This might be the question I get asked most often on my Connection Calls.
When someone books a call with me, there is frequently a quiet assumption that gets brought into our conversation. It usually sounds something like: “So you’re going to hand me a meal plan and tell me exactly what to eat, right?” Sometimes it comes with a little dread. Sometimes with relief. And always, it is not the full picture of the work we can do together.
Because while a nutrition plan is absolutely part of what I do, a structured meal plan is just the tip of the iceberg. So let’s talk about what an eating disorder dietitian actually does, and why so much of the real work happens far beyond a meal plan.
Where does the “it’s just meal plans” idea come from?
Many of the people I meet have had previous encounters with dietitians and other providers inside eating disorder programs that run through our public health system. Now I truly believe those dietitians are doing the very best they can. However, the reality is that they often carry enormous caseloads and have very limited time with each person they care for.
So for a lot of people, meeting with a dietitian has looked like this: you come in every couple of weeks, or maybe once a month. You review your intake. Your dietitian adjusts a few recommendations to support your recovery. And then the appointment is over. It is efficient and well-intentioned, but there simply is not room for much more.
When that has been your only experience, it makes complete sense to assume that is all a dietitian does. I get to work a little differently, and it is one of my favourite things about private practice.
So… do you actually give meal plans?
Yes, sometimes I do. There can absolutely be a time and place where the structured guidance of a meal plan is warranted in eating disorder treatment.
But my meal plans are not one-size-fits-all. They are never a rigid prescription handed down from on high. They are built collaboratively, with you, designed to meet you exactly where you are and land in that sweet spot that is challenging yet doable. The goal is always to gently move you forward in your recovery, not to hand you one more set of food rules to feel like you are failing.
Often, instead of leading with a meal plan, I love to first walk clients through my recovery roadmap. It is a framework I use to help make the winding path of recovery feel a little clearer and more manageable, and to support clients to see where they are and form treatment goals that get them where they want to go!
If you would like a peek at how I think about this, you can download the first three steps of my recovery roadmap here. It is a free guide and a lovely place to start.
What an eating disorder dietitian actually does
I sometimes tell clients, a little tongue in cheek, that I am the “food and feelings” dietitian. That nickname captures it well, because we spend so much of our time on everything wrapped around the food, not just the food itself.
When we work together, I want to understand the whole picture. Yes, I want to know what your intake looks like. But I also want to know your grocery shopping rhythms, whether you do any meal planning, your history and relationship with food, how your family viewed food growing up, and how your eating disorder has shaped the way you see food and your body. All of those threads matter, and we get to explore them together.
Because we have more time and space in our sessions, we can actually do the deeper work, which often includes:
- Challenging food rules and fear foods, frequently by building a practical, personalized “food ladder” and working our way up it, one challenge at a time.
- Doing nervous system work and building coping skills for anxiety around eating, sometimes weaving in skills from modalities like DBT to support you through tough moments at mealtimes.
- Digging into what is happening in your gut and building a digestive support toolkit, because GI distress is so common in recovery and deserves real attention.
- Beginning to explore the deeply intertwined relationship between food and body image.
- Untangling the roots of diet culture that have been keeping you stuck.
- Providing psychoeducation about nutrition and how food actually impacts your body and your brain.
We might even do meal support together, right there in session. That could look like sharing a meal virtually, or meeting up for one of my outdoor meal support sessions, where we gather at a coffee shop or a park and challenge a food side by side. There is something powerful about not having to face the scary stuff alone.
What does working together actually look like over time?
Eating disorder recovery is rarely a quick, linear process. It is a winding road with plenty of ups and downs, so I tend to work with clients over longer stretches of time.
Generally, I am working with someone for a minimum of about three months. It usually takes a good three or four sessions just to build a strong foundation of trust, the kind of relationship where we can start to really peel back the layers. Once that foundation is there, we can begin to have some of the harder, stickier conversations, like how to gently release your grip on the eating disorder and start building a life apart from it.
The season of recovery you are in shapes our work, too. Sometimes I am supporting someone as they step down from a higher level of care, helping them reconnect to life at home and navigate the triggers that surface once they are back in their community. Other times I am helping someone prepare to step up into a higher level of care, building up their nutrition rehabilitation so they are as supported as possible for the intense work ahead. And sometimes I have the honour of walking with a client across many different levels of care, over the course of years.
Why a team-based approach matters
I always prefer to work within a team, because each of us brings a unique lens and role to eating disorder treatment.
I work very collaboratively with therapists and physicians, and with family members too, especially through my eating disorder parent coaching service. We can approach similar things from slightly different angles, which provides so much benefit for the individual – it’s true collaborative care.
It is also important to me to be honest about the limits of my scope. There are things that are explicitly not in my lane. I do not advise on medication adjustments or prescribing, for example. That belongs with your physician, and I defer to them while staying in close collaboration.
Because so much of my work touches our relationship with food and body image, it sometimes overlaps with the work my therapist colleagues are doing. When a conversation reaches a place where I want to make sure you are truly held and supported, I will gently say something like, “This sounds like a wonderful thread to keep pulling with your therapist. Would you be okay if I help support that hand-off?” Knowing where my role ends and a teammate’s begins is part of taking good care of you.
Do I need a diagnosis to work with an eating disorder dietitian?
No, you do not.
I support individuals with clinically diagnosed eating disorders, and I also support people all across the disordered eating spectrum. You do not need a diagnosis to find help here. You are worthy of care and support exactly as you are!
So many people who have been chronically dieting or quietly struggling have never once called it an eating disorder, even when their experience closely mirrors one. If that is you, please know there is absolutely space for you here too.
Why I do this work
Honestly, I love this work because I get to go so far beyond prescribing a meal plan.
Part of why I love being a dietitian is that I get to deeply know the humans who sit across from me in session. I get to see you as a whole person, not just your eating disorder. And it is precisely that kind of knowing that lets us align your recovery goals with what genuinely matters to you and where you want to go in your life.
That is the heart of it. Not rules on a page, but a real relationship in service of a bigger, freer life.
Curious whether working together might be a good fit?
If any of this resonates, I would love to connect. As a non-diet, weight-inclusive Registered Dietitian, I support clients healing from eating disorders and poor relationships to food across the disordered eating spectrum. I work virtually with clients throughout Alberta and British Columbia, with in-person sessions here in Calgary.
You can book a free Connection Call with me anytime. Think of it as a no-pressure conversation about where you are and where you would like to go, and whether working together feels right.
And if you would like a head start, you can always grab the first three steps of my recovery roadmap here.
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