Remission Resources: What To Do When You Can’t Find a Dietitian

After burying my nose in many books and academic articles, I have developed a very strong opinion about the role nutrition plays in the arduous but rewarding process of  ED remission. I believe that proper nutrition, not psychiatrist visits or some form of psychotherapy, is the key to finally being free from your eating disorder. You see, when your brain is malnourished after long-term starvation, it does not have the energy or the capacity to function at an optimal level. That means that all those visits with your therapist and/or shrink are a waste of your time, energy, and money because to get through therapy, you need a brain that actually works.

But of course when you have an eating disorder, getting the sky-high amount of nutrition that is required is basically impossible if you are trying to eat enough on your own. That’s why a registered dietitian is one of the most important members of your treatment team. They have received years of training in helping to heal people with the power of nutrition and they can easily design a meal plan based not only on the unique needs of your body, but also on your dietary preferences.  Throughout my years of being treated by a registered dietitian, I have also found they do an excellent job at focusing on reshaping one’s relationship with food. This is especially important for us eating disorder sufferers since our ED has made food an enemy instead of a something that is not only necessary for sustaining life, but also incredibly enjoyable.

Unfortunately in the US, it is challenging to find a registered dietitian who is experienced in treating eating disorder patients and affording one.  A lot of the times, insurance fails to cover dietitian visits despite the fact that these visits are vital for achieving eating disorder remission.  This means too many ED sufferers are left without the support and knowledge of a dietitian which can hinder their remission progress because they are not getting the nutrition they need.  In these situations, the only option is to start exploring other options. After going on an expedition in the unknown and dangerous territory of the internet, I have gathered some commendable resources that could be used in place of a dietitian. But before I tell you these awesome resources, I want to remind you that these should be used if and only if you are completely unable to see a registered dietitian.  No website can replace the knowledge and compassion of these individuals.

 

The Best Resources for Eating Disorder Remission Nutrition (all of these links will open in a new tab 🙂 )

  • ASK THE DIETITIAN Meal Plan Maker:  I am beyond impressed with this wonderful website and I honestly believe it is the GREATEST resource out there for those in need of a nutritionally-balanced meal plan. The site is the brain-child of Joanne Larson, a licensed registered dietitian who has worked in a myriad of places including hospitals, clinics, and  mental health facilities.  Her website contains informative Q&A articles on a whole host of ailments (including eating disorders) as well as three incredibly helpful tools that will aid you in creating a meal plan that suits your unique nutrition needs.
    • Steps to making your own, one-of-a-kind meal plan
      • 1. Click on the link to be taken to ASK THE DIETITIAN’s “Healthy Eating Plan for Life” tool.
      • 2. Fill in the “Your Body Data” section of the form.
      • 3. Next it’s time to fill in the “Calorie Distribution” part of the form. Do not change the percentages of carbs, fats, or proteins. All you have to worry about in this section is the amount of calories. To figure out how many calories you need, you need to go to ASK THE DIETITIAN’s “Healthy Body Calculator” tool.   Fill in ALL the information except the the Body Fat section and the Waist-to-Hip Ratio section (these can be triggering and they are NOT NEEDED to calculate your calorie needs. When you get to the Weight Goal section, you either need to say you want to maintain or gain. If you have a lost weight due to your eating disorder, you need to accept the fact that you need to gain weight.  Your body and brain deserves to be at a weight where it functions best and that is not at your current eating disorder weight.  Also, when you get to the Calorie Distribution section, DO NOT CHANGE ANYTHING.  Once you complete the form, click “Next”. You will be brought to a page where it tells you how many calories your body needs to be or get healthy.
      • 4. Now that you have the calories you need, go back to the “Healthy Eating Plan for Life” tool. Fill in your preferences. If you are recovering from a restrictive eating disorder, I highly recommend you choose full-fat milk because fat it vital for healthy brain function.  Also higher-fat foods give you more calories for a smaller amount so you will not have to eat as much.
      • 5. Once you complete the form (except the sections I told you not to), click “next”.  You will be taken to a page with your exchange-based meal plan.
      • 6. Highlight and copy your meal plan to a document (Google Docs or Word work best) so that you can save it and print it out.
    • Because this meal plan is based on the exchange-system, it can be quite flexible.  If you are not familiar with the exchange system, click here for a detailed list of food group exchanges.

 

  • The Kartini Clinic Meal Plan: This straight-forward, no-nonsense meal plan was created and is implemented by the Kartini Clinic in Portland, Oregon. Founded in 1998 by Dr. Julie O’Toole (a physician who is VERY well-known in the Maudsley/FBT community), the Kartini Clinic treats children to young adults suffering from a wide-range of eating disorders including anorexia nervosa, bulimia nervosa, EDNOS, and food phobia. Unlike many eating disorder professionals, Dr. O’Toole believes eating disorders are a biological brain disorder that are not caused by parents or by  patients, which I totally agree with. Of course there are some treatment philosophies of hers that I disagree with completely, but I do believe her meal plan is excellent for patients who prefer more rigidity in their meal plans.
    • The meal begins at a base amount of 2150 calories (which is PERFECTLY ACCEPTABLE). A lot of the times, patients need to add more to the meal plan in order to reach a healthy weight for their unique body type and they do this by adding “extras”. Extras include things like adding Benecalorie to their whole-milk yogurt or drinking calorically-dense nutritional supplements like Boost or Ensure.   Unlike most ED remission meal plans, this meal plan only has patients have 3 meals and 1 snack per day. The thought behind this is that eating less frequently allows patients to not focus on food every waking hour.  Another thing you must know about this meal plan is that that require patients to eat full-fat  foods. This means no skin milk, low-cal almond milk, or low-fat yogurt. I know that that can be quite frightening, but remember fat is VITAL for a healthy brain and body.

 

  • Herrin Food Plan: This  meal plan was designed by Marcia Herrin, a renowned registered dietitian who is actually the founder of the respected Dartmouth College Eating Disorder Treatment Program. Like most meal plans for eating disorder patients, this plan requires patients to consume food 6 times a day (3 meals, 3 snacks) and it is based on choosing certain food groups for each meal and snack.  The plan also requires patients to have one cup or double the serving size of each food group AND to consume two “fun foods” each day. What exactly is a “fun food” you ask? Well, let me tell you right off the bat it is anything BUT fun for eating disorder patients. “Fun foods” are basically Herrin’s term for the foods that show up in the nightmares of ED patients around the world. We’re talking cake, donuts, croissants, non-diet soda, fries, chips – basically EVERYTHING an ED patient refuses to even get close to.   Now I understand that it is important for eating disorder sufferers to begin to enjoy food and eat things that aren’t necessarily health foods, but in my opinion requiring patients to do this TWICE a day is a little excessive. Healthy eating means eating everything in moderation and eating dessert twice a day is definitely NOT moderation. Obviously that is just my opinion, so take it or leave it.

 

Finding a dietitian is hard work and sometimes it just isn’t possible to meet with one for various reasons. I hope these resources are helpful to those who can’t meet with a dietitian and give me a chance at achieving remission 🙂

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One thought on “Remission Resources: What To Do When You Can’t Find a Dietitian

  1. Awesome post – totally agree (although in Australia Dieticians are subsidised under a government scheme if you have an ED so you do get some fee assistance). I have a few close friends who are Sports Dieticians and it is scary how little they get taught at University (In Aus anyway) about dealing with ED’s – basically they only learn it if they go onto do further specialist training and then work intensively with a psychologist experienced in EDs as well. It’s sad because as you point out – without proper nutrition and nutritional support, the rest of the program does very little!

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