When The Dietician at the Hospital Doesn’t Understand Eating Disorders

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By: Elizabeth Janiello

“You are in good health, Elizabeth.” These are the words my dietician at the psychiatric hospital spoke to me. When she called me back to talk with her, I felt relieved. Finally, I can talk to someone in this hospital who understands eating disorders. Someone that can help me navigate the hospital while having an eating disorder. She sits me down, tells me my weight, and I instantly know that she has no clue how to work with patients with eating disorders. She didn’t ask what I’ve been eating since entering the hospital. She didn’t ask what I was eating before getting to the hospital. She simply said my height and weight and declared that I am in “great shape” and “very healthy”. She said, in broken English, “You are happy with your weight, yes?” Honestly, I respond no. I am not happy with my weight. She says, “You could lose a little, maybe a few pounds.” She asks, “Do you have a goal weight?” I respond with the weight I would like to weigh, one that I know is unhealthy, one that I know is meant for middle schoolers. But this is the weight I would like to be at. She responds, “Okay, that is fine.” She walks away.

Talk about a medical professional who knows nothing about eating disorders. I don’t know why I even expect anyone to understand eating disorders at this point. This is another reason I am so thankful for Project HEAL. I am fortunate enough to work with an entire team of specialists who SPECIALIZE in eating disorders. I am so very lucky.

I’d like to say that being here is helping me get better. But right now, I’m not so sure. I still feel stuck and defeated. And I know I’m letting my depression and anxiety get the best of me. Writing this has helped put me on a better path- a recovery-focused path.

Sitting in front of me is a banana, what I took for lunch from the cafeteria. To all those who are struggling and reading this, I am going to do something for you. I am going to eat this banana for you. It is literally the last thing I want to do. I am already in “restrictor mode” as I call it. But my outpatient dietician says that everyday we are given hundreds of opportunities to make decisions. For any given choice, one will be comfortable and safe, and one will be uncomfortable and scary. She told me to always chose the scary and uncomfortable choice. For me, restricting is safe and comfortable. I restrict when I’m scared, anxious, sad, angry, lonely, defeated, etc. Any emotion I’m feeling- I restrict. So, in this moment, I’m going to do the hard, scary, uncomfortable thing. I’m going to eat my banana. Right now, I’m doing it for you, for anyone who is reading this blog. But maybe one day soon, I’ll want to do it for me.


Lizzie studied Psychology at Hillsdale College, a small liberal arts school in Michigan. She currently works as a research assistant in Washington, D.C. She is in recovery and hopes to one day use her experiences to help others struggling with eating disorders. Lots of love and please stay strong! You’ve got this. 

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