WHO ARE ITUITY?
We are a weight-neutral health service for people experiencing eating disorders, weight or shape concerns, or just really sick of dieting.
In prioritising body autonomy, we always meet clients where they’re at.
We disrupt diet culture, advocating for moral-free and internally directed eating practices that serve our clients personally. And through a weight-neutral, equity-informed approach, we support clients in embracing a connection to their body that doesn't interfere with the connection to identity and community.
To empower you towards an experience in which your body is no longer your identity.
WANT TO REFER?
Specialising in eating behaviour, we know that sometimes it can be helpful to have a specific diagnosis, and sometimes the diagnosis can get in the way. We work with people of all eating disorder diagnoses, as well as people who present with disordered eating, or without a diagnosis. We welcome people of all sizes, genders, sexualities and endeavour to provide neurodiversity-affirming care.
Matching our nutrition therapy to the appropriate treatment model, our dietitians work with children, adolescents, adults and families.
WHEN TO REFER TO A DIETITIAN?
Dietitians are often thought of as the 'food police' or in eating disorder treatment as 'the meal plan people'. Whilst meal planning is part of what we do, what a dietitian can offer is so much more:
Our dietitians are trained in skills to support all eating disorder diagnoses at all stages of community-level recovery.
WAITING FOR AN APPOINTMENT WITH PSYCHOLOGIST
Whether your client is an adult or adolescent, all evidence-based models of treatment begin with nutritional restoration and can begin with a dietitian.
UNSURE IF CLIENT HAS AN EATING DISORDER OR NOT
Dietitians are well placed to have in-depth and safe conversations about intake to inform your diagnosis and can help improve relationships with food even if disordered eating is sub-clinical.
UNSURE ABOUT RECOVERY
Ambivalence is expected when working with eating disorders. Dietitians are skilled in navigating readiness for change and enhancing motivation.
Overeating, restrictive eating, and compensating can complicate gastrointestinal symptoms. Dietitians are well placed to assess and manage food impacts on GI issues in ED recovery.
VEGAN / VEGETARIAN
ED rules might include sometimes possibly ethically based rules like vegan or vegetarian eating. Dietitians can help to navigate the appropriateness of these rules and nutritional considerations of their limitations.
UNEXPLAINED WEIGHT CHANGES
Whether weight is going up or down, these conversations with clients are delicate. Dietitians can take the time to explore the full picture without reinforcing value in smaller bodies or triggering ED thoughts.
More than half of people presenting for bariatric surgery suffer from Binge Eating Disorder. Eating disorders are psychiatric illnesses and surgery does not change that. A dietitian can help provide support in these cases.
BARRIERS TO SEEING A DIETITIAN
CLIENT ALREADY 'KNOWS WHAT TO EAT'
Recovery often involves helping clients 'recalibrate' their understanding of nutrition. Often clients place too much importance on eating 'well', or hold unrelenting standards of healthy eating, or over-inflate the impact each choice will have. But we also do way more than just tell clients what to eat.
CLIENT IS AFRAID OF BEING WEIGHED
Whilst weight is used in a lot of eating disorder treatments, it's not necessary for every presentation and our clients get to be a part of the discussion on whether it's a part of treatment or not.
CLIENT IS AFRAID OF BEING TOLD OFf
Though we can't erase previous experience with food police in one session, we are very conscious of the shame and guilt felt by our patients and work hard to demonstrate our lack of judgment.
CLIENT feels THEY'RE not sick enough
Though it's important that our client's perspective is considered, we always want a get a sense of whether it might be that it's just the ED that thinks they're not sick enough. You don't need to wait until the ED is worse to deserve support.
WHAT DIETITIANS DO
ENGAGE CLIENTS IN CRITICAL THINKING
Eating Disorder logic often doesn't add up but highlighting that doesn't improve recovery. Dietitians can utilise their nutrition comprehension to gently support clients to critique their ED thoughts about food.
predictable weight restoration
When clients need to do nutritional restoration in recovery, the typical fear is that they will gain weight very quickly, that it will be ever-increasing and never-ending. Dietitians provide confidence in a measurable degree of change that acknowledges the client's fear and supports recovery.
People with eating disorders can often be overly rule-bound or lacking helpful structure. We navigate the right amount of direction to impart to support recovery. We provide confidence without developing more rule-bound eating.
CHALLENGING FOOD RULES
Eating disorders will typically involve rules about what to eat, when, how, and how much to eat, or rules about what to do if certain foods/amounts are eaten. Dietitians can highlight the costs of these rules and support clients to disprove their predictions.
SEE FOOD AS MORE THAN JUST CALORIES
Sometimes clients forget how far their eating disorder has taken them from a positive relationship with food, family, and friends. Dietitians can help to reinforce the client's values in fun and social eating.
support DEVELOPMENT OF inTernal trust
We are the best resource to help clients navigate eating throughout their recovery. Starting with evidence-based advice on intake and eventually developing internal trust in eating, body cues, and personal values.
BODY IMAGE HEALING
Dietitians talk about more than just food. Recovery usually involves some degree of devaluing image as part of self-worth and identity. As clients are often preoccupied with the impact of intake on appearance, our work is well-positioned to support our client's experience of their body and sense of self.
HEATH WITHOUT WEIGHT BIAS
We can help separate weight from health allowing clients to pursue health to the extent they wish and are able. This typically allows for sustained health-promoting behaviours in place of diet cycling or ED relapses.
MORE INFO ON
Eating Disorder support
EATING DISORDER PLANS
In November 2019, Medicare introduced 64 new MBS items to support a model of best practice, evidence-based care for eating disorders. With an Eating Disorder Plan (EDP), eligible patients can access a Medicare rebate for up to 20 sessions with a dietitian and up to 40 sessions with a clinical psychologist in a 12-month period from the date the EDP is developed. It is expected that there will be a multidisciplinary approach to patient management through these items.
Whilst the referrer (managing practitioner) must review the EDP with the patient, as the patient approaches the end of each course of ten sessions with the psychologist before accessing the next course, 20 sessions with the dietitian are accessible without review . However, it is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. See a flowchart of the stepped model here.
Patients are eligible to claim Medicare rebates on dietetic services if they have been referred by their GP, Psychiatrist or Paediatrician under an EDP for either:
What if the EDP eligibility criteria are not met?
Patients not eligible for the EDP may still be eligible to claim up to 5 visits in a 12-month period under a Chronic Disease Management Plan (CDM) for a medical condition that has been (or is likely to be) present for 6 months or longer. Mental Health Care Plans (MHCP)s are valid for psychological services, not dietetic services.
Without either an EDP or a CDM, patients are still able to access our services, but as private patients without medicare rebates. They may be able to claim rebates from their private health fund.
The WA Eating Disorder and Outreach Consultation Service is a state-wide service that supports clinicians in safely managing their adult and youth (16+) patients with eating disorders. They provide consultation, education, and resources for clinicians working in inpatient, outpatient, and private settings.
WAEDOCS is a multi-disciplinary team comprising a nurse practitioner, consultant clinical psychologist, consultant liaison psychiatrist, specialist physician, senior dietitian, clinical nurse specialist (mental health) and peer support worker.
WHAT WAEDOCS PROVIDE
WAEDOCS REFERENCE GUIDE
You can contact WAEDOCS by phone or email between Mon-Fri 9:00AM-6:00PM:
Tel: 1300 620 208
WAEDOCS has developed a quick reference guide for clinicians on the management of eating disorders in youth and adults, which includes information on assessing risk in patients, guidelines for comprehensive medical monitoring, and criteria for hospital admission
If you're looking to learn more about eating disorders or HAES and non-diet approaches to health provision, several excellent training options are available below