Navigating Dietary Preferences in Eating Disorder Recovery: A Client’s Guide

Guest Post by: Braelen Hunt, RDN from Side by Side Nutrition

Understanding Your Dietary Choices in ED Recovery

Navigating dietary choices during eating disorder (ED) recovery can be challenging. You might wonder if a particular preference is driven by your eating disorder or if it’s a legitimate dietary need, like cultural practices, allergies, or intolerances. Let’s break it down together.

Your Autonomy Matters

During ED recovery, it’s common to hear phrases like “that’s your eating disorder talking.” While this can sometimes help, it can also make you feel like you’re losing control over your own decisions. It’s important to respect your autonomy—your right to make choices for yourself.

Respecting Your Preferences

In treatment, you should never feel like your dietary preferences are ignored in favor of nutrition and weight goals. There’s a difference between a preference and something that feels necessary for your comfort and safety, like sensory sensitivities or a sense of choice.

A Neurodiversity Approach

To make sure you feel safe and respected, applying a neurodiversity approach in ED treatment is crucial. This approach focuses on your individual experiences and needs, rather than just following strict rules. Here’s how it helps:

Autonomy

Your right to make decisions for yourself is essential. Sometimes, your eating disorder can make it hard to make safe choices, but taking away your autonomy completely can make you feel even more stressed and unsafe.

Choice

Being able to make choices helps you trust yourself and feel secure in your treatment. When your choices are taken away, it can make you feel more anxious and less in control, which isn’t helpful for recovery.

Curiosity

Instead of immediately judging your food choices, it’s helpful when your treatment team gets curious about why you make certain choices. This way, you can work together to find solutions that meet both your nutritional and emotional needs.

Common Reasons Behind Dietary Choices

Here are some common reasons why you might make certain dietary choices, and how to address them:

Sensitivity to…

• Certain texture, taste, or smell 
• Lights, sounds, textiles
• Gluten or lactose 
• GI distress 
• Changes in medications 

Fear of…

• Weight gain
• Choking or gagging
• GI distress
• Unfamiliar foods
• Foods seen as “forbidden” 
• The meal time itself
• Rejection or criticism
• Abandonment
• Neglect
• Failure

Cultural and Religious Practices

• Fasting
• Abstaining from specific food groups
• Abstaining from the combination of specific food groups, such as meat    and dairy
• Accessing specific restaurants and grocery stores to ensure                  requirements are met, such as Kosher or halal 

Validate & Accommodate

Validate and Accommodate

• Work together to balance nutrition with sensory needs. Substitute with another food group or supplement. Plan food exposures at a different time. 
• Address any sensory issues that might be causing distress.
• Address GI symptoms like nausea or pain. See our GI Distress Tips & Tricks handout for more info.

Safety & Harm Reduction

Establish a sense of safety, both internally and externally. Use therapy techniques that work for you, like breathing exercises, mindful movement, sensory engagement, and more. Prioritize nutrition while meeting your nervous system’s needs with support and accommodations. 

Harm Reduction, Autonomy, & Respect

Establish an order of priority. Nutrition must come first, then autonomy and observing religious and cultural practices. Practices that interfere with weight restoration, such as fasting, can wait until the client is nourished enough. 

Respect your beliefs and practices while focusing on nutritional rehabilitation. Collaborate to ensure all needs are met and accommodate cultural and religious practices as much as possible.

Remember, your journey to recovery is unique, and your preferences and choices deserve to be respected and understood. By working together and using a neurodiversity approach, you can find a path that honors both your nutritional needs and your personal experiences.

Resources & Further Reading

• Felt Safety: The Foundation of ARFID Support – Lauren Sharifi Nutrition
• Applying the Neurodiversity Paradigm to ARFID — RDs for Neurodiversity
• Fight, Flight, Freeze, or Fawn: How We Respond to Threats