1st Appointment with a Dietitian - Eating Disorder Video #46

http://www.katimorton.com
This week's video has to do with demystifying the dietitian and what that first appointment with them would look like. Just like making an appointment with a therapist you have to give us a call and make sure that you are comfortable seeing us. If you like the way that they sound on the phone and you get a good feel for them, than you can set up a time. If not just let them know that you will contact them if you are ready to set up an appointment. Once you get to that appointment, the dietitian will be looking to gather some history about your relationship with food, treatment history, any health issues, behaviors with food, when they started, etc. Their focus is food and how we act around it, and although there will be times when it feels like they are just focusing on the small things, it is all of those small items that add up to recovery.
Every week when you see them they will check in with you and see how everything went with the food and what you were able to do and not do. That is why it is so important that we are honest with our dietitian. If we give her false information, than she could be going round and round with us thinking that certain things are not a problem, and therefore not really being helpful to us. So just do your best to be honest, tell her about your struggles and things that you simply couldn't do. Then we have more information that we can take back and come up with a new and better plan for you.
If you see your first dietitian in an inpatient or residential clinic than it will look very similar, but most of the history and health questions will have already been gathered by other treatment team members. Also, we tend to move a little bit faster while in residential or inpatient because there is 24 hour support available and we are having process groups every day. Having all of that extra support and supervision allows us to meet goals and work through the tough situations more quickly. I hope that this video helps demystify what it will look like to make an appointment with a dietitian and in turn help us keep moving towards a Healthy Mind and a Healthy Body.

welcome back everyone and thanks for tuning in

now i know ;ast week i talked a little bit with kate machado

she's a registered dietician

and i know i told you guys i was gonna sit down with her

and i know it seems like it's been forever

but we finally got our schedules to work.

today's topic is just kind of demystifying what it means to go see a dietitian

i know many of you are scared to call a therapist and are scared to see our doctor

even makign an appointment can send us into a frenzy

so we want to picture that we feel okay

and we know what to expect because a lot of time we're getting anxious

because of the unknown, it's scary when we don't know

so i guess my question for kate today is

just tell us a little bit about what the first session will look like

obviously there's a lot of different ways

but i think the first thing to think about it how to find a deitian that specialices

in eating disorder in your area or in the area that your eating disorder is in

because the ore specific the better

but it just really depends on the individual

so like you were saying it is really...

anything new can be anxiety provoking

so looking for a dietian...well how do you judge?

you base them on their name, on their location

on the picture you see on the internet

none of that is going to be a good indicator

the best way to find a dietician is through a referral

whether you're seeing a therapist who can reger you to one that they work closely with

or a doctor can refer

there are a lot of really good websites out there

kati probably has this on her references page

that you can look for to refer to specialists in eating disorders

and then make a phone call to see if you can have a good phone call

if you don't feel comfortable, you're interviewing them first

if you don't like the way it's going say

"well thank you, i don't want to make a time"

if you do want to go forward and make a first appointment

just set that up and the first appointment

and right now i'm kind of talking about outpatient basis first

and then i'll get to an inpatient basis

so if you want to make an appointment outpatient

the first appointment is usually between 1 and 1 and a half hours

and that will generally cover everything

from the history of your eating disorder,

how long you've had it

what kind of treatment you might of had in the past

what behvaviors you are currently dealing with

what you've did in the past

it will definitely include a lot about food and possibly your weight

and the history of maybe your physical changes

or any kind of medical conditions you've had

so that's usually as i found the most fear inducing part

for a lot of new clients that come in

because it's really personal to tell this stuff to someone you don't know

especially since often eating disorders are kind of kept private

kept secret, so then telling someone that you're not that comfortable with

all of your secrets

and then i know there's a really big fear of being honest

because what if we are judgemental, what if we come across as

"oh my gosh, that is so disgusting"

"i can't believe you've done that"

and any good dietian i know that works with eating disorders

has no judgement when dealing with clients or treating clients

there is probably nothing we haven't heard before

not just that we haven't heard before

but it's part of the eating disorder

and everbody's different and is going to experience behaviors differently

and most imporatn thing is you can be honest to us

because as a dietiaitan who may be addressing specidic issues

when it comes to how much were you really eating before

and what foods can you eat

and what foods make you sick or have really intense reactions to

in terms of psychological or physical

but if you do not tell the whole truth

i can go around in circles and give you all this good advice i think i have

that really is useless because it may not be based on what truth you've told me

for me that's probably the biggest part of the first session

having someone come in

they may have their general data

age, height, kind of basic history of themselves

and then it would be applying the program to their situation at the time

but i can't do that unless i'm feeling like that person is willing to try

at least and open to some of the suggestions

so that might mean someone's coming in

maybe they've had an eating disorder for a year

and it's been getting a lot worse

and they're not eating much at all

on a daily basis, or keeping a lot in on a daily basis

so it might just be increasing the amount of times you eat

a little bit at a time

and that can be really scary

but any first session would just be about

really small steps in the beginning

in terms of an outpatient basis

and hten we would see how that goes for the first wek

and at that point i would recommend a weekly reoccuring appointment

until there's progress beign made

and hten kind of on the flipside

if i'm doing an intial session in more a treatment center session

a lot of the backgroung info i may have gotten from the other treatment team members

and yes i would collect that info again

just to get to know the client and

hopefully the client will like to be working in this kind of manner

and thenreally star addressing the food iissuues

when it comes to how much, when, where to eat, what types of food to eat

how to do it, and really practical information

i think that can be one of the hardest things

when it comes to therapy or treatment

a lot of it seems big scope like

"well just get over your anxiety" and

"just eat again it's really not a probelm"

but it really comes down to specifics like

"you have to eat this thing at this amount at this time

and then tell me about it, what did you feel"

so it's not like youre doing it completely on your own with no support

i think our biggest job is

we might put out some recommendations and then seeing how you do with it right away

and then addressing everything from there based on those first experiences

but i think for me when i see new patients in whatever kind of level

i would say a good part of any first session is building a repoir with the client

and getting to know them because everyone is different

when it comes to how they take advice and how comfortable they are with speaking to someone else

and so it may seem really easy the first session

cause it's not that hard

unless you're not comfortable talking to somebody

but that's kind of the benefit of doing this video right now

to understand what it will feel like and preparing for that first session

yeah definitely and like kate said everybody is different

so any first session we're triyg to get to know you

make sure you're comfrratble, make sure we have a good relationship

because we're working togeteher

i'm always saying "we" and "us" because it's a team

we're workin with you

you're not alone and thngs will be hard

and we're going to challenge you

because otherwise we're not doing our job

and we're not a good part of your team

so it might feel like we're pushing you a little bit

but it's just to see the honest input from you

like "well i tried this and this is how i felt and i couldn't do it"

because then we take that and we pput it back in our "machine"

and we try to come up with another option

that's the importance in seeing an individual dietitian

or in person because they can take what you're sayin in the moment

or what's going on in your life in that present time

and gind a way for you to get through it

and for me it's with food, or it's with eating and getting the support you need to eat

but it's really doable and as many times as i

ive heard that patients arent looking forward to seeing me

or that they're really upset that oyou've given them more food to eat

i have no hard feelings with anybody

becauase when sobmed goes through and coes out the other end of recoverey

they are so greatful tat i was there and we just laught about

how mean they were to me and how they were really afraid of me

and so none of hta scares me, it doesnt scare me away

doesn't oush me away, doesn't make me dislike somebody

it's just hte aeating disrorder

and that's what i'm daelintg with so i'm not intimidated by that at all

and i think that any dietieian who's experience with eating disorders is the same exact way

more than anything we just want to help

but some of the biggest fears we deal with is

"well how much am i going to have to eat,

"am i going to get fat?

"what does she know about me, she's blah blah blah, looks a certain way"

and a lot of what we get is "what are you eating and why do you do that"

and obviously that's just the eating disorder so we try to turn that back around and work with the client

and really just address sombody where they're at

yeah and those will be all the other questions we answer with kate

i know that you have those concerns

and we'l talk abotu them and adres them and kind of show how we use them

in our sessions and what she does when she works with you developing meal plans

and what that looks like on the other side

so i hope that was informational and we'll keep doing more of these videos

as we keep taking one step at a time towards a healthy mind and a healthy body

and don't forget to subscribe to my channel

because then when i post my next video of sitting down with kate you'll be notified about it