In part four of the nutrition series, Director of Nutrition Mary Dye, MPH, RD, CEDRD, LD/N continues to share about the nutrition philosophy at Oliver-Pyatt Centers. Mary dives into the use of meal plans and how clients are supported through dietary challenges throughout the day.
At Oliver-Pyatt Centers, our meal plans have the basic pattern of 3 meals and 3 snacks but caloric levels vary from client to client. Registered Dietitians set the initial plan and adjust it over time to the client’s needs (to meet weight gain goals if needed, for example) and authentic (not ED driven) preferences and cue system. We study each client’s patterns and when certain criteria have been met, we move them from staff portioned foods to having clients portion their own plates. As client’s gain more autonomy, we know that the pull of the ED often gets strong in each transition. This a reason why we do not use measuring tools in our model. Instead, we move clients from staff plated to eye-balled portions with staff feedback, helping them to continue to read and respond to their internal cues and visual knowledge of their meal plan rather than rely on external cues such as calorie numbers or measuring tools. Calorie and exchanges can be followed perfectly and still leave a person wanting for more or feeling un-satiated, therefore we take satiety into account when considering whether or not a client has ultimately met her needs in a meal or snack.
Since our dietitians aren’t meal planning in sessions, we are able to use our sessions addressing table behaviors, patterns, rituals, food rules, barriers to dietary acceptance and expansions, etc and to help our women discover their preferences, positive associations and memories of foods, taste, texture, ways to navigate their meal plan in their increasingly autonomous life in recovery, etc. Essentially, by having food exposures 6 times per day and bringing all of the information gathered into session, we can initiate dietary challenges and changes that led by the client’s experience rather than by the dietitian telling them how to eat. We are continuously able to help them learn from what they’ve already experienced. This is a huge factor in sustained recovery, especially in populations of clients who have been in and out of treatment or those who have been told how to eat but never given the chance to develop their own understanding of how to nourish their body.
We are so grateful to do this work of challenging, reconnecting and nourishing the women who come through these doors in this unique and bold way.