

Neumark-Sztainer,D., Wall, M., Larson, N. I., Eisenberg, M. E., Loth, K. (2011). Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a

10-year longitudinal study. Journal of the American Dietetic Association.  doi: 10.1016/j.jada.2011.04.012

O’Hara, L., & Taylor, J. (2018). What’s wrong with the ‘war on obesity?’: A narrative review of the weight-centered health paradigm and development of the 3C framework to build critical competency for a paradigm shift. SAGE open, 1–28. DOI://1d0o.i.1o1rg7/71/02.1157872/241450812484707128878728888

Richmond, T.K., Thurston, I.B., Sonneville, K. R. (2020). Weight-focused public health interventions: No benefit, some harm. JAMA Paediatrics. 

Ross, R., Blair, S., de Lannoy, L., Després, J., Lavie, C. J. (2015). Changing the endpoints for determining effective obesity management. Progress in Cardiovascular diseases, 57, 330–336. http://dx.doi.org/10.1016/j.pcad.2014.10.002

Tribole, E., & Resch, E. (2020). Intuitive eating: A Revolutionary Anti-Diet Approach, 4th ed. St Martin’s Publishing Group: New York.

Tribole, E., & Resch, E. (2017). The intuitive eating workbook: ten principles for nourishing a healthy relationship with food. New Harbinger Publications: Oakland.

Pietiläinen, K. H., Saarni, S. E., Kapiro, J., & Rissanen, A. (2011). Does dieting make you fat? A twin study. International Journal of Obesity. doi:10.1038/ijo.2011.160- online publication, 9 August 2011

Wing, R. R., Bolin, P., Brancati, F. L., Bray, G. A., Clark, J. M., Coday, M., et al. (2013). Cardiovascular effects of intensive lifestyle intervention in Type 2 diabetes. The New England Journal of Medicine, 369, 145-54. DOI: 10.1056/NEJMoa1212914

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