An Austin Dietitian’s Perspective on Eating Disorders and How Support Might Help

This content is educational and reflective in nature and is not meant to replace clinical advice.

If you’ve ever wondered what it might be like to work with a dietician, or have felt intimidated or not “sick enough” to reach out, you’re not alone. In my work as a therapist, I often support clients navigating eating disorders, disordered eating, and body image concerns. I’ve noticed how much uncertainty and fear can exist around what nutritional support looks like. I wanted to help make that feel more approachable and demystify the process, so I connected with a dietician here in Austin. 

Brittany Thiel is a registered dietitian with Doherty Nutrition, specializing in eating disorders, disordered eating, and overall well-being through a client-centered, non-diet approach. She offers both in-person sessions in Austin and telehealth support to clients across several states. My hope is that hearing her perspective, and knowing more about what to expect, can ease some of that anxiety and help you feel a little more supported in whatever place you’re in with food and body image.

Now, let’s hear from Brittany!  

 What It’s Like to Work with a Dietitian

1. What do you love about working with this population?

   
   

I love the light bulb moments! By that, I mean the moments when knowledge and experience click together for someone. This often happens when someone is experiencing the patterns in the binge-restrict cycle, and I show them a diagram of how the cycle works. Some people have never even heard about this before, so when they see it all laid out, they’re like “Oh my gosh, yes! That’s exactly what I’ve been going through.” They see they’re not alone in it.

2. What do people expect will happen in a nutrition session — and how is it different?

   
   

I often find that people come into nutrition sessions thinking they’ll leave with a strict plan, a list of do’s and don’t’s, and expectations of what must happen by their next appointment. I like to remind all of my clients that we are a team! I am on their side and understand from personal experience that we are human beings - perfectionism is never the goal.

Patterns That Actually Make Sense

3. What patterns do you commonly see in people who experience high levels of perfectionism around food?

   
   

I often see these people struggle with motivation levels and a feeling of discouragement that many times comes up in the first few sessions. If we put so much pressure on food being perfect, it makes total sense that it will feel like a failure when we don’t achieve those unrealistic goals we have set up in our heads. It helps to reassess goals and expectations to be realistic and achievable - small steps are the way to go!

Brain + Body Connection

4. What do clients often blame on willpower that is actually biological?

   
   

Late night eating. If we don’t eat enough throughout the day, our biological hunger and need for food will build and build until it feels uncontrollable by the evening. I explain it as a way of our body playing “catch-up.” You can compare it to not talking to your best friend for a while about day-to-day life, eventually, you both will feel the need to have a two-hour gab session to catch up together!

5. How does restriction or irregular eating affect the brain?

   
   

About 20-30% of what we eat goes directly to our brain for energy. If restriction or irregular eating is occurring, then the body conserves the little energy that it’s getting to “ration out” to all of the different things our body has to do to function the best that it can. Restriction affects our brains, but it also impacts every other organ in our body as well.

6. How does nourishment affect concentration, emotions, and intrusive thoughts?

   
   

If we don’t have enough energy for our brains because we’re not nourishing ourselves enough, then of course it’s going to impact how our brain is able to concentrate, manage emotions, and think. Sometimes intrusive thoughts get so loud that it feels nearly impossible to challenge them, and if our brain isn’t working at full capacity, it often starts to work against you.

Fears About Getting Help

7. What are the biggest worries clients have before seeing a dietitian?

   
   

Being interrogated by the food police! I have so many clients who have come to me worried about receiving judgements on what they eat and if it’s “good enough.” I often have to remind my clients that I am not the food police. I’m not here to judge your choices or reprimand you if you didn’t eat a veggie at dinner (spoiler alert - I miss my veggies sometimes too!). It’s also a valid worry for many people, but one that I always try to break down with building a safe space for my clients and reminding them that I’m human too!

8. What if someone isn’t ready to change/give up their ED behaviors — can they still come?

   
   

Absolutely. Seeking help and coming to nutrition sessions is taking that first step in the right direction! Sometimes just showing up consistently is the goal.

What Support Actually Looks Like

9. What kinds of goals do you help clients work toward (besides weight or meal plans)?

   
   

I like to take a whole-person approach when we work on goals together. Sometimes people don’t expect me to ask them about sleep or their job, but it really all does impact one another, and food plays a role in it all.

10. How do you coordinate care with your clients' therapists and other providers when working on ED recovery?

    
    

I view coordinating care like a team huddle. We truly are all on the same team as our clients and want to make sure we are all on the same page to provide the best quality care we can.

Gentle Self-Reflection

11. What are some signs that you recognize with your clients that they’re actively recovering/making progress?

    
    

Taking initiative and being proactive! When we start to see the shift from external motivation to internal motivation, it’s a huge step in progress. Another sign is when we’ve created a solid foundation that we can begin to build on. 

12. What are signs someone’s relationship with food is taking up too much mental space?

    
    

When we think about health, I think many people think of physical health. What we don’t often think about are all of the other dimensions of health like social, mental, intellectual, and spiritual health. When these other areas of health take a negative turn, that is a big sign to me - like skipping brunch with your friends to go to the gym or ruminating on the thought if others saw you eat that snack versus focusing on the exam you're taking.

13. When does food stop being about food and start being about safety, control, or coping?

    
    

Food starts to cross an unhealthy boundary when it becomes your only tool in your toolbox to feel in control or cope with your negative emotions. When food is our only tool we use in these situations, it becomes associated with these moments and suddenly takes on a much different role in your day-to-day life. Working with both a dietitian and a therapist can help to add tools in your toolbox to begin allowing food to simply just be food.

14. Who tends to benefit from support even if they think they’re “not sick enough”?

    
    

Anyone can benefit from support, but especially those who might not have the support in their personal circles or may not be ready to share their story with others. A challenging relationship with food can be very isolating, making you feel like you’re alone in this. It’s never too early to seek out support.

Where To Start

15. What would you say to someone reading this who feels nervous but curious?

Curiosity is wonderful! It is so helpful and is actually a big part of working on  your relationship with food - to be curious about how your body works and learning about it. But new things can be scary - including for me! Sometimes just focusing on step 1, like your first appointment with a dietitian or sharing your challenges with a loved one is so brave! No one says you have to commit to a lifetime of anything in step 1!

Learn more about Brittany and reach out to schedule a session here: https://dohertynutrition.com/brittany-thiel/