Eating disorders are serious mental condition that can cause debilitating physical and mental symptoms which could be life-threatening. Seeking help for recovery is therefore crucial especially as early diagnosis and treatment can improve the recovery outcome. A multidisciplinary team consisting of an eating disorder therapist, a doctor and an eating disorder nutritionist is often needed for the treatment. The latter plays a key role in helping the sufferer heal their relationship with food and their body. To know more about the role of a nutritionist in eating disorder recovery, head over to this article:

Many sufferers can be faced with anxiety in seeking help but doing so is undoubtedly a courageous first step. To help put your concerns to rest, know that we provide a safe space where you can communicate your fears, struggles and your reality. We listen to you with a non-judgemental and empathetic approach and provide you with tailored recommendations to best support you during your recovery. Here is what you can expect in an initial first evaluation with an eating disorder dietitian.

First and foremost, building a relationship based on trust with the client is of utmost importance for our nutritionists in accompanying you in this journey. Therefore, we usually set up a free discovery call with you even before booking a first appointment to discuss briefly about your goals, your needs, struggles, address any insecurities about the treatment and to explain our approach. This way, we make sure you feel comfortable with our approach and confident in booking a first appointment with one of our eating disorder nutritionists.

At that first appointment, a lot of time is spent getting to know you. For instance, the nutritionist will ask questions about your lifestyle: your current living situation, your job/study, relationship with physical activity (whether it’s too rigid/only associated with calorie burning to control the weight or used as a method to compensate for your food intake).

The eating disorder dietitian will also assess your medical condition including any previous medical conditions and treatments done, family history of any medical condition, existing symptoms whether it’s behavioural, physical, mental and social that could be related to the eating disorder and any medications or supplements that you might be taking.

In addition, the nutritionist will assess your food intake and compare to your needs and also enquire about your relationship with food. For instance, she will dig deeper to identify if there are any restrictions, food rules, rigidity about food and the root causes for an unhealthy relationship with food (ex: body image issues, low self-esteem, coping mechanism to deal with anxiety, identity crisis, etc.)

Along the same line, the eating disorder nutritionist will evaluate any diets history which might still have an impact on some existing food behaviours or beliefs. For example, you have followed a low carb diet or a keto diet, you may still think that carbs are bad for you and restrict yourself as a result. Therefore, if the dietitian identifies those type of cognitive triggers, she will be able to debunk any myth or belief in future follow-ups in an attempt to decrease and eliminate any restrictive behaviours.

And if there are restrictive eating patterns, the nutritionist will enquire about your fear foods. This will help her tailor a structured treatment plan that aims at re-introducing those fear foods gradually in your diet without it being too anxiety-provoking.

As for binge-eating sufferers, the nutritionist will dig deeper with regards to the binge-eating episodes discussing the potential triggers, the context in which they usually arise, the foods you gravitate towards and how you usually feel after physically and mentally and if there are any compensatory methods.

And as an eating disorder often goes hand in hand with an obsession of the weight, the dietitian will assess any thoughts and behaviours that could reinforce a negative body image. For instance, the presence of obsessive body checking behaviours (frequent weigh-ins, body-checking behaviours in the mirror, pinching certain body parts, etc.) will be evaluated. Depending on the client, the weight history might be discussed but if weight is triggering for you, the topic will be avoided.

Once all the information is collected, the nutritionist will educate you on how the unhealthy food and body image thoughts and behaviours could be impacting negatively your well-being (mental, social and physical). She will also do some psycho-education to teach you how an eating disorder works.

Then after the teaching part, we set realistic objectives for the next session with the ultimate goal of helping you heal your relationship with food and your body. Sometimes the objective could be to become more aware of the eating disorder and try to dissociate yourself more from it. Sometimes the recommendations could be about letting go of some body-checking behaviours if they are too prevalent or we can also focus on increasing slowly the food intake or normalizing some foods. Regardless of the objectives we set together, they will definitely be individualized for your needs so that they are achievable. Also, in determining the objectives, we always try to use a collaborative approach to make the changes the least stressful for you. For example, if we decide to increase your food intake, we will agree on which food to start with that is the least anxiety-provoking and the portion you feel comfortable eating.

Throughout that first appointment with your eating disorder nutritionist, you are encouraged to express any concerns, fears, and questions about the treatment plan and the approach. The recommendations will be adapted to you and if they are too anxiety-provoking, they will be adjusted. Also know that all the information that you share with us remain confidential and can only be shared with your consent unless there’s an immediate threat for your health.

Eating disorder recovery is a journey, often filled with its ups and downs and therefore, follow-up sessions are required. For future sessions, the eating disorder dietitian will likely outline a treatment plan to let you know what you can expect to work on at the follow-ups. The goals of the follow-ups are to provide you with ongoing support and through regular communication with your nutritionist, the treatment plan can be adjusted to better meet your changing needs and reality. The frequency of the follow-ups will also be tailored to your needs and can be discussed at the first appointment with your eating disorder nutritionist.

Making a first appointment for eating disorder recovery is undoubtedly hard but reaching out is a courageous first step towards healing and reclaiming your life. Also, we can assure you that we put a lot of effort during the first appointment to build trust so that opening up about your struggles becomes easier for you. So don’t hesitate, give us a call so we can chat and see how our nutritionist can help you with your eating disorder.

Eating disorders are life-threatening mental conditions which are typically characterized by an excessive preoccupation with body image and food. Here are the most common types of eating disorders:

• Anorexia Nervosa: Typically characterized by under-eating often out of fear of gaining weight
• Binge-eating disorder: Usually characterized by episodes of binge eating without use of compensatory methods (such as in bulimia)
• Bulimia Nervosa: Typically characterized by repeated episodes of losing control with food and then accompanied by methods to compensate for the binges such as use of laxatives, purging or excessive exercise

Each eating disorder comes with its own challenges and are quite complex but ultimately, all of them could lead to detrimental impacts on an individual’s physical, psychological and social well-being.

However, the earlier the detection is made, the better the outcomes of the treatment for recovery. Hence, it is important to be able to recognize the warning signs of an eating disorder in order to seek professional help.

Physical signs and symptoms

• Fatigue, weakness and feeling dizzy especially when getting up or moving around
• Slowdown or irregularity of heartrate, respiratory rate and of blood pressure
• Sleep disturbance or insomnia
• Gastrointestinal symptoms such as feeling distended in the stomach region (especially after eating), abdominal cramps and constipation
• Irregular periods or absence of periods
• Decrease in body temperature resulting in feeling cold often and as a result the individual could develop lanugo which is sudden hair growth on the body (arms, face and back)
• Swelling of the parotid glands (which is the area located just below and in front of each ear) if purging is done repeatedly
• Dental issues such as cavities, erosion of the enamel if the individual resorts to vomiting
• There could be sudden variations in the weight but it is important to note that the weight is no longer a diagnostic criterion for eating disorders and relying on weight to diagnose someone could lead to under-reporting.

Psychological signs and symptoms

• Mood swings, irritability, lack of concentration, increased withdrawal
• Increased obsessive thoughts about food choices, calories, portions leading to anxiety and guilt around food)
• Intense preoccupation of gaining weight
• Body dysmorphia: perceiving oneself as being overweight/fat even if they are not or if they are even underweight

Behavioral signs and symptoms

• Always checking the nutritional values of food obsessively on the labels or on the internet.
• Tracking calories and portions obsessively
• Episodes of binge-eating
• Frequent body-checking behaviors in the mirror, weighing oneself obsessively, or pinching certain body parts
• Hiding to eat, wanting to eat more by oneself instead of with others
• More food rituals such as cutting food in small pieces, chewing excessively and eating foods in a specific order: for example, vegetables can always be eaten first
• Always going to the bathroom after meals
• Exercising excessively and being very rigid with the frequency, duration, intensity and calories burnt during physical activity

It is important to note that not all people with an eating disorder will experience the above symptoms and the latter are not diagnostic criteria for eating disorders. However, they can definitely be red flags to seek professional help.

It might undoubtedly be a delicate topic to engage in but if you see signs of an eating disorder in a family member or friend, start the conversation by expressing your concern. Use “I” instead of “you” to avoid any accusatory tone. The eating disorder voice is already present constantly in the sufferer’s head and they certainly do not need to feel blamed or criticized as this might make them more on the defensive. For example, instead of saying: “You need to eat more”, try saying “I’m scared to see you skip meals so often.”

Your concerns might be met with denial or a refusal to seek help for their eating disorder. However, try to remain calm, empathetic and continue listening to the individual without judgement. Sometimes, the person might just be afraid to seek help or does not know where to get help. A good starting point for resources could be free helplines offered by some organizations such as Nedic or Aneb where the individual can open about their struggles over the phone, text or by email.

And if you or your loved one is ready to make the first step in seeking help from an eating disorder therapist, we are here to accompany you. Please contact us to see how we can help!