If you have bulimia nervosa, your therapist may recommend that you receive nutritional counseling. That’s because, typically, people with bulimia know a lot about food, but that knowledge is often skewed and used in self-destructive ways. Therefore, nutritional counseling can help put you on the right track when it comes to buying, preparing, and eating food.
Why Consider Nutritional Counseling for Bulimia?
Often, a person with bulimia will restrict calories for a period of time. Then, because he or she is hungry, the person will binge. Therefore, nutritional counseling for bulimia involves a discussion of how to eat normal meals and snacks to help regulate your appetite. You also may be asked to keep daily food logs and records of your sense of fullness through the day. These logs provide baseline information at the beginning of nutritional counseling and allow the dietitian (see below) to monitor your progress. You can become more responsive to your body in recognizing both fullness and hunger.
The goal is to encourage normal eating, but you may be wondering: What's "normal?” You may fear that eating certain foods will cause immediate weight gain. So nutritional counseling also includes education about the nutritional value of different foods. This helps to expand food horizons to include foods that you may not have felt safe to eat before.
In addition to developing a stable eating pattern, nutritional counseling can include instruction on how to shop at a supermarket, how to see through fad diets, and even how to order from a restaurant menu in a way that helps you to avoid triggers that could lead to binging and purging.
How Is Nutritional Counseling in Bulimia Most Effective?
Nutritional counseling can calm your fears and give you accurate information and skills that you may not otherwise have. However: It hasn't been shown to be effective as a stand-alone treatment. You should receive nutritional counseling in conjunction with appropriate psychotherapy, such as cognitive-behavioral therapy.
Who Provides Nutritional Counseling?
Registered dietitians (RDs) are generally best qualified to offer nutritional counseling. An RD can pursue even more specialized training to become a Certified Eating Disorder Specialist in Nutrition (CEDSN).
Sources:
American Psychiatric Association. "APA Practice Guidelines: Treatment of Eating Disorders" (3rd ed.). Accessed 24 January 2009.
Church J. Personal interview, November 2008.
Hsu LKG, Holben B, and West S. Nutritional counseling in bulimia nervosa. International Journal of Eating Disorders 11 (1992): 55-62.
Hsu LKG, Rand W, Sullivan S, Liu DW, Mulliken B, McDonagh B, and Kaye WH. Cognitive therapy, nutritional therapy and their combination in the treatment of bulimia nervosa. Psychological Medicine 31 (2001): 871-879.
Sundgot-Borgen J, Rosenvinge JH, Bahr R, and Schneider LS. The effect of exercise, cognitive therapy, and nutritional counseling in treating buliia nervosa. Medicine and Science in Sports and Exercise 34 (2002): 190-195.
