How does a dietitian help for different types of eating disorders?

Different eating disorders require different support methods. I've outlined below a list of different ways a dietitian can support you with your specific eating disorder in a compassionate, evidence based manner.

Anorexia Nervosa

Anorexia often begins as a way to feel in control, through food, numbers, or routines. But over time, that control starts to control you. Meals can feel overwhelming, hunger cues fade, and normal foods start to feel “unsafe.” Many people feel trapped between wanting to recover and fearing the loss of safety that restriction provides.

Physically, anorexia can affect every organ system. You may experience extreme tiredness, feeling cold, dizziness, digestive issues, hair loss, loss of menstruation, or difficulty concentrating. Emotionally, it can bring anxiety around eating, withdrawal from friends or family, and constant preoccupation with food and body image.

How a dietitian can help:

• Work with you to create an individualised plan that provides regular, adequate nourishment (even when hunger cues are unreliable).

• Provide clear examples of portion sizes and food combinations to guide you when your sense of what’s “normal” has been lost.

• Help with weight restoration at a safe, medically monitored pace, and supporting you both physically and emotionally through this.

• Provide strategies to reduce digestive discomfort (such as fullness or bloating) as the gut adapts to normal eating.

• Slowly help you to reintroduce feared foods, working through anxiety step by step.

• Support you to rebuild your trust in hunger and fullness cues, reconnecting with your

• body over time.

Bulimia Nervosa

Bulimia often feels like a never ending cycle of restriction, bingeing, purging, guilt, and self-

blame, promising you won't do it again and will be good again tomorrow, only to do it all

again the next day. Many people describe feeling “out of control” around food, followed by

panic and shame. The secrecy and exhaustion that come with this cycle can make it hard to

reach out for help.

Physically, repeated vomiting or laxative use can cause electrolyte imbalances, dental

enamel erosion, reflux, and fatigue. Emotionally, the cycle can feel exhausting and confusing

as food feels both comforting and punishing.

How a dietitian can help:

• Help break the cycle by setting a structured, regular eating routine to prevent the biological drive to binge.

• Explain how restriction fuels binge-purge behaviour, helping you to understand that what’s happening is a physiological response - not because you lack of willpower.

• Help restore hydration and electrolyte balance while working alongside your GP.

• Offer meal planning tools that make it easier to eat consistently without obsessing over calories or numbers.

• Help you practice neutralising “good” and “bad” foods, building flexibility and reducing guilt.

• Support you to feel more present in your body and tune into feelings of fullness and satisfaction.

Binge Eating Disorder (BED)

Binge eating disorder often hides in plain sight. Many people blame themselves for “lack of

control” or “willpower,” but the cause of BED is because you aren't trying hard enough, it is

rooted in unmet needs and feeling deprived - either physically or emotionally.

Episodes of binge eating are often followed by guilt, distress, or physical discomfort. You

may eat quickly, secretly, or past fullness, and feel unable to stop. Many people alternate

between restriction and overeating, creating a cycle that reinforces guilt and loss of trust in

the body.

How a dietitian can help:

• Create more consist eating patterns where you eat regular, nourishing meals and snacks.

• Provide information on how food can impact your blood sugar and hunger hormones and influence binges.

• Work through triggers for binge eating (emotional distress, fatigue, rigid rules) and create alternative coping tools.

• Provide gentle portion and meal structure guidance, rebuilding your understanding of what adequate nourishment looks like.

• Encourage mindful eating and connection to satisfaction with food, that leaves you feeling satisfied and content.

• Collaborate with your health care team to align nutrition goals with emotional healing.

Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID is associated with fear, sensory sensitivities, and/or a lack of interest in food. Some

people avoid eating because of textures, smells, or colours, or a lack of appetite and interest

in in food while others fear choking, vomiting, or illness. For many, mealtimes bring anxiety

or distress, especially in social situations.

ARFID can lead to nutrient deficiencies, fatigue, growth delays, or social withdrawal. It can

make eating feel like an exhausting chore and can also be hard to navigate with family.

How a dietitian can help:

• Assess nutritional adequacy and identify and resolve any deficiencies.

• Create individualised meal plans that include safe foods while gradually expanding variety.

• Use graded exposure techniques to introduce new foods, starting with very small, tolerable changes.

• Work collaboratively with occupational therapists or psychologists for sensory and exposure therapy.

• Support families and partners to make mealtimes less stressful and more supportive.

Other Specified Feeding or Eating Disorder (OSFED)

OSFED describes significant disordered eating that doesn’t meet the full criteria of another

diagnosis - but still causes distress, health impacts, and loss of freedom around food.

You might experience restrictive eating without being underweight, a fixation on "healthy" foods or infrequent binging/purging or emotional eating. Many people with OSFED feel invalidated or “not sick enough” to deserve help, but would still benefit from dietetic support.

How a dietitian can help:

• Validate that your experiences are serious and deserving of care.

• Work with you to stabilise eating patterns and ensure nutritional adequacy.

• Support you in understanding how energy balance, hunger, and fullness are disrupted and how to restore them.

• Support you to feel less dominated by constant food or body thoughts and concerns.

• Address both physical symptoms (such as fatigue or nutrient deficiency) and emotional distress related to food.

Disordered Eating

Disordered eating sits on a spectrum between “normal eating” and a diagnosed eating

disorder. It can look like chronic dieting, skipping meals, feeling guilty after eating, exercising to “earn” food, or avoiding foods seen as “bad.”

While it may seem manageable at first, disordered eating can gradually take up more mental

space, leading to anxiety, social isolation, and loss of trust in your body. Over time

disordered eating can shift along the spectrum and result in a diagnosable eating disorder.

Working with a dietitian early can prevent disordered eating from progressing into a more

serious condition — and help you develop a relationship with food that feels peaceful and

intuitive.

How a dietitian can help:

• Identify early warning signs before patterns become entrenched and/or lead to an eating disorder.

• Offer nutrition education to address food myths with factual information.

• Help you reconnect with hunger and fullness cues, building attunement with your body rather than feeling it needs to be controlled.

• Provide meal planning and gentle structure to stabilise eating and energy levels.

• Support you to find flexibility and enjoyment in food again.

Next Steps

Recovery from an eating disorder is possible. Research shows that dietitians can significantly improve the physical and mental health outcomes of people experiencing eating disorders. They also are able to help you find peace, freedom and joy with food again (something that might feel completely out of reach or a distant memory).

If food has become hard for you, or someone you know, I want to gently encourage you to reach out for help. We are here not to judge, but to offer motivation and hope with practical and compassionate support.