As we begin and continue our work together, you’ll start to notice some themes in my approach to nutrition counseling:
I will not give you a diet. We aren't going to count anything - no macros, no calories, no points. There will be no food rules. Food beliefs will be explored and dismantled. Our work together will be to find freedom and peace surrounding food choices. You won't hear me talk about eliminating a food or food group. You won't hear me talk about food being healthy/unhealthy or good/bad. More often than not, we are working to add food back into your day. You will learn how to find your internal compass when it comes to taste preference, hunger, fullness.
Do those two words make your heart sing or fill your stomach with lead? Depending on your definition; it could go either way. In my eyes a meal plan is this: a plan for your meals, a vague idea about what you will eat for the week and it helps to define your grocery list. A meal plan is not a hard and fast, rule bound contract that you must follow. A meal plan in my eyes is not a set number of calories or exchanges.
A meal plan is something that YOU will be doing most of the work to create. Only you know what your taste preferences are. Only you know what your trauma foods are. Only you know what your eating disorder rules are. With my guidance, you will slowly be coming up with a plan for meals and snacks that makes sense to you, your work schedule, your family life, your recovery. I have been in this world long enough to know that when I make the meal plan, it is rarely followed. It feels like step-brother of a diet. It can feel very shame based if you don't follow it during the week. It is setting you up, and I don't want any part of setting you up for a failure.
***Now if you have been in treatment or you need weight restoration, this is a whole other story, you might need to be more 'rigid' with eating in the beginning of our work together.
I will not only explore what is happening with food in your life, I will also explore the why. Why are you eating the way you are eating? Why are your behaviors part of your life? You developed disordered eating or eating disorder behaviors not to be malicious towards yourself. More often than now behaviors started as a coping mechanism to help you get through a time in your life. The behaviors where helpful...till they weren't. Knowing the why will help us on our path towards your eating recovery. Your “why” may be have started because of any of the below reasons or any reasons not listed:
I firmly believe that we cannot merely work on actions around food, but also the reasons why food and eating behaviors helped you during difficult times. The combination of this work and working with a therapist will help us to find a path towards food freedom.
Note: I partner with some trusted therapists and psychiatrists. If you need additional emotional/mental health support during this journey, I have listed some providers that hold in high regard and trust to give unparalleled guidance to my clients.
Lisa Panicola, LPC
Denise Stoesz, MA, LPC
Darby McBride, MA, LPC, NCC, CYT-200
Erin Grumley MA, LPC
I am a dietitian that practices Health at Every Size® (HAES), which means that I align with the principles of the HAES® approach that promote balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes. For more information about my use and belief about HAES, check out my post here.
I work with my clients from an Intuitive Eating approach. For more information on Intuitive Eating, check out the 10 Principles of Intuitive Eating here. I am also a Certified Intuitive Eating Counselor, which means I have been trained and certified by the founders of Intuitive Eating to use the Intuitive Eating principles to help people find peace with food and create a healthy relationship with their mind and body again. I am the only dietitian in Missouri to hold the credentials of certified eating disorder registered dietitian AND Intuitive Eating counselor.
There are providers who prescribe Intuitive Eating and/or HAES approach to some clients, but diets to others. I am not one of those providers. I won’t compromise my values from client-to-client. When you come to me, you can trust that I will be treating you and all of my clients with the same set of ideals.
When looking for a dietitian to walk beside you on your journey you have a few in the St Louis area to choose from. While it may seems odd to market my 'competition' to you I want you to know this is a purposeful decision. While the following list of uber-qualified dietitians knows all the same "things" about nutrition recovery we have wildly different personalities, strengths and specialty areas. I have referred to all of these fine folk and they have referred to me.
In no particular order:
Finding the right fit for you is crucial for recovery. You might start with one person and need to change at some point. This happens. Don't worry if you need to 'fire' your dietitian, I promise she has been there before. Have the conversation, don't just ghost her. One of the amazing things is that a good, caring dietitian will WANT to have this conversation. She will be able to model appropriate reactions to you setting up boundaries for yourself.
But, when you find yourself a caring, ED nutrition savvy, ED busting RD...listen to her. She might literally be your lifesaver.
My first session with you is all about us getting to know each other. I want to learn about who you are--what your home life is like, what you like and dislike, what brings you to me, and so on. I’ll be listening, connecting and learning about you.
You might not walk away with actionable steps after this first session, that is by design. The purpose of our first meeting is for you to get to know me. It is a time for you to determine if I have what you want. If my ideas, thoughts, concepts about food, diets and weight is something you want to learn more about.
One of the most important actions you can take after you leave treatment for an eating disorder is to set yourself up for success. This includes finding a Certified Eating Disorder Registered Dietitian to support your continued recovery. I offer a comfortable and safe place to maintain your meal plan. If you come to me with a meal plan from a treatment facility, our work will start by following that meal plan. Eventually, our work will transition towards a less rigid plan, with the ultimate goal of working on Intuitive Eating. I will be in touch with the dietitian you had in treatment if you allow me to talk with her.
So much work can be done by talking through eating problems in meetings. But, at some point, you will want to put your new tools to the tests. If you are struggling with stressful food shopping or restaurant outings, the off-site sessions with Sarah might be what you need.
Shopping for food can feel overwhelming when you are recovering from disordered eating. I offer grocery store tours aimed at helping her clients feel comfortable walking through the store again.
The week prior to the tour, your session with me will look a little different. We will be preparing a “game plan” for the tour. This is different from client-to-client, because struggling at a grocery store looks different from client-to-client. Some people want to work on making grocery store trips shorter, others want to work on not checking food labels, and still others have unique struggles that they want to work on.
The day of the tour, we will meet at the store and have a quick mental and emotional check-in. Once we go inside, the experience begins. I will be with you, walking you through what a “normal” grocery store experience would be like. Afterwards, we debrief any feelings or thoughts that arose.
The goal of this process is to find peace around a common life experience: buying groceries.
Struggling with an eating disorder or disordered eating means that going to restaurants may also be stressful. I offer restaurant outings to give support to clients in real time when at a restaurant.
Restaurant outings involve similar planning to the restaurant tours. The session prior to the outing, we will plan where to go, what you want to work on, and what you want the experience to look and feel like. For example, if you have business lunches often, we might work on eating at a similar style restaurant so that you can build skills for those meetings. Every client's needs are different and I cater to all of those diverse needs.
Similar to the grocery store tour, we will meet briefly before going inside the restaurant to check-in. Throughout the outing, we will be dining in a "regular" fashion to help you become immersed in the experience. Afterwards, we process the experience in a supportive and reflective way. The goal of this exposure is to learn how to begin entering restaurants again without disordered eating behaviors.