Kelly Walker, registered and licensed dietitian, shares about Monarch Cove's unique nutritional philosophy combining evidenced based eating disorder treatment with intuitive eating.

1. KELLY WALKER, RD LD
CASTLEWOOD TREATMENT CENTER
Understanding
Our Nutrition Philosophy

2. Our focus today
Castlewood’s philosophy
The role of a Dietitian
Nutrition Therapy and Intuitive Eating
Exercise philosophy

3. Castlewood’s philosophy
Our goal is to provide education, support, and
nurturing guidance as our clients let go of their
eating disorder behaviors and distorted thoughts
regarding food and weight
 Abstinence from eating disorder behaviors
 Recognize how it got to this point
 Understand the internal core belief system
 Facilitate autonomy around eating

4. Our Nutrition Approach
Internally-driven
“All foods fit”
Nutritionally Balanced according to the ADA’s
guidelines and recommendations
Understanding food’s role and function
Goal is Intuitive/normalized eating

5. Three Phases of Intuitive Eating in
Eating Disorder Treatment
Nutrition Rehabilitation Phase I: Intuitive Eating is
Contra-Indicated.
Phase II- Identifying, Normalizing, and Responding to
Satiety Cues.
Phase III- Indicators of Readiness for Intuitive Eating
(Tribole & Resch, 2004)

6. Ten Principles of Intuitive Eating
1- Reject the Diet Mentality
2- Honor your Hunger
3- Make Peace with Food
4- Challenge the Food Police
5- Feel your Fullness
6- Discover the Satisfaction Factor
7- Cope with your Emotions without using Food
8- Respect your Body
9- Exercise- Feel the Difference
10- Honor your Health- Gentle Nutrition
(Tribole & Resch, 2004)

7. The Role of a Dietitian
Gaining the client’s trust- First Session is Key
Understanding the client as a whole
 Therapy
 Nutrition intake
 Body image
Part of the therapy process

8. The Role of a Dietitian
Manage the clients food and fluid intake
 Meal Planning and Portioning
 Variety
 Moderation
 Consistency
Achieve healthy weight and weight stabilization
Address medical concerns and provide nutritional
management
Teach the Role of Food in the body

9. The Role of a Dietitian
Challenge the Diet Mentality
Discuss appropriate exercise plans
Teach mindful and respectful eating
Work to understand hunger and fullness
 Emotional and Physical

10. The keys to meeting our goals
Understanding the function
Connect the dots
Process along the way
Decrease shame
Aid in compassion

11. Food Rituals
Work to eliminate from beginning
Understand the function
Facilitate client’s desire to change
Vary differences depending on diagnosis

12. Where do food rituals come from?
Control: “If you’re going to make me eat…”
Fear of not getting enough
Fear of getting too much
Never enough and always too much
Deny food as food
A way to further disconnect from the food

13. How do we work on trauma foods?
GOAL: to detach the association between trauma
and food and to eventually eliminate fear response
with exposure.
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

14. Eating disorder fear foods
Introduce from beginning
Consistently increase variety and reinforce by
educating the importance
Help them maintain variety as autonomy increases

15. Fluids
Restriction
Fluid loading
Bingeing on fluids
Understand what’s behind the behavior
Fluid protocol/role in refeeding

16. We model a realistic structure for
normalized eating by incorporating:
Artificial Sweeteners
Soda
Caffeine
Meal outings
Vegetarianism
Grocery Shopping
Cooking

17. Meal Experience
Self portioning
Modeling
Mindful Meals vs. Distraction Meals
Discussion After Eating
How to support struggles at the table
Supplementing

18. De-coding “I’m terrified of gaining weight.”
Getting to know themselves/core beliefs
Needs going unmet
Being Unloved
Unpredictability

19. Relapse Prevention
How food effects mood and can set one up for
behaviors
Urge Cards
Teaching how to create meal-structure in “the real
world.”
Behavioral Chain Analysis

20. Our Exercise Philosophy
Individualized
Learning moderation and re-learning what it feels
like to enjoy exercise
A privilege – the food comes first
Focus on How it Feels
Disassociate Exercise from Weight Loss
 A Way to Take Care of Yourself
 The mind, body connection
 Yoga, Walks, Mindful Walks, Nia, Community Activities, Strength
Building
(Tribole, 2010)

21. Recovery process
An ongoing process
Constant challenging of fear foods, trauma foods,
food rituals
Maintaining “stabilization weight”
Utilize support from others
 Eliminating the “I can do this myself” mentality
Identifying “Red Flags” before they turn into a laspe
and/or a relapse.

22. Questions?

23. References
Tribole, E. (2010). Intuitive eating in the treatment
of eating disoders: The journey of attunement.
Perspectives, 11-14.
Tribole, E., & Resch, E. (2004). Intuitive eating, a
revolutionary program that works. (2 ed.). St.
Martin's Griffin.