Nutrition Counseling
The main goal of nutrition counseling is to adopt healthy eating attitudes and behaviors. In addition to knowing about nutrients and why we need certain foods, fears and false beliefs about food must be resolved. Nutrition therapy should help the patient learn to make reality-based eating choices and food related behaviors.
Balance of carbohydrates, protein, and fat
The diet should incorporate a balanced amount of carbohydrates, protein, and fat. All of these macronutrients are necessary for satisfying food cravings, feeling satiated, and spacing time between meals.
Educating the client
People with EDs often think they are experts in nutrition. However, the media influences much of what they know and is not a reliable source. Taking a multivitamin is not a bad idea but they should be informed that it is not a substitute for eating in maintaining health.
Functions of nutrients
It is important for the patient to think of food as a source of nutrients and not just calories. Patients are benefited by knowing the effects of certain nutrients in the body, why they need them, and which foods those nutrients are found in.
Increasing variety of foods
People with EDs use all kinds of irrational reasons to eliminate foods from their diet. As a result, their diet may be reduced to only a handful or less of foods. It is unlikely that these few foods provide all the nutrients our bodies require. Introducing new foods not only increases nutritional status but it also gives them confidence in their ability to eat normally. Each new food makes the next one easier. Each success challenges the belief that there are “bad” foods.
Increasing zinc and protein
Patients with anorexia nervosa are usually in need of increasing all nutrients. Early in treatment, it is important to steer them especially towards zinc and protein. The appetite-suppressing effects of zinc deficiency act as a sustaining factor for the eating disorder. So restoring appropriate levels is necessary for recovery. A diet low in protein contributes to muscle wasting, reduced basal metabolic rate, and decreased mineral absorption.
Establish a regular eating schedule
People with bulimia nervosa typically have eating patterns that put them in a cycle of restricting and gorging. Because the main trigger for binging is hunger, it is important to get the patient on a regular eating schedule to avoid becoming overly hungry. Following a schedule will also help the person become more in touch and responsive to hunger and satiety cues. “Bad,” restricted foods tend to be those that trigger a binge. To reverse this behavior it is necessary to make all foods okay.
Caffeine and other fluids
These are sometimes used to provide energy or a sense of fullness. Reducing the amount of fluids taken in can help the patient become more aware and responsive to feelings of hunger and satiety. Also, drinking too much water can lead to or enhance electrolyte imbalances.
Prepare for triggering events
Disordered eating habits can be triggered by multiple factors. It is important for the patient to determine these events and learn more effective ways to deal with them. Because triggers can be both situational (like having dinner with family) and emotional (like feeling lonely), this is an aspect of nutrition therapy that can be addressed by both the dietitian and the psychotherapist. Being aware of and prepared for these events is the most effective way to avoid disordered eating behaviors.
What does healthy eating look like?
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