Why dietitians are an essential ingredient to treatment

Author: Megan Hellner, DrPH

Megan is Equip’s Nutrition Director.  She has been an eating disorder dietitian for nearly 20 years, working in all levels of care including inpatient, residential, day treatment (PHP), intensive outpatient (IOP), and outpatient private practice.

I have been a registered dietitian (RD), specializing in eating disorders, for nearly twenty years.  Like most dietitians, I initially worked in patient-focused settings, rarely meeting the parents or family members.  I loved the patients that I worked with, I loved my kind and thoughtful colleagues—but I didn’t love that the patients often struggled to find sustained recovery. For 10 years, I watched hundreds of patients experience initial success, only to relapse shortly after discharging to go home.  My colleagues and I were eager to include families in treatment—but we were not sure how.

In traditional treatment, parents often felt blamed for their child’s eating disorder and were routinely:

1. Excluded from conversations regarding treatment planning and goals  

2. Told that their involvement would make things worse, not better

3. Asked to support the recommendations of the team, from a distance

A decade into my career, I was introduced to Family Based Treatment (FBT) where services are family-centered, instead of patient-centered.  FBT provided a sound alternative to conventional treatment, as parents were armed with the skills and tools to help their child sustain recovery.  However, FBT as it was originally conceived, didn’t include dietitians as part of patient care. 

In FBT treatment, dietitians often felt dispensable and were routinely:

1. Excluded from conversations regarding treatment planning and goals  

2. Told that their involvement would make things worse, not better

3. Asked to support the recommendations of the team, from a distance

It may surprise you that Equip, whose foundation is built upon FBT, would then have a dietitian as their first clinical hire.  We joke that it’s because one of our co-founders cooks exclusively with a toaster-oven, but the truth is, Equip knows that dietitians are essential ingredients!

I have spent the past 10 years working as an FBT Dietitian, and I’m proud to lead the dietary team in bringing these essential dietary services to Equip families.

Nutrition Prescription

  • Equip Dietitians give families personalized Nutrition Prescriptions. For our patients on weight restoration, they may need 3k, 4k, or even 5k calories per day to gain 1# per week.  Dietitians know how to safely increase calories and guide patients towards health.

Recipes, Meal Plans, and Snack Menus

  • While feeding your child may be intuitive, feeding your child 2-3x what a normal child eats, is not.  Equip dietitians provide practical guidance including recipes, meal plans, and snack menus to help parents achieve the difficult task of feeding their child a high-calorie diet.

Nutrition Education

  • While many people with eating disorders may have memorized the caloric content of everything in a grocery store, they tend to lack proper, fact-based, nutritional knowledge.  Equip dietitians help patients and their families to differentiate between Diet Culture Pseudoscience and nutritional facts—helping the entire family to develop a healthy relationship with food.

Activity Prescription

  • Parents are often fearful that physical activity will slow recovery or result in relapse.  Adults in recovery report “not trusting their bodies” and being unsure of how to approach physical activity.  Equip dietitians celebrate the many benefits of sports and exercise and help patients and their family return to healthy activity.

Manage physiological side effects

  • Stomach pain, reflux, low hunger cues, gas, constipation—dietitians help to manage many of the physiological issues that can occur on the road to recovery.

Food variety and challenging fear foods

  • Eating disorders have often robbed patients of their favorite foods, and resulted in the elimination of entire food groups.  Dietitians know how to safely reintroduce foods and bring variety back into a family’s diet.

Preparing to launch

  • As teens recover from an eating disorder and prepare to leave their parents’ home for school and work, Equip dietitians give them real-world skills to independently feed themselves and stay in recovery.  

At Equip, dietitians are a critical component of our five-person care teams. Every patient/family gets their own dietitian, for unlimited sessions and between-session messaging, to help them on their journey to full health.  Dietitians stay with you, long after you’ve reached your treatment goals, to continue to help you as you go through life transitions—returning to sports, going away to college, or studying abroad!  Equip dietitians are an essential ingredient to sustained recovery.