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The Registered Dietitian's Role in the Treatment of Eating Disorders

A Presentation by Mirasol Clinicians to the University of Arizona College of Medicine Psychiatry Grand Rounds.

Anne Ganje, RD

Mirasol clinicians were recently featured at the University of Arizona College of Medicine Psychiatry Grand Rounds. Speakers included Medical Director Stephen Remolina, Executive Director Diane Ryan, Clinical Director Maeve Shaughnessy, Nutrition Director Anne Ganje and Trauma Therapist Ann Twilley Garcia.

The purpose of the Psychiatry Grand Rounds series is to provide mental health professionals with updates on psychiatric topics with the goal of increasing knowledge, competence and patient care. The full presentation is available on the Univeristy of Arizona's Biomedical Communications website at

"My work is helping my clients make the connection between their uncomfortable emotions and their eating disorder behaviors," says Ganje. The dietitian's role is challenging because he or she is in charge of the client's food. This can be very activating and stressful for clients, but it also provides many opportunities for the client to process anger.

Food games and rituals are common in eating disorder clients, and can include everything from over chewing to peeling grapes to choosing high-fiber foods for their laxative effect. Clients may use of cinnamon, hot sauce green tea to stimulate their metabolism, eat foods in specific order, hide food in the sleeves or pockets or restrict water consumption. Vegetarianism, dairy-free and gluten-free diets are common covert means of limiting food choice.

As a last-ditch effort to control calories, clients my resort to compulsive exercise, including taking every opportunity to stand or walk around. Ganje concludes that her goals are to work with the clients to normalize food thoughts and eating disorder urges, to support them in acceptance of their new body shape and size, to help them to recommit to the recovery process when they relapse, and, ultimately, to learn to view food as a source of comfort, love, connection and health.

More Videos in This Series

  • Dr. Stephen Remolina The Complexity of Eating Disorders
    Stephen Remolina, MD, Medical Director
    Dr. Remolina shares some of his experiences in working with eating disorders and demonstrates how complicated they can be by presenting case histories for bulimia nervosa, anorexia nervosa and binge eating disorder.
  • Diane Ryan What's New in Eating Disorder Research?
    Diane Ryan, LPC, MA, Executive Director
    Ryan highlights some of the latest research on eating disorders, especially binge eating disorder, which is in the spotlight right now because of its recent addition to the DSM-V
  • Maeve Shaughnessy Treating Eating Disorders: An Integrative Approach
    Maeve Shaughnessy, MS, LPC, Clinical Director
    Eating disorders rarely occur in a vacuum. They are frequently accompanied by anxiety, depression, PTSD, bipolar disorder or borderline personality disorder, so it's essential to treat the whole person — mind, body and spirit.
  • Ann Twilley Garcia EMDR in the Treatment of Eating Disorders
    Ann Twilley Garcia, MA, LPC, Trauma Therapist
    By accessing traumatic memories in a safe environment, EMDR enables clients to develop new and more positive associations between the traumatic memory and more adaptive memories or information.