Understanding Our Nutrition Philosophy

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Understanding Our Nutrition Philosophy

• Deborah Hinds, DTR
• Michelle Berger, RD/LD
• Castlewood Treatment Center

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Our focus today

• Castlewoods philosophy
• Our role as a Nutritionist / Dietitian
• Food rituals, trauma foods, fear foods
• Nutrition therapy
• Exercise philosophy
• Life after residential treatment

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Castlewoods philosophy

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

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Our role as a Nutritionist / Dietitian

• Gaining the clients trust
• Understanding the client as a whole
• Therapy
• Nutrition intake
• Body image

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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

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The keys to meeting our goals

• Connect the dots
• Process along the way
• Decrease shame
• Aid in compassion

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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

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Food Rituals

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

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What underlies food rituals?

• Fear of not getting enough
• Fear of getting too much
• Never enough and always too much

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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

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Eating disorder fear foods

• Introduce from beginning
• Consistently increase variety
• Help them maintain variety as autonomy increases

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Fluids

• Restriction
• Fluid loading
• Understand whats behind the behavior

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Realistic Structure

• Artificial Sweeteners
• Soda
• Caffeine

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Nutrition Therapy

• Process vs. Content

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Deprivation and

• Self hate
• Control
• Numbness

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Knowing Self

• Fears
• Strengths and weaknesses
• Deepest desires
• Foods place in your life

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Respecting your body

• Listen
• Acknowledge
• Consistancy
• Support

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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

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Life after residential treatment

• Stepdown
• Intensive Outpatient Program (IOP)

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Stepdown

• Learning life skills with support
• Meal planning
• Preparing and cooking food
• Grocery shopping
• Meal outings / challenges
• Using peers for support
• Maintaining stabilization weight

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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

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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

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Questions?