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Nutrition counseling in the treatment of eating disorders

Nutrition counseling, also referred to as nutritional counseling, food counseling, or nutrition therapy, is a form of eating disorder treatment that is part of a comprehensive, multidisciplinary treatment plan. It's conducted by a registered dietitian/nutritionist who specializes in treating eating disorders.

Nutrition counseling for eating disorders focus on the whole person. It includes addressing and repairing any issues caused by malnutrition, as well as helping someone work on issues tied to body image, emotional dysregulation, and their fears or anxieties around food.8

Together with medical interventions, talking therapies, family therapy, and other treatment methods, nutritional counseling can help someone achieve positive outcomes in recovery by giving them important knowledge about food, metabolism, physiology, and hunger/fullness cues, helping them make lasting dietary changes that promote overall well-being.1

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7
 minute read
Last updated on 
November 2, 2023
June 3, 2024
Nutrition counseling for eating disorder treatment
In this article

What is nutrition counseling?

Nutrition counseling is an essential aspect of a multidisciplinary treatment approach to eating disorders, with nutrition counselors being the food and nutrition expert who can help people rebuild food and body trust.7

During nutritional counseling, an individual’s specific needs will be taken into account, including any unique fears and food attitudes they may have, as well as their medical history and any co-occurring mental health disorders. The dietitian/nutritionist will offer emotional support, as well as providing correct nutrition education and addressing nutrition misinformation and eating disorder beliefs.

The eating disorder dietitian may also discuss someone's individualized nutrient needs, for example, changes in vitamin and mineral requirements for someone of a specific age, body type, and gender. Generally, the conversations focus on adequate nourishment to support recovery. 

Finally, the eating disorder dietitian may help patients learn how to recognize the cues of hunger and satiety (absence of hunger), as well as how metabolism works, to help them better understand their own body and needs.

nutrition counseling definition graphic

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How to treat eating disorders with nutrition counseling

Nutrition therapy is usually done in conjunction with other forms of counseling, including cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). This helps round out an individuals' healing experience, not only helping them relearn how to eat adequately, but helping them understand why they might engage in harmful eating behaviors, and giving them tools to change these behaviors.

Aside from the unique care that each individual needs, the goals of nutrition therapy can sometimes be dictated by the specificity of struggle.3

Treating anorexia nervosa (AN)
Treating bulimia nervosa (BN)
Treating binge eating disorder (BED)
two people in a kitchen talking

What to expect in nutrition counseling

Eating disorder dietitians/nutritionists work closely with each individual, listening to concerns and providing support when facing new challenges and food fears.

The nutritionist will create a personalized plan to help individuals learn:4
  • What foods and drinks are needed to consume to maintain good overall health
  • How the body uses nutrients and why they are important
  • How to identify and prepare snacks and meals that support recovery goals
  • How to recognize food fears, and how to overcome them
  • The connection between thoughts, feelings/emotions, and eating behaviors

Nutrition counseling generally occurs alongside other eating disorder treatments, such as CBT and DBT, though meetings with a dietitian/nutritionist can be separate occasions from those therapy sessions.

Nutritional counseling also usually happens along every level of care for eating disorders, from residential treatment to partial hospitalization programs and outpatient care.1 The role of the dietitian/nutritionist may change over that time, switching from a more intensive focus on malnutrition at the start of treatment to a more supportive role as recovery progresses, helping restore healthier body image and relationships with food.4,8

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How to make an appointment with a nutritionist

Most of the time, you can make an appointment with a nutritionist simply by contacting their office. They'll likely ask you typical intake questions, including your name, address, and health insurance information.

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Benefits of nutrition counseling as eating disorder treatment

There are several benefits of nutritional counseling. Some of them include:

  • Improved digestion and gut health: Nutrition counseling can result in improved digestion and nutrient absorption in patients with eating disorders by promoting adequate, consistent nutrition intake. Getting sufficient nutrients has shown to be a crucial aspect of improving overall gut health.9
  • Reduced fatigue and increased energy levels: Addressing nutrient deficiencies,, sometimes seen in patients with eating disorders can help reduce feelings of chronic tiredness.2 Plus, fueling adequately can increase energy levels due to the stabilization of blood sugar levels. 
  • Lasting recovery-focused habits: The dietitian teaches skills and tools to last for the long term. With a solid knowledge of how to challenge negative food thoughts and behaviors, individuals can prevent lapses and support their long-term recovery.
benefits of nutrition counseling graphic

Efficacy of nutrition counseling in healing eating disorders

When treating eating disorders, nutrition therapy is an important tool to help patients relearn eating skills and build trust in their body. 

Intensive nutrition therapy, along with sufficient energy intake, can result in physical and emotional stabilization, specifically, reduced food-related anxiety in people with anorexia nervosa (AN).5

A combination of nutritional counseling for eating disorders and cognitive therapy have been shown to result in significant decreases in binge-purge behaviors, as well as an increase in self-control and improvement in dysfunctional attitudes in people with bulimia nervosa (BN).6

man at nutrition store

Nutritional counseling at Within Health

In traditional treatment programs, nutrition counseling will only involve meal planning for the week. At Within Health, we offer meal and snack support/coaching, meal delivery, as well as in weekly nutrition groups.

Our dietitians/nutritionists also work with patients to learn more about their food beliefs, and help them correct any misconceptions or debunk any myths they may perceive as truth.

Learn about remote treatment

If you would like to learn more about what nutritional counseling Within Health offers, or are interested in starting treatment at our virtual care program, you can get in touch with our clinical care team now.

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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Reiter, C. S., Graves, L. (2010, April 25). Nutrition therapy for eating disorders. Nutr Clin Pract, 2, 122-36. 
  2. Pfnür, I. A. H. (2022). Vitamin B12 Deficiency as the Cause. Deutsches Arzteblatt International, 119(12), 216.
  3. An introduction to nutritional therapy. (2018, February 21). National Eating Disorders Association. Accessed August 2023.
  4. Nikolic, M., Pavlovic, M., Vojinovic, M. M. (2009). Medical Nutrition Therapy in Management of Eating Disorders. Acta Medica Medianae, 48, 50-55.
  5. Pettersson, C., Tubic, B., Svedlund, A., Magnusson, P., Ellegård, L., Swolin-Eide, D., Bertéus Forslund, H. (2016). Description of an intensive nutrition therapy in hospitalized adolescents with anorexia nervosa. Eating Behaviors, 21, 172-178
  6. Hsu, L., Rand, W., Sullivan, S., Liu, D., Mulliken, B., McDonagh, B., & Kaye, W. (2001). Cognitive therapy, nutritional therapy and their combination in the treatment of bulimia nervosa. Psychological Medicine, 31(5), 871-879. 
  7. Ozier, A. D, Henry, B. W. (2011, August). American Dietetic Association. Position of the American Dietetic Association: nutrition intervention in the treatment of eating disorders. Journal of the American Dietetic Association, 111(8), 1236-41.
  8. Kwak, K. Nutrition Therapy for Eating Disorder Recovery. (2022, April 4). Kristin Kwak: Nutrition Therapist. Accessed August 2023. 
  9. Kim, S. E. (2019). Importance of nutritional therapy in the management of intestinal diseases: beyond energy and nutrient supply. Intestinal Research, 17(4), 443–454.

FAQs

Can a nutritionist help with eating disorders?

Yes. Dietitians/nutritionists often play a pivotal role in eating disorder treatment, helping with everything from identifying and correcting any issues related to malnutrition to helping with  emotional and mental aspects of eating disorders, such as negative body image and harmful beliefs about food.7

Do nutritionists take insurance?

This answer depends on a number of specific details, including your health insurance company and if your nutritionist works with them. Often, dietitians do accept insurance, or they may work for larger health groups that accept insurance. But before you begin working with someone, it's best to call ahead and make sure they will accept your health insurance plan.

Do I need a referral for a nutritionist?

Again, this answer depends on your health insurance and dietitian/nutritionist. Usually, you can pursue nutrition counseling without a referral, but in some cases or practices, referrals may be necessary. It's best to reach out directly to the dietitian/nutritionist you're interested in working with or your primary care physician for more information. 

How much does it cost to meet with a nutritionist?

Costs for nutritional therapy vary dramatically based on the clinician or clinical group involved and any health insurance coverage you may have. Out-of-pocket costs may be $100 or more per session, but that can be much lower, or even free, with different insurance plans. Call ahead with your insurance company or dietitian/nutritionist for more information.

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Further reading

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