Understanding
Our Nutrition Philosophy
Deborah Hinds, DTR
Michelle Berger, RD/LD
Castlewood Treatment Center
Our focus today
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Castlewood’s philosophy
Our role as a Nutritionist / Dietitian
Food rituals, trauma foods, fear foods
Nutrition therapy
Exercise philosophy
Life after residential treatment
Castlewood’s philosophy
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Stop eating disorder behaviors
Understand how it got to this point
Work on internal core belief system
Facilitate autonomy around eating
Our role as a Nutritionist / Dietitian
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Gaining the client’s trust
Understanding the client as a whole
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Therapy
Nutrition intake
Body image
Our Goal as a Nutritionist / Dietitian
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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
The keys to meeting our goals
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Connect the dots
Process along the way
Decrease shame
Aid in compassion
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
Food Rituals
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Work to eliminate from beginning
Understand the function
Facilitate client desired change
Polarized food rituals
Vary differences depending on diagnosis
What underlies food rituals?
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Fear of not getting enough
Fear of getting too much
Never enough and always too much
Trauma foods
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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
Eating disorder fear foods
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Introduce from beginning
Consistently increase variety
Help them maintain variety as autonomy
increases
Fluids
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Restriction
Fluid loading
Understand what’s behind the behavior
Realistic Structure
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Artificial Sweeteners
Soda
Caffeine
Nutrition Therapy
Process vs. Content
Deprivation and…
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Self hate
Control
Numbness
Knowing Self
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Fears
Strengths and weaknesses
Deepest desires
Foods place in your life
Respecting your body
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Listen
Acknowledge
Consistancy
Support
Our exercise philosophy
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Very individualized
Learning moderation and re-learning what
it feels like to enjoy exercise
A privilege – the food comes first
The mind, body connection
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Pilates / Yoga
Life after residential treatment
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Stepdown
Intensive Outpatient Program (IOP)
Stepdown
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Learning life skills with support
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Meal planning
Preparing and cooking food
Grocery shopping
Meal outings / challenges
Using peers for support
Maintaining “stabilization weight”
Intensive Outpatient
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Applying life skills
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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”
Recovery process
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An ongoing process
Constant challenging of fear foods, trauma
foods, food rituals
Maintaining “stabilization weight”
Utilize support from others
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Eliminating the “I can do this myself”
mentality
Questions?