Dietetics and eating disorder recovery

For #DietitiansWeek this year, Orri’s senior clinicians came together to discuss how to heal our relationship to food in recovery. Here’s a recap of what was discussed.

Kerrie, Orri’s CEO and founder, introduced the topic of food by explaining how it takes on a different role depending upon how the individual is relating to their eating disorder: how their eating disorder is presenting in their life, and where they are in their recovery.

It is important to keep in mind that this means recovery goals, time and outcome will completely differ from person to person. An individual’s complexity around food can vary also, depending on how they have been raised around mealtimes or food, and how communication is held around this.

“It’s all about the food, and still not about the food. It’s that dichotomy and dilemma that we’re having to hold and understand.”

Maxine, Service Director, highlighted the importance of recognising that our relationship with food is not static.

Our relationship to food can change from day-to-day and depends upon many factors, such as the client’s headspace, the environment, the approach that’s being taken, and the emotional experience. If a client is experiencing a challenging day whilst attending a meal or snack, we offer the supportive space to listen to them and to explore any feelings that may arise.

“There are times when we need to step in and support, and other times when we give more autonomy and independence. It takes bravery to call it out and say what we see.”

Having autonomy is integral to our clients, as we see that recovery is their journey and not ours.

This very much links with the guidance Paula, Senior Dietitian, provides her clients from a dietetics perspective.

Paula works with transparency around food, where, rather than mirroring the restrictions that an eating disorder can impose, she and her clients work together on how to structure a day with regular meals and snacks. Planning our days with a mindful food plan can help us to develop hunger, satiety, or reduce any chaotic urges around eating and food.

“We need to separate ‘rules’ from ‘structure’.”

Paula and Ben, Orri’s Chef, work closely together in the kitchen to create the daily menu. Our kitchen is open-plan, meaning that there are no secrets. Clients are able to watch Ben prepare the food and can be involved in their food choices.

Ben does not cook with measurements, scales or calories in mind, but instead with variety. The food at Orri is presented with different colours, tastes and textures, so our clients can enjoy and challenge themselves with any fears related to food.

“It’s about striking a balance with food that clients feel is safe and accessible, and at the same time challenging certain elements of their eating disorder. At the end of the day, that’s why they are here, at Orri.”

We mentioned the impact environment can have on an individual with food in recovery. Sitting down to eat can be a tense time – for all involved – so we aim to create a relaxing atmosphere that shifts some of the focus away from the food. At home, you can do this by playing music or by opening conversation where it is appropriate.

Allowing our clients to just be who they are at the table is our goal, and we hope they can take this back home to their families and loved ones.

Orri’s approach to recovery with food

We do dietetics a little differently at Orri. We do not to talk about calories, nor do we lay down rules.

People with eating disorders already have a lot of rules. Rather than replace their rules with another set, Paula prefers to start working with clients from where they are, taking gradual steps forward at mealtimes.

If she notices someone struggling, Paula or one of our specialist team members will step in and help them make changes that support their recovery.

“That’s what treating an eating disorder is all about—it’s making changes which are going to be sustainable.”

Our specialist team work collaboratively alongside our clients, holding their recovery goals and needs at the forefront of the work.

Our approach is to understand the role of the relationship with food in an individual’s life, and to work with clients through gradually paced and compassionate interventions that help them to come out the other side.

Paula always asks clients at their first meeting, “where are we going to start?” One of the fundamentals in reintroducing a relationship with food is building a trusting therapeutic relationship with the team involved. You can more about our flexible “stepped” approach in eating disorder treatment here.

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