Understanding Our Nutrition Philosophy

Deborah Hinds, DTR

Michelle Berger, RD/LD

Castlewood Treatment Center

Our focus today Castlewood’s philosophy Our role as a Nutritionist / Dietitian Food rituals, trauma foods, fear foods Nutrition therapy Exercise philosophy Life after residential treatment

Castlewood’s philosophy Stop eating disorder behaviors Understand how it got to this point Work on internal core belief system Facilitate autonomy around eating

Our role as a Nutritionist / Dietitian Gaining the client’s trust Understanding the client as a whole

Therapy Nutrition intake Body image

Our Goal as a Nutritionist / Dietitian To manage the clients food and fluid intake Gradually work with client to increase

autonomy Teach mindful and respectful eating Work to understand hunger and fullness

The keys to meeting our goals Connect the dots Process along the way Decrease shame Aid in compassion

Anorexia, Bulimia, and Binge Eating Disorder

• Stabilize eating with consistent meals and snacks

• Increase variety of foods

• Look at how they “use” food

• Address all food rituals

• Get to a stabilization weight and gradually increase autonomy

Food Rituals Work to eliminate from beginning Understand the function Facilitate client desired change Polarized food rituals Vary differences depending on diagnosis

What underlies food rituals? Fear of not getting enough Fear of getting too much Never enough and always too much

Trauma foods Not encouraged until therapist indicates

and/or trauma has been processed Work gradually to decrease association

between food and trauma Continue processing with client during and

after eating Encourage client to be patient

Eating disorder fear foods Introduce from beginning Consistently increase variety Help them maintain variety as autonomy

increases

Fluids Restriction Fluid loading Understand what’s behind the behavior

Realistic Structure Artificial Sweeteners Soda Caffeine

Nutrition Therapy

Process vs. Content

Deprivation and… Self hate Control Numbness

Knowing Self Fears Strengths and weaknesses Deepest desires Foods place in your life

Respecting your body Listen Acknowledge Consistancy Support

Our exercise philosophy Very individualized Learning moderation and re-learning what

it feels like to enjoy exercise A privilege – the food comes first The mind, body connection

Pilates / Yoga

Life after residential treatment Stepdown Intensive Outpatient Program (IOP)

Stepdown Learning life skills with support

Meal planning Preparing and cooking food Grocery shopping Meal outings / challenges Using peers for support

Maintaining “stabilization weight”

Intensive Outpatient Applying life skills

Meal planning with support Preparing and cooking food independently Grocery shopping independently

Continuing to challenge fear foods, trauma foods, food rituals

Continuing to maintain “stabilization weight”

Recovery process An ongoing process Constant challenging of fear foods, trauma

foods, food rituals Maintaining “stabilization weight” Utilize support from others

Eliminating the “I can do this myself” mentality

Questions?