Working with an Eating Disorders Dietitian- Supporting you every step of the way.

Eating disorders are serious, complex and potentially life threatening mental illnesses. They are characterised by persistent disturbances in thoughts, feelings and behaviours related to food, eating, body image and sense of self. As dietitians who support individuals on this journey, we have seen firsthand how eating disorders can affect every aspect of an individual's life.

However, with timely treatment, including ongoing care and the support of a skilled multidisciplinary team, recovery is absolutely possible.

In Australia, over 1.1 million people are currently living with an eating disorder, yet fewer than one third receive the treatment and support they need. Contrary to common stereotypes, eating disorders don’t discriminate; they affect people of all ages, genders, body shapes and backgrounds.

Understanding Eating Disorders

Eating disorders present in different ways. There are several recognised types.

These include:

• Anorexia Nervosa (AN)

• Bulimia Nervosa (BN)

• Binge Eating Disorder (BED)

• Other Specified Feeding and Eating Disorder (OSFED)

• Pica

• Rumination Disorder

• Avoidant/Restrictive Food Intake Disorder (ARFID)

• Unspecified Feeding or Eating Disorder (UFED)

• Muscle Dysmorphia

• Orthorexia Nervosa (ON) proposed criteria

These conditions are not just about food. They are deeply rooted in emotional, psychological and often traumatic experiences. The signs may be subtle or hidden. Recovery involves addressing the whole person and understanding the function of the eating disorder, whilst developing and strengthening a sense of self outside of the illness.

The Dietitian’s Role in Eating Disorder Treatment

When someone is struggling with their relationship with food and their body, food can feel overwhelming, confusing or even frightening. It can be used as a tool to cope with difficult emotions, thoughts or challenging situations. As dietitians, our role goes far beyond prescribing meal plans. Our goal is to help make food feel safe again, rebuilding trust, knowledge and confidence around eating with the use of evidenced based treatment models, alongside a strong multidisciplinary team that supports both nutritional and psychological recovery. We use skills and work with you and all members of your healthcare team to establish functional coping strategies, liberating the need for strict control over food and your body.

Key responsibilities of a dietitian working in this space include:

• Early Identification & Screening: Individuals suffering from an eating disorder may not initially seek help directly for their eating concerns. In our experience, patients often present with other concerns such as gastrointestinal issues, weight concern or the need to follow medically prescribed but highly restrictive diets (such as IBS or low FODMAP). Others may come in with concerns about food intolerances, ethical or health driven dietary choices (such as veganism) or performance pressures related to weight sensitive sports like gymnastics or dance. Through gentle and curious conversations, dietitians are able to explore these patterns, thoughts, feelings around food and body that can uncover signs of disordered eating or eating disorders. By combining empathy, compassion and curiosity with validated screening tools, we can help identify disordered eating behaviours and refer to appropriate clinicians to continue to explore a formal diagnosis.
  

• Comprehensive Nutritional Assessment: As dietitians, we examine medical history, clinical symptoms, physical measurements, relevant blood tests, dietary intake and requirements, weight and weight history. We also explore eating behaviours, meal patterns, food rituals, beliefs about food and body, compensatory behaviours, early years nutrition, dieting history, social background and supports and personal goals. We will also help to manage physical symptoms, including low energy levels, gastrointestinal issues (such as constipation and bloating), changes in appetite and hunger/fullness cues that are common during recovery.

No two people are the same, so neither is our approach and we always ensure the patient is at the centre of our care.

Meal Planning and Practical Support:

• Personalised plans or food recommendations: Developing flexible, personalised meal plans or recommendations that meet the patients energy and nutrient needs while gradually exploring and challenging food fears and rigid rules.

  
  

• Shopping and meal preparation: Providing practical support and guidance on food procurement, preparation and portioning. This might involve exposure sessions to practice these skills such as visiting a supermarket or local cafe together, eating a challenging food or cooking a new meal together. We help you in real life.
  

• Challenging fear foods: Collaborating with the patient to systematically reintroduce foods that the patient has avoided or fears, helping to reduce anxiety and expand dietary variety.

  
  

• Nutrition Counselling & Psychoeducation: Through compassionate, trauma-informed, person centred care, dietitians help their patients understand their relationship with food, triggers, mood, health and wellbeing. We guide patients in re-establishing regular eating patterns, challenging food fears and myths, reconnecting with hunger and fullness cues and finding ways to eat that supports their recovery and sense of self. At OnCore Nutrition we are trained in CBT-E, FBT, DBT, ACT, Motivational Interviewing and are credentialed in eating disorder management. We acknowledge that it’s not always about the food and continually engage in professional development to provide the best possible care to our patients and their support network.
  

• Support Through Recovery and Relapse: It's important to understand that recovery for eating disorder patients is not always linear. Dietitians support patients by developing strategies for difficult periods and transitions by creating structured, individualised plans that anticipate challenges and reinforce progress.

A dietitian helps to heal the physical body from the effects of the eating disorder, while simultaneously working to heal the relationship with food and body in a practical, evidence-based and compassionate manner. We empower individuals to develop sustainable, flexible and nourishing eating habits that support their overall well-being and recovery.

Why Working Within a Multidisciplinary Team Matters:

One of the most important aspects of eating disorder treatment is the multidisciplinary team. No one clinician can support all aspects of recovery alone. Dietitians collaborate closely with GPs, psychologists, psychiatrists and paediatricians to provide integrated care.

Why Nutrition Matters in Recovery:

While therapeutic work addresses the emotional and cognitive aspects of eating disorders, dietitians are uniquely positioned to support the body’s recovery from the physiological impact of disordered eating. While one goal may be increasing nutrient intake, recovery is not just about eating more. It’s about what, when and how someone eats and how those patterns support their brain and body in recovery. We focus on:

• Nutrition timing and distribution

• Rebuilding metabolism

• Nutritional adequacy and meeting macro and micronutrient needs

• Nutritional variety, food diversity

• Supporting spontaneity, social eating, food enjoyment and freedom

• Supporting gastrointestinal function

• Supporting healthy eating behaviours for every unique body

• Establishing a respectful relationship with one’s body and food. Importantly, a ‘positive’ (aka cheerleader-type) relationship will not always be a meaningful goal, rather a neutral, respectful one.

By doing so, dietitians help restore not just physical health, but also the energy, vitality and mental clarity needed to fully engage in psychological treatment and get the most out of life.

Working with individuals experiencing eating disorders is one of the most rewarding and important parts of our role as a Dietitian. It requires compassion, patience and respect for each person’s individual experience.

If you or someone you know is struggling with an eating disorder, reaching out to a healthcare team that includes a dietitian can be a powerful and important first step towards recovery. At OnCore Nutrition we offer free discovery calls. Contact us on 03 9088 4252 or email enquiries@oncorenutrition.com if you’d like to learn more.