Nutritional Therapy & Education
Rosewood aims to change the way you think about nutrition by learning more about how your body functions and operates. One of our first priorities when you arrive at Rosewood for treatment is to have you meet with one of our Registered Dietitians (RD) one-on-one. Our lead dietitian is a Certified Eating Disorder Registered Dietitian and a Board Certified Specialist in Eating Disorders. Your meeting with the RD helps us customize a nutrition program specifically for you. We’ll seek to:
- Evaluate your nutritional needs
- Assess your unique history and relationship with food
- Understand the progression of your eating disorder behaviors
- Learn about any medical complications, dietary allergies and intolerances we need to know about to personalize your meal plan
With this information, the RD will design a customized meal plan for and with you—one you’ll enjoy while you’re with us at Rosewood and long after you complete your treatment. At mealtime, our chefs prepare delicious meals, using locally grown ingredients whenever possible and presented with the artistic flair you might expect in a gourmet restaurant. While the menu may be the same, each patient’s plate is customized for their eating preferences and needs. One patient’s plate may accommodate a vegetarian diet, another might be gluten-free.
An Integrative and Comprehensive Approach to Food
Our dietary philosophy is to assess and address all your nourishment needs—and there are several. We’ll account for any medical needs, which can be especially important if you’re severely malnourished when first admitted. We’ll also tailor your nutrition program to align with your therapeutic and emotional needs. For example, certain foods contain nutrients that can enhance your therapy at Rosewood while others could be counterproductive. Our overarching goal is to help you normalize your relationship with food. We’ll seek to help you achieve freedom with food, so you won’t feel imprisoned by rigid guidelines and rules about your diet. Instead, our approach is all about balance, variety and moderation. In this respect Rosewood is fundamentally different from many other eating disorder programs that emphasize rigid thinking. We emphasize flexibility.
Mealtimes at Rosewood
We believe mealtimes themselves are therapeutic. They should be enjoyable on many levels, not just as time to feed the body. We offer three nutritionally balanced meals and three energizing snacks daily. They give you an opportunity to reconnect with your body and others in the program. You’ll learn to pay attention to the things that happen physiologically when you eat. It’s a communal time for mindfulness when you’ll notice how your hunger level changes. You’ll also develop a better awareness of any personal triggering sensations as you experience them, so you can learn to disconnect your triggers from rigid or destructive thinking. We don’t count calories at Rosewood. Instead, we use an exchange system that’s based on guidelines from the American Diabetic Association. This gives you more flexibility in your eating choices and reinforces a non-threatening, pleasurable and nourishing relationship with food.
Nourishing the Most Severely Malnourished Patients
Because some of our patients arrive in near-critical condition, following months or years of unhealthy eating habits, Rosewood is able to provide acute care services. Our first priority for a patient who is in this much danger is to restore medical stability. This may involve the use of a pediatric feeding tube. Medically complex patients can’t just start eating normally again. It takes time for the body to begin accepting food. Our staff is trained to avoid the complications associated with refeeding syndrome, which can cause problems if food is re-introduced too quickly. We do lab work on compromised patients every day, including close monitoring of levels of potassium and electrolytes. When managed properly, these levels often start to return to normal very quickly. During this process, the body re-learns how to perceive hunger and fullness cues. Slowly the body transitions out of survival mode and starts healing itself.
Teaching the Science of Nutrition
As your treatment moves forward, you’ll get a thorough education in the science of nutrition. You’ll address complex and varied eating issues while meeting individually with our dietitian. You’ll participate in meal planning classes, attend educational presentations, and engage in individual experiential activities. You’ll also learn about the body’s natural processes for metabolizing and gaining nourishment from food; the importance of meal planning and portion sizes; techniques to be mindful of your body; and practical skills you can use to continue your recovery after returning home.
Our Unique Nutrition Program Nourishes You in Numerous Ways
The program is designed to accomplish several important goals as part of your treatment—including:
- Identify food rituals or “self-imposed rules and beliefs” that limit your ability to be flexible and enjoy a variety of foods. Examples of these beliefs may include: eating fat makes you fat, the less you weigh the healthier you are, touching food lets calories sink in through the skin.
- Construct a comfortable, safe, and positive association with food.
- Change the way you think about nutrition by learning more about how your body functions and operates (including metabolism, digestion, the importance of calories).
- Dispel food and body myths, and cultivate new thoughts and ideas for meeting nutrition needs.
- Help you recognize the connection between appetite cues and overwhelming feelings/emotions, and how to use these tools to uncover the “true” sense of hunger and fullness.
- Teach you to plan and prepare meals and snacks – at home or while dining out.
- Provide education on understanding and managing a variety of medical complications associated with eating disorders, including: constipation, diarrhea, Irritable Bowel Syndrome, electrolyte imbalances, anemia, reflux, heartburn, cardiac abnormalities, amenorrhea, dental sensitivities, osteoporosis, hypoglycemia, and ketosis.
- Address any personal issues and challenges related to physical activity.
- Review family patterns and create a relaxed, comfortable mealtime atmosphere that stems from improved communication skills. This empowers you to implement and maintain these mealtime techniques at home.
- Construct an individualized plan for continued professional support and abundant living after treatment.
- Provide specific support to binge eating issues and post-bariatric challenges associated with eating disorders such as nutrient malabsorption, dumping syndrome, texture tolerances and quantity tolerance.
- Manage diabulimia and other medical issues related to dietary intake, such as Celiac’s disease, food allergies and food intolerance.
- Help you overcome issues related to body image, which might surface during your treatment process.
Meal Plans for Eating Disorders
One of the goals of eating disorder treatment at Rosewood Centers for Eating Disorders is helping patients develop a healthy relationship with eating and food. A healthy relationship with food involves:
- Making nutritionally sound choices, yet not being overly restrictive and missing out on the enjoyment of eating.
- Eating a wide variety of foods.
- Letting go of fears about particular foods or food groups.
- Learning to respond to natural cues for hunger, fullness and satiety.
- Giving some thought to eating and food choices, but not having food become a preoccupation that crowds out other thoughts or activities.
For someone in recovery from an eating disorder, developing these healthy attitudes toward eating takes time and practice. One of the ways we build the foundation for ‘normal’ eating is through the use of individualized meal plans that meet each person’s nutritional needs, while offering variety, balance and appeal.
Eating Disorder Meal Plans Designed by Registered Dietitians
At Rosewood, each meal plan is created by a registered dietitian (RD). Each plan is customized to each individual’s anthropometrics, health status, physical activity level and food preferences; every aspect of Rosewood’s nutrition program is highly individualized. We can accommodate a wide range of health conditions, including diabetes, celiac disease, gastric bypass, food allergies, as well as dairy-free, gluten-free or vegetarian diets and religious preferences. Bodies need nourishment from food to fuel everything that we do – growth, repairing cells damaged due to the wear and tear of living, moving, and thinking, to name just a few. Some of the essential components of meal plans include:
- Protein – Protein is essential for a range of body functions, including building and repairing tissue, bones, muscles, blood, skin, nails and hair, as well as regulating hormones. Protein sources include meat, fish, poultry, milk, beans, soy, nuts and eggs.
- Fiber– Fiber helps regulate bowl movements and prevents constipation. Whole grain breads and cereals, oats, lentils, fruits and vegetables are great sources of fiber.
- Fats– Fats are essential for energy, growth and brain health. Sources of fats include avocados, nuts, seeds, yogurt, olive oil and some sweets.
Eating Disorder Meal Plans Progress Along with Recovery
Early in recovery, particularly if patients are medically compromised due to a long-term or severe eating disorder, the focus of the meal plan is the medically supervised weight restoration. As recovery progresses, we address fear foods by helping patients prepare both physically and mentally to reintroduce them into their diet. These fear foods can be challenging for the patient, therefore we approach this compassionately, offering plenty of encouragement and support. Alleviating fear about eating and helping patients remember the foods that they like to eat is a delicate balancing act. To do that, patients must have the freedom to make some choices. Our chefs love special requests! If a patient is craving a particular meal, or really likes a dish and wants to have it again, our onsite chefs are happy to deliver. The final phase of recovery meal planning is about inspiration and participation.We provide a changing seasonal menu, using local ingredients, a variety of cooking techniques, and wholesome balance. We educate patients about their nutritional needs, and help them learn to make their favorite meals for themselves. Our chefs lead groups in making homemade bread, desserts and other dishes to share during meals. When individuals in recovery leave Rosewood, our goal is that they have the confidence and coping skills to eat nourishing foods that sustain their health, and are able to participate in social situations involving foods, free of fear and anxiety. They have the skills to plan balanced meals, the skills to prepare simple, satisfying dishes, and the ability to listen to and act on internal hunger and satiety cues.
Hear from an Expert
Jennifer Lentzke, Certified Eating Disorder Registered Dietitian explains:
- Societal factors that can contribute to “dangerous dieting”
- How dieting can progress to eating disorders
- Therapeutic and nutritional interventions that can be implemented