Dietitians: How to Approach a Client with a Suspected Eating Disorder

Dietician speaking with patient on the couch

Contributor: Crystal Karges, MS, RDN, IBCLC, Special Projects Coordinator at Eating Disorder Hope/Addiction Hope

Registered dietitians are food and nutrition experts who have met academic and professional requirements for achieving the RD credential. Registered dietitians on a minimum have a bachelor’s degree, have completed an accredited, supervised practice program, passed a national exam by the Commission on Dietetic Registration, and regularly complete continuing professional educational requirements in order to maintain their registration.

Registered dietitians cover a breadth of topics within their course training and internship experience; however, the topic of eating disorders is not commonly addressed. Some dietetic students may have the option to include a rotation in their internship or coursework that allots some training in the eating disorder field, but this is usually a specialty that is learned with focused schooling/training post internship.

For dietitians who are not familiar with treating patients that have eating disorders, it may be difficult to identify signs and symptoms that can present in a counseling session. Dietitians can often be the first to engage with a client that has an eating disorder, due to the nature of the disease, and understanding how to recognize a potential eating disorder can help with appropriate interventions.

Approaching a Client With a Suspected Eating Disorders

Registered Dietitians work in a variety of settings, including inpatient and acute care, long-term care facilities, schools, outpatient clinics and private practices. Registered dietitians also have the option to work in a specialty with which they feel most proficient, whether it be weight management, pediatrics, diabetes, heart health, eating disorders and more. While some dietitians may specialize in eating disorder recovery and offer outpatient services for such, clients with potential eating disorders may present in a variety of settings.

Woman having a conversation with her therapist on couch in officeIndividuals struggling with eating disorders may present to a dietitian for issues not related to their disease but due to symptoms that are part of the disorder. For example, a person dealing with binge eating disorder may seek out a dietitian for advice or counseling on weight loss. On the surface, this type of patient may legitimately appear to need help controlling their weight; however, if an underlying eating disorder is present, there are much greater issues at stake that need to be addressed.

For a dietitian who is not trained in eating disorders, it may be difficult to recognize this without appropriate screening and assessment tools. Asking certain questions related to food and eating habits, such as “How do you eat when you are alone versus with other people”, or “What are your thoughts about gaining or losing weight?”, may open up a topic of conversation that can give greater insight into a bigger picture. Being able to recognize potential eating disorder symptoms, such as extreme restricting, binging, purging, hoarding food, etc., can be identified in a initial consult conversation.

Leading a Client to Appropriate Resources

If an eating disorder is suspected, it is important to help a client identify this and seek appropriate care as professionally as possible. If you are a registered dietitian who may potentially encounter clients with eating disorders, be ready with adequate resources. If you do not feel comfortable treating this type of patient, have resources for other dietitians who do specialize in eating disorder care or a list of eating disorder specialists, such as therapists, counselors, psychiatrists, and primary care doctors.

Therapist discussing eating disorders with patientIt can be difficult to confront a patient who may have an eating disorder, particularly if the patient appears to be in denial or is coming to see you for an unrelated issue. However, since dietitians deal with food and nutrition, this is something that is commonly seen. Being able to appropriately direct a client to the resources they need for treating their eating disorder can help with early identification and intervention.

If you are a dietitian seeking resources for education in the field of eating disorders, consider organizations such as the Academy for Eating Disorder Professionals, the International Association of Eating Disorder Professionals, and the International Federation of Eating Disorder Dietitians.

Community Discussion – Share your thoughts here!

If you are a dietitian who specializes in eating disorder treatment, what resources were helpful to you in practice?

Crystal Headshot 2About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on May 31, 2016
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