What does a Dietitian do?
Paula Tait is a Dietitian but, contrary to what you might expect, her job is not just about food. In fact, during sessions with clients, Paula tries to minimise the amount she talks about food.
Everyone at Orri eats three meals a day, plus two snacks, which provides them with ample opportunity to focus what they’re eating and to explore how they respond to food emotionally. “Talking about food all the time feeds the eating disorder—it’s exactly what it wants and how it controls you,” she explains.
Nor does Paula (or anyone at Orri, for that matter) talk about calories. “What we’re trying to do is to help people develop a more natural relationship with food and to have an eating pattern that ultimately means individuals are able to respond to their hunger, which is quite normal. Our belief is that it is not normal to count calories,” Paula says.
A restrictive eating disorder, such an Anorexia, may start with calorie counting. An individual becomes increasingly restrictive and can end up weighing and measuring obsessively, unable to eat something unless they know its calorie content. “It wouldn’t be unusual for me to hear that somebody has 26 grams of cucumber with Ryvita, not 25 and not 27,” Paula explains.
“People get really embedded in the numbers, but your calorie intake and energy expenditure fluctuate every day so it’s not helpful.”
At Orri, we offer homemade food. “What we’re trying to communicate is that it doesn’t matter exactly how many calories you have, it’s that you have a snack and a cup of tea in the afternoon, a regular everday occurance,” Paula says.
“That’s what treating an eating disorder is all about—it’s making changes which are going to be sustainable.”
The food here is also delicious, which makes a huge difference to Paula’s job as clients are unlikely to complain about the quality of the food. “I’ve never come across such good food on an eating disorder unit,” says Paula. Whether it is fresh muffins or a fragrant curry, our chef Ben prepares food from scratch using top quality ingredients and always presents it beautifully. And when Paula has an idea or our people’s requirements change, Ben responds immediately.
It is Paula’s job to ensure that clients always get balanced meals and appropriate portion sizes but, when Paula meets with clients, rather than focus on the details of the food she usually talks in practical terms, either educating people or working out next steps. Paula wants her clients to be a healthy weight but she doesn’t impose strict eating plans or punish people with extra calories if they don’t eat enough. She does everything she can to work with her clients, never against them. “We both know they have to weight recover or find a balance, so we work together, to try and find a way that they can do it,” she explains.
Paula avoids setting rules for how a client must or must not eat. People with eating disorders already have a lot of rules—their lives are made up of rules. So rather than replace their rules with another set, Paula prefers to see how they get on at mealtimes and, if she notices they’re struggling with something, she’ll step in and help them to make changes. “That’s what treating an eating disorder is all about—it’s making changes which are going to be sustainable,” she explains.
At the end of each day, Paula agrees the menu with Ben for the following day. When clients arrive the next day, they look at the menu and select what they’d like to eat that day. “We don’t turn it into a big group, it’s just a casual conversation, just as I might ask you, what sandwich would you like at lunchtime? It’s as simple as that,” Paula says.