Of all the clients I work with regarding disordered eating, I probably see the most uncertainty about whether or not to seek help from those with anorexia nervosa. It’s pretty easy to see why – almost by definition, those with anorexia nervosa are in two minds about whether or not they want to change. Without exception, my clients can see that the anorexia has taken over their life, and used up all the space in their mind… but they also feel that it does good things for them somehow. Perhaps it gives a sense of control. Perhaps they feel like they are less happy when they don’t “follow the ED rules”.
The key thing is, there’s always things they’re worried about losing by seeking help, especially if they’ve never done so before. Everyone needs to judge the importance of these things up for themselves, so here’s my list of 5 things to consider when deciding if you want to seek help from a dietitian:
You cannot gain weight simply by talking to a dietitian. You cannot lose control simply by talking to a dietitian.
I can’t talk for all other dietitians, particularly those who work in hospitals where they often have protocols they have to follow regarding food intake. That said, I consider that my job is to help you identify whether or not you might see a benefit to changing your relationship with food. For every different client that walks through my door, I work alongside them to identify what they do and don’t want to change, and that’s my starting point. Just remember: if you change nothing, then nothing changes.
You can’t talk your way out of having an eating disorder.
Many have tried. Many people have tried reading endless self-help books, googling it, perhaps even discussing things with a therapist at a “talking” level. All those things can indeed be very helpful in getting people to understand their eating disorder. But are they enough to achieve recovery by themselves? Almost certainly not. The truth is: if you want to recover from an eating disorder you must make changes to how you eat. Otherwise the eating disorder has control. You have to start somewhere with those changes, gently at first, but you have to make a start sometime.
Who else can do the job wedging cracks in the tight net of eating disorder rules and rituals around food?
The internet? (Not a good idea!) Your friends? Family? It’s tricky, because many people have absorbed populist ideas about food which may not necessarily be balanced, well-advised nutritional advice. They might trigger eating disordered thoughts to get worse. Plus, they may not feel comfortable being put into a place where they are supposed to contain a powerful, sometimes angry eating disorder. And why would they know more about food than you anyway? I’ve been doing this gig for 7 years now and I’m putting it out there that I know more about how to eat for true wellness than your eating disorder does. Bring it, “ED”.
You can stabilise your basic health.
Has your doctor been worried about unstable blood test results? Are you being pressured by your doctor or family into having regular blood tests and medical monitoring? If so, there’s a good reason that would be happening, but what often gets missed in the frantic testing and coping, is that taking extra vitamin supplements will help in the short term only. To stabilise long-term, you need to actually eat the right amount and balance of foods so your body isn’t in a constant state of flux. It might be a slow process of gradually challenging small food fears, but do you really want to stay in this limbo of constant medical monitoring for the next year? Again, change has to start somewhere.
What if it helps?
What if this actually helps you recover. For good. What if, with therapy (by a qualified psychologist or psychiatrist) and small meal changes over time, you gradually reach a place where you are free of the rigid daily control your eating disorder exerts over you? How would your life change if you could reach that place? How would your career opportunities change? Could you finally commit to finishing uni? What about your relationships? Maybe the arguments with your family would stop. Maybe you’d be able to prioritise romantic relationships and future possibilities that had been ruled out before because you didn’t have enough of yourself left to share with someone else. Could you go travelling? Catch up with friends instead of making excuses? Engage with life?
Instead of worrying about what might go wrong, have a think about what if it goes well!
So there you are. My 5 reasons to see an eating disorders dietitian which you can add in next time you’re thinking of pros and cons as to whether or not you want to get help for your eating disorder. It’s definitely worth having a think about.
Article by Claire Marnane, Eating Disorders Dietitian
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