(piano music)
- Welcome back everyone and thanks for tuning in.
Now, I know last week I talked a little bit
with Kate Machado.
She's a registered dietician.
I know that I've told you guys
I was gonna sit down with her
I know it feels like it's been forever,
but we finally got our schedules to work.
And, today's topic is just de-mystifying
what it means to go see a dietician,
and I know that many of you are scared to call a therapist
and we're scared to see our doctor;
even making an appointment can send us into a frenzy.
So, we want to make sure that we feel okay
and we know what to expect, because a lot of times
we're just getting anxious because of the unknown.
It's scary when we don't know, right?
So, I guess my question for Kate today is,
just tell us a little bit about what
the first session will look like.
- Well, obviously it will look
a lot of different ways, but I think the first thing
to maybe think about is, well, "How do find a dietician
that specializes in eating disorders in your area
or in the area that your eating disorder is in?"
'Cause again, the more specific the better, but it just
really depends on the individual.
So, like you were saying, it is really...
anything new can be anxiety provoking,
so looking for a dietician,
well how do you judge?
You base them on their name, on their location,
on a picture you've seen on the internet.
I mean, none of that is going to be a good indicator.
I think the best way to find a dietician
is through a referral.
Whether you're seeing a therapist
who can refer you to one that they work closely with,
or a doctor can refer.
There are a lot of really
good websites out there that Kati has on
her references page that you can look for that
refer to specialists in eating disorders as dieticians,
and then make a phone call,
see if you can have a good conversations with them,
if you like the rapport.
But, if you don't feel comfortable,
you're interviewing them first, so if you
don't like the way it's going say,
"Well, thank you.
I'll call you back
if I want to make a time."
If you do want to go forward and make
a first appointment, just set that up and
the first appointment...
and right now I'm kinda talking about
an outpatient basis first
and then I'll get to the more of an inpatient basis.
So, if you want to make an appointment
to see a dietician outpatient, the first session will
usually be between on to one and a half hours,
and that will generally cover everything.
From the history of your eating disorder,
how long you've had it, what kind of treatment
you might have had in the past, what behaviors
you are currently dealing with,
what you did in the past.
and then it will definitely include a lot
about food and possibly your weight
and the history of maybe your physical changes
or any kind of medical conditions you've had.
So that's usually, as I've found, the most
fear inducing part for a lot of new clients
that come in, because it's really personal to
tell this stuff to someone you don't know.
Especially since often eating disorders are
kind of private; kept secret, so then
telling somebody that you're not that
comfortable with all of your secrets.
Then I know there a really big fear of being
honest because, you know, what if we are judgmental?
What if we come across as
being like, "Oh my God!
"That is so disgusting,
I just can't believe you've done that."
And, for me and any good dietician I know
that works with eating disorders
has no judgement when it comes to meeting
new clients, treating clients.
There is probably nothing we've not heard before.
Not just that we haven't heard it before but
its part of the eating disorder and everybody's
different and is going to experience
their behaviors in different ways and
the most important thing, I think, is that
you can be honest to us.
Because, as a dietician who may be addressing
really specific issues when it comes to,
"Well, how much were you really eating before
and what foods can you eat and what foods
make you sick" or you know, you have
really intense reactions to in terms
of psychological or physical, but if you
do not tell the whole truth I can go
around in circles and in days and giving you
this all great advice that I think I have
that really is useless because it
might not be based on what truth you have told me.
So, for me, that is probably the biggest
part of the first session.
Is having someone come in, they may have their
general data, which you know; age, height,
kind of basic history of themselves,
and then it would be applying a kind of a program
to their situation at the time.
but I can't do that unless
I'm feeling like that person is willing
to try it at least and open to
some of the suggestions.
So that might mean someone's coming in,
maybe they've had an eating disorder, you know
for a year and it's been getting a lot worse
and their not really eating very much at all
on a daily basis, or keeping a lot in on a daily basis.
So, it might just be increasing the amount of times
you eat, a little bit at a time and that
can be really scary.
But, any first session would just be about
really small steps in the beginning,
in terms of an outpatient basis and then
we would see how that goes for the first week
and that point I would usually recommend
a weekly reoccurring appointment
until there's pretty good progress being made.
Then kind of on the flip side of it,
if I am doing an initial session in more of
a treatment center basis, a lot of the background
information I may have already gotten from
the other treatment team members, and so yes
I will collect that information again
just to get to know the client and hopefully,
you know, the client will like to be working
in this kind of manner and then really start
addressing a lot of the food issues
when it comes to how much, when,
where to eat, what types of food to eat,
how to do it and really, really practical information.
I think that can be one of the hardest
things when it comes to maybe therapy or treatment.
A lot of it seems really like big scope, like
okay well just get over your anxiety and
just eat again, it's really not a problem
but it really comes down to the specifics.
Like, you have to eat this thing,
at this amount, at this time
and then tell me about it right after you did it
and what did you feel?
So, it's not like you're doing it
completely on your own, by yourself
with no support.
I think our biggest job is, you know
we may put out some recommendations
and then seeing how you did with it, right away,
and then addressing everything from there
based on those first experiences.
But, I think for me, when I see new patients
on whatever kind of level, I would say a good
part of any first session is really
just about building a rapport with the client
and getting to know them because
everyone is really different when it comes to
how they take in advice or feel comfortable
speaking with someone else, and so it may seem
kind of really easy the first session
because it's not that hard unless
you're not comfortable talking to somebody,
but that's kind of the benefit of maybe
doing this video right now is to
understand what it will feel like and
kind of preparing for that first session.
- Yeah, definitely and like Kate said and
like I said to you tons of times, everybody is different.
So, any first session we're just trying
to get to know you, make sure you're comfortable,
make sure we have a good working relationship
because we're working together.
You know, I'm always saying we and us
because it's a team; we're all working with you.
you're not alone and things will be hard
and we're going to challenge you 'cause
otherwise we're not doing our job and
we're not a good part of your team, you know.
so, it might feel like we're pushing you
a little bit but it's just to see,
to be honest, to get the honest input
from you like,
"Well I tried this and this is how I felt
and I couldn't do it.
It didn't work."
or "this happened."
because then we take that information,
we almost like put it back
in our machine and we try to come up
with another option.
So, I think..
- It's all, you know, that's the importance
I think of seeing an individual dietician
or an actual in person because they
can take what your saying,
what your feeling in the moment,
or what's going on in your life
at that present time and find a way
for you to get through it.
For me, it's with food or it's with eating
and getting to the part you need to eat.
But, it's really, really doable.
You know, as many times as I've heard
that patients aren't looking forward
to seeing me, or that they are really upset
that you've given them extra food to eat,
I have no hard feelings toward anybody
because when somebody goes through
and comes out on the other end of recovery
they are so grateful that I was there
and we just laugh about how mean they were to me
maybe, or they were really afraid of me.
So, none of that scares me.
It doesn't scare me away.
It doesn't push me away.
It doesn't make me dislike somebody.
It's just the eating disorder and that is
what I'm dealing with, so I'm not
really intimidated by that at all.
I think any dietician who is familiar
with eating disorders is the same exact way.
More than anything we just obviously want to help.
But, some of the biggest things that we deal with,
some of the biggest fears are,
"Well, how much am going to have to eat?"
"Am I going to get fat?"
"What does she know about me?"
"She's blah blah blah, looks a certain way."
And, a lot of, I think, we get kind of
put on the spot like,
"Well, what are you eating?"
"Well, why do you do that?"
and obviously that's just the eating disorder
trying to find a way so we always just turn
that back around and work with the client
and really just address somebody where their at
with the team we have.
- Exactly.
And, those will be all of the
other questions we will answer in future videos with Kate.
You know, I know a lot of you
do have those concerns and we'll talk about them
and address them and kind of show you
how we use them in our sessions and
what she does when she works with you.
developing meal plans and what
that kind of looks like on the other side.
So, I hope that was informational and we will
keep doing more of these videos as
we keep taking one step at a time
towards a healthy mind and a healthy body.
And, don't forget to subscribe to my channel
because then when I post my next video
of sitting down with Kate,
you will be notified about it.
- Yay.