Why We Need to Approach Individuals with a History of Disordered Eating with Care

How Health Professionals Can Support Their Clients Better Navigate Recovery

I remember when it came to my attention that my “healthy eating habits” were far from healthy. I was venting to one of my fellow Marines, Sam, about how little I was eating and how much I was exercising to maintain our strict height and weight standards. He paused briefly before asking me, “Are you okay?” 

While my initial reaction was to say yes, I knew deep in my heart that the answer was no. That no opened the door for me to admit for the first time that I had developed an eating disorder (ED). It also allowed me to commit to a path of recovery. 

What I’ve learned about EDs.

I’ve learned through the recovery process that EDs are complex mental illnesses that affect individuals' physical, emotional, and mental health. According to the National Eating Disorder Association (NEDA), EDs have the highest mortality rate of any mental illness! In recognition of Eating Disorder Awareness Week (February 27 – March 5, 2023), we at Enhance Black Women’s Health believe we must spread awareness about this serious issue.

That’s why we must talk about the tendency of health professionals to recommend certain dietary practices. 

Having been trained as a health coach, I know firsthand that it's essential to be mindful of recommending certain dietary practices to clients with a history of EDs. Whether it’s intermittent fasting, Whole30, Paleo, Keto, or AIP, providing dietary recommendations to these populations can be especially problematic, and here’s why: 

Reason #1: Certain dietary practices can contribute to an unhealthy preoccupation with food and eating. 

For individuals with a history of EDs, following certain dietary practices can trigger obsessive thoughts and behaviors around food. As a result, this can lead to a relapse or exacerbation of their symptoms.

This isn’t to say these individuals can never follow certain dietary practices. However, it would be imperative if they choose to follow any dietary practice that they’re doing so with the support of a coach, dietitian, or therapist. 

Reason #2: Certain dietary practices can disrupt hunger and satiety cues which may lead to eating beyond fullness. 

Eating can be particularly challenging for individuals no longer connected to their hunger or fullness cues. Therefore, individuals with a history of EDs must work to rebuild that trust in food again. 

By this, I mean they must learn how to approach eating with a non-judgmental and individualized approach. This means learning to trust that one day they will learn to eat when hungry and stop when they’re full, even if that’s something they cannot do today. 

Reason #3: Certain dietary practices can encourage an unhealthy and unsustainable approach to nutrition. 

When working with clients with a history of EDs, assessing their relationship with food and their mental and emotional well-being is essential before making any recommendations. You can do this by considering the unique circumstances and challenges that may impact their eating decisions. 

Even though I’m providing insights based on my research and what I’ve seen working with clients, it’s important to remember that every client is unique. While emphasizing the importance of eating regular meals might work for one client, another might be better served by focusing on developing a mindful eating practice. Regardless of the nutritional approach, ensuring it can be done healthily and sustainably is essential.

In conclusion, eating disorders are a severe issue affecting millions worldwide.

We must be mindful of recommending certain practices to individuals with a history of disordered eating or EDs. By working together, we can help individuals develop a healthy and sustainable approach to nutrition that supports their physical, emotional, and mental well-being.