Summer Featured Dietitian Ellen Glovksy

Ellen Glovsky, PhD, RD

Tell us about your career, Ellen.

 

I’m a Registered Dietitian and Motivational Interviewing trainer. I have a private practice in the Boston, Massachusetts area, where I treat clients with eating disorders and disordered eating. Many of my clients have binge eating disorder and want to lose weight. I use a Health At Every Size approach, with no dieting, because I believe that restrained eating or dieting causes bingeing. My practice is small, and much of my time is spent providing training and consultation in Motivational Interviewing to a variety of organizations around the country.

 

Why Motivational Interviewing?

 

Motivational Interviewing is an evidence-based approach to helping people change their behavior about their health. Using MI, we assume our clients are the experts in their own lives, and have all the answers they need. Using MI, the health care provider’s job to help find our clients find those answers themselves, with our help. MI has been used in the treatment of all types of eating disorders, and has been shown to be more effective than the typical approach or offering meal plans and “encouraging” patients to follow them.

 

I believe that training of dietitians should include MI from the beginning, and these skills should be emphasized as the best way to work effectively with patients. As a dietetic intern in 1970-71, I was taught the basics of “teach the diet”, which was most
of what I was expected to do. Of course, we were encouraged to understand our patients and to help them integrate the new eating pattern into their lives, but the basics were really to get them to change the way they were eating. When we
use MI in health behavior change counseling, we guide the patient towards their own solutions. Of course our role includes providing information on the best possible changes, but this information is only offered when the patient is ready to receive it.

 

 

What do you appreciate most about this field?

 

I have had a very rich and varied career as an RD. Over the past 20 years, I have pursued additional training to become a nutrition therapist and specialist in eating disorders. About 10 years ago I began my training in MI as a clinician, and in 2006 I received training to be an MI trainer. I have a book about to be
published, Wellness, Not Weight: Health At Every Size and Motivational Interviewing. This book is an anthology of chapters on these topics, written by a wonderful collection of professionals in many fields.

 

I feel that I am “living the dream” in my career, having an opportunity to do the things I love the most!

 

Editors Note: IFEDD Members interested in Ellen’s book can visit this link for more information:

http://trainingwithdrellen.com/2013/05/31/my-new-book-will-be-published-soon-2/

 

 

 

May Featured Dietitian Brooke Glazer

What kind of work do you do?

A lot! I have a private practice in Brentwood, CA, where I specialize in working with clients with eating disorders or any type of disordered eating. I also work as the RD at the Eating Disorder Center of California (EDCC), an outpatient (PHP/IOP) eating disorder treatment center in Los Angeles. With clients at the EDCC, I conduct one-on-one nutrition sessions, lead nutrition groups, go on restaurant and supermarket outings, and cook and eat meals together.

 

From these experiences I realized that meal support (the act of eating meals with clients) was something clients were getting while in treatment but missing in an outside setting. Because of the importance of meal support in the recovery process, I started Joie Meal Support, a company that provides meal support to people struggling with eating disorders in any setting. I’m excited to see the impact that Joie will have in the eating disorder community.

 

What is your guiding philosophy?

All food is good food. Eat when you’re hungry and stop when you’re full. To me, healthy eating encompasses balance, variety and moderation. I believe in eating foods that taste delicious and also foods that make you feel good. Food is not only is food fuel, but food is relationships, mood, love and connection. Full recovery is possible-- people are not “in-recovery” from their eating disorder for the rest of their lives.

 

Because each client has their own specific struggles, I cater to each client’s individual needs by creating unique nutrition plans. I believe in meeting each client where they are at while also pushing them to challenge their eating disorder beliefs. My goal is to help clients become natural and confident eaters…to be the person who orders meals as-is at restaurants, shares pizza and pasta on a date, and not only bakes cookies for
those they loves but eats them too.

 

What non-traditional techniques do you use to help your clients?

I invite my clients to text me for support when they are struggling. For clients who have a hard time keeping a food journal, I encourage them to take photos of their food to text to me in the moment or show me in session. If a client is going out to eat in a restaurant, we look at the menu together in session and decide what they’re going to order. If a client has a particular fear food, I invite them to bring it into session and we eat it together. I am happy to do sessions via phone or FaceTime with clients who live faraway.

 

What keeps you motivated?

My clients and colleagues! I feel lucky to be surrounded by so many smart, unique and compassionate people. Having overcome an eating disorder myself, I’m excited about helping other people recover too.

 

Thank you Brooke! For more information on Brooke's new business, please visit www.JoieMealSupport.com.

 

April Featured Dietitian Garalynne Binford

Tell us about your work...

I work as an eating disorder dietitian in a public funded regional outpatient
service called the Auckland Regional Eating Disorders Service.  Part of my
job is providing direct outpatient nutrition education and counselling to adults with eating disorders. The adult team is multi-disciplinary and works really closely together. The other part of my job is providing consultation to other services in our region.  Mostly that involves me seeing patients short-term while they’re getting the rest of their outpatient treatment in a different mental health service.  It also involves training dietitians in the mental health side of eating disorders and training mental health professionals in the food side of eating disorders. 

 

I’m also lucky to have been given work time to complete a Masters research thesis
entitled Normalised Eating in the Treatment of Eating Disorders.



 

What is eating disorder treatment like in New Zealand?

I grew up and trained in Seattle, but I’ve only ever worked in eating disorders in New Zealand. Most of the treatment is provided by publicly funded services.  Most of it is delivered in an outpatient setting, and a lot of that is delivered by non-specialist clinicians.  A big chunk is also delivered in residential facilities. New Zealand uses a “hub and spoke” model for eating disorder service delivery.  There are three main “hubs” (Auckland, Wellington and Christchurch). They all have residential services attached to them. In addition to providing direct care to the large cities they’re located in, they all provide consultation across their region (for Auckland, that’s the top half of the North Island). So that way the whole country is covered by public funded specialist care.  

 

How do you envision our profession moving forward?

If dietitians are going to survive working in mental health settings, I think we need to be recognised as mental health clinicians. Mental health needs to be a larger component of dietetics curriculum. But if one is going to work in mental health, there needs to be certification which allows dietitians to competently assess psychiatric risk as part of their core role, just like other mental health professionals.  Dietitians are also at very high risk of not being recognised as an evidenced-based profession in eating disorders. Well-designed research studies describing dietitian interventions and evaluating their effectiveness are sorely needed.

March Featured Dietitian Leanne Johnson

What is your current position?

I am currently a Registered Dietitian and Owner of Soulfull Nutrition Counselling. I started Soulfull Nutrition Counselling because of my nvolvement with schools, the church community, and the sport of roller derby. My eyes were opened to the vulnerability and tenderness of the girls and women within these environments, many of whom had expressed to me their struggles with disordered eating behaviors and clinically diagnosed eating disorders.

 

I did some research and there seemed to be a gap in my community where people with eating disorders were falling through. The prevention initiatives and treatment options in this area were minimal with limited access, and I began to realize that if I didn't take a step of faith to provide help, that perhaps no one else would. It became my mission to provide kind and compassionate nutrition counselling to all clients struggling with food and/or weight issues, and to offer prayer and encouragement to those whose faith is an important part of them.

 

With ongoing training and supervision, volunteering services, providing community presentations, and promoting awareness of my services, Soulfull Nutrition Counselling is beginning to fill that gap. I have begun making strong community connections with other health care professionals to facilitate the
inter-disciplinary team treatment which is so key for eating disorder  recovery. I am looking forward to what the future has in store.


 
What do you see as barriers to our field in Canada?

 



The biggest barriers for EDDs in Canada are a lack of

trained Supervisors, a  non-standardized process for specializing in eating disorder treatment, and  what I believe to be a professional fear of helping clients or patients with disordered eating behaviors. Though in the past year I have seen many positive steps in mental health awareness and materials highlighting the importance of nutrition for psychological illnesses, there needs to be more national collaboration from dietitians in Canada to address our role in providing help at each level of treatment for eating disorders.



What do you hope to see in 10 years in our profession?

 
In 10 years I would like to see a paradigm shift in our professional

beliefs of what defines health. We live in a weight/shape/size/food

focused society fixated on numbers, calories, and BMI.

If we can remold our own perceptions in dietetics and encourage

patients and clients to understand that health and happiness

does not come from controlling our food and weight,

but that such joy comes from nourishing and accepting ourselves,

I believe we would be able to better relate to and support our clients towards better health. Ultimately, my hope is that dietitians will bridge the gap, step out of comfort zones, engage in dialogue, and take action together to understand eating disorders and the positive and influential role we can have in their treatment. I hope one day wewill no longer be afraid to help our eating disorder clients, rather, I hope that we will feel empowered to walk with our clients on their journey towards healing and freedom.

January/February Featured Dietitian Caryn Honig

What do you do?

I have a variety of different jobs and responsibilities which makes every  day new and exciting for me. I own The Healthy Weigh which is a private nutritional counseling practice specializing in treating patients who struggle with eating disorders and/or disordered 

eating. I have owned and operated The Healthy Weigh for over 15 years. I have  one full-time dietitian and three part-time dietitians who work with me. I also have a therapist on board and a  psychiatrist is starting with us this month! I also have nutrition and dietetics contracts at two local psychiatric hospitals. Running the practice (scheduling,  billing, public relations, giving lectures and presentations and everything else that goes with running a private practice) and seeing patients who suffer from eating disorders are two of my jobs. My other job is teaching at University of Houston. I teach Introduction to Nutritional Counseling, Current Issues in Eating Disorders, and Pilates. I love teaching. I believe it is my true passion. I am currently working on a doctorate in education. Once I complete my doctorate, I hope to teach full time.

 

How did you get involved in this field?

I struggled with bulimia, then anorexia, then compulsive over-exercise in a time when eating disorders were not well-known or well-treated (the early 80’s). I went to college on an athletic scholarship and I was so very sick but nobody knew! I finally received psychiatric care, however did not see a dietitian (for a long time, I didn’t know there was such a thing). Desperate to learn how to eat normally again, I went to a dietitian who specialized in diabetes. She did not know about eating disorders but put me on a diabetic meal plan. At that time I was working in television….and while going through recovery, I decided to become a dietitian. I had to start college all over again. Eventually I became a registered dietitian specializing in eating disorders.    

 

What do you think are the biggest issues facing the profession?

I think there are a few issues facing the field of dietetics. In Texas, anybody can give nutrition advice—and get paid for it. Personal trainers, “nutritionists,” health food store employee….anyone can offer nutrition advice. It is definitely a problem in Texas. Another issue is that insurance companies are reluctant to cover nutritional counseling for eating disorders.  

 

What keeps you motivated?

When patients are able to eat “normally,” without fear, guilt or shame and are able to truly embrace recovery – that’s what keeps me motivated. When patients get married, graduate from college, have children and lead healthy and happy lives….that’s what keeps me motivated as well. Teaching is very motivating. Helping students improve their counseling skills and grow and thrive is extremely rewarding and motivating.

 

What is the best piece of advice you have been given?

Never give up….your dreams can come true! With hard work and perseverance, you can do whatever you set your mind to.

 

What do you consider your greatest professional accomplishment? 
Starting a successful private practice from scratch is my greatest professional accomplishment. I remember my first office was a rented room in a small fitness studio. All of the furniture I had was donated, free and very mismatched! I didn’t even have a computer or phone system. 15 years later I am fortunate to have a fabulous group of dietitians working with me, a beautiful office, and a solid reputation. It’s my greatest professional accomplishment.

 

 

To contact Caryn, visit www.TheHealthyWeighOnline.com or email her at carynhonig@gmail.com.

November/December Featured Dietitian: Marci Anderson

 What do you do?

I do lots of things, which is why I love my job! I own a private practice in Cambridge, MA and currently have 3 other RDs working for me. We all specialize in working with disordered eating and utilize a non-weight focused approach to nutrition counseling. You can check us out at www.marciRD.com. The majority of my time is spent providing individual counseling. But I also supervise the employees that work for me, address billing issues, participate in social media, write for my blog, develop power points and presentations for upcoming talks, and manage the course I teach for Plymouth State University. The course is nutrition counseling for eating disorders and is designed for grad students and current clinicians looking to learn more about working with eating disorders. My colleague/friend and I just developed and launched a weekend intensive workshop "Intuitive Eating, Intuitive Living" which I'm really excited about.  One of the things I love about my job is that no day is the same and I have total autonomy in how I spend my time. I love being my own boss and feel fortunate to work with a group of amazing women that I admire, respect, and thoroughly enjoy being around. 

 

How did you become interested in the field?

I learned about dietetics from my Uncle who sees a dietitian for his Type 1 diabetes. Given my love for people, science, and food, the field of nutrition is an ideal fit. However, it wasn't until my dietetic internship through California State Long Beach that I had my first opportunity to work with eating disorders. It turned out to be the only rotation in my internship that I loved. So from that moment I knew I wanted to get involved in the field of eating disorders. Providing nutrition therapy appealed to me because the work was challenging, meaningful, and multi-disciplinary. After many years, these are elements that I still love about my work.

What do you think are the biggest issues facing the profession?

Well, the sad news is that I will never be out of a job. Our culture normalizes disordered eating and the amount of work for us to do in this field is immense. However, in the state of Massachusetts, one of the biggest issues I see is lack of coverage at the inpatient and residential levels of care. I'm quite fortunate in that nutrition counseling for eating disorders is covered relatively well on an outpatient basis. But I'm watching clients get discharged after shorter and shorter visits which is alarming.

 

What keeps you motivated?

I can think of a number of things that keep me motivated:

1. My clients. I LOVE my clients. They are intelligent, creative, and inspiring. When I see them take courageous steps forward toward recovery it really keeps me going.

2. Clinical supervision. I can't get enough of it! It validates my work and supports me when I'm feeling stuck or ineffective.

3. Collegial support. I am so fortunate to have a great network of supportive colleagues. I couldn't do this work without them.

4. Work/life balance. When I started to get burned out it usually means that my client load is too heavy, I haven't had enough play time, haven't had enough laughter and need more self-care. Even a weekend away from email, extra sleep, time with my husband, and a good book does wonders.

 

What is the best piece of advice you have been given?

Supervision, supervision, supervision. At the start of my career I spoke with a nutrition therapist who has been doing eating disorders work for nearly 30 years. She spoke to me about how vital clinical supervision has and continues to be in her career. This advice stuck with me and has been one of the very best investments I have made for myself and my career. I cannot say enough about it. A good supervisor reduces your stress levels, increases your knowledge and confidence, and provides invaluable support. We can't do this work alone! 

 

September/October Featured Dietitian: Kathryn Fink

What do you do? 

I have quite a diverse practice. I work 2 days a week for a psychiatric center as senior dietitian. I oversee the dietitians, JCAHO policies and procedures, educate the physicians, nurses and therapists about the emotional aspects of eating and work with any eating disorders and complex patients. I have my own practice where I work with the emotional aspects of eating, focusing on eating disorders, post bariatric surgeries and weight management via intuitive eating as well as go around and speak on these same topics.

Basically, I help people move towards the acceptance that all foods fit in moderation.   My motto is “There’s Always Room for Ice Cream and Chocolate!”.  My desire is to connect with professionals and consumers and educate them about the post bariatric clients out there that are struggling.  I want everyone to know  that there are dietitians that specialize in the emotional aspects in eating and can address some of the  complications that those individuals might be experiencing.  Often times I am taking what the bariatric surgeon has told them, the fear and messages they play in their head about not eating certain foods and gaining weight and food intolerances and separate it out into what works best for them to get them towards the ultimate goal of normalized eating!

 

How did you become interested in the field?

That is actually kind of funny.  When I finished school, I said that I didn’t want to work with eating disorders and renal patients.  After I got out of school,  I started job working at a psychiatric center and started to realize how much our past sometimes impacts our relationship with food and our bodies. I started going to many the therapist education sessions on trauma and counseling and drew the connection with food and disordered eating. The patients I worked with helped me to see how rewarding restoration of normative eating is for the physical and mental health.

 

What do you think are the biggest issues facing the profession? 

Insurance reimbursement, perceived value of normalized eating and the media messages.  It seems there is not enough focusing on positive, balanced relationships with food and our bodies.

 

What keeps you motivated? 

Attending workshops, client success stories and peer support.

 

What is the best piece of advice you have been given? 

Take care of yourself first.  Booking clients when they can come  all the time and sacrificing your free time does not help anyone,  Simply state what appointment choices you have and when asked if you have another slot on your “reserved” time, politely say you are booked up. You are, you are booked up for self-care!  Of course, that is one I continue to struggle with, but I am continuing to work on improvement.