Recently, I attended an eating disorders talk given by a well-known local dietitian. Boy, was I in for a surprise!
The R.D.'s talk centered around the benefits of proteins, the dangers of carbs. Toward the end, she gave us some sample high-protein breakfasts, including a couple she routinely eats. Each contained about 50% of the calories typically recommended for breakfast by nutritionists.
I was surprised that someone was sharing this information at a gathering of eating disorders professionals and when I asked her how she presents this information to her clients without triggering their symptoms, the facilitator noted that the dietitian was focusing mainly on nutritional recommendations for medical populations (e.g., diabetics).
An eager hospital-based internal medicine doctor in the crowd supported many of the RD's points, stating that he often places his patients on "no-carb" diets for successful weight loss. I'm guessing that this physician does not follow his patients long-term.
My takeaways from this talk?
1) Physicians shouldn't be prescribing diets for their patients. A 2010 study revealed that medical students receive, on average, 19.6 hours of nutritional education, hardly enough to qualify them as nutritional experts.
2) Again and again, weight loss through restrictive dieting is recommended for medical populations, but typically, these restrictive diets lead to weight-cycling (which has more deleterious effects on health than remaining at a higher, stable weight). Significant weight-cycling occurs as a function of deprivation-influenced overeating.
3) Those who struggle with eating disorders need to be VERY careful in selecting their providers. It is not enough to see a dietitian who lists eating disorders as one of her specialties. Instead, those with e.d.'s must vet their providers to ensure that they understand typical symptom triggers, promote a healthy relationship with food, and operate from a recovery perspective.