Homeward Bound Nutrition 2024: Nutrition Counseling from a Health At Every Size ®  (HAES) Approach

DeliveryRank meets Cara D'Anello, MS, RD, LDN, CYT (She/They), a Registered Dietitian specializing in chronic dieting, disordered eating, and eating disorders across all body types and minds. With five years of experience in eating disorder treatment and outpatient group practice settings, Cara provides a compassionate space for individuals to process their relationship with food and body, aiming to help clients reclaim agency around food and honor their bodily needs. Utilizing a Health At Every Size® (HAES) approach, Cara promotes health equity and the end of weight discrimination, fostering sustainable, authentic, and values-driven relationships with food. 

Cara, what inspired you to specialize in eating disorders as a Registered Dietitian?

There are many dietitians who come into the eating disorder field due to their own lived experience or having seen their loved ones struggle with food. My experience reflects that of someone who struggled with their own eating disorder and witnessed family members struggle with scrutiny over their bodies resulting in vigilance around food. While in college, I had first hand experience seeing an eating disorder specialized dietitian, which was the first time I felt seen and comfortable talking about my control around food.

When I finished my training to be a Dietitian and entered a new stage of my own recovery, it felt necessary that my career be centered in nutrition counseling. With a newly found approach to eating that was gentle and non-shaming, I felt inspired to support individuals in a similar way my dietitian had supported me. 

Can you explain your approach to nutrition counseling and how the Health At Every Size ® (HAES) framework that influences your practice?

I take an anti-diet and Health At Every Size ® approach to nutrition, which means that I do not believe in the pursuit of weight loss as a behavior towards health, adequate nourishment, and/or a sustainable relationship with food. Dieting is incredibly harmful to our health, does not result in sustained weight loss, and increases the risk of disordered eating and inflammatory risk factors. 

You can learn more here: https://haeshealthsheets.com/why-we-dont-recommend-intentional-weight-loss/.

Instead of weight centric counseling, I focus on how to best support my clients around adequate nourishment and a less guilt ridden relationship with food. I include conversations around how social determinants of health, anti-fat bias, classism, ableism, transphobia, homophobia and racism impact our relationship with food and our bodies.

How do you support clients in reclaiming their relationship with food and body, particularly those who feel overwhelmed by the ever changing information around nutrition?

If I wasn’t in my profession, I would feel just as overwhelmed by the ever changing landscape of nutrition! Almost all of my clients come to our work feeling like they are eating “ the wrong way” or eating “bad foods”. I use quotations as I do not believe in moralizing food choices or behaviors. The foods we choose to eat always serve some sort of function, whether it be socially, emotionally, and/or physically.

When I am working with folks who feel overwhelmed by everchanging nutrition information, common questions that come up are:

 1. How do I have more energy throughout the day?

 2. How do I lessen my overwhelm when making food decisions? 

In our work together, we discuss what adequate nourishment looks like, how macro and micro nutrients are involved, and what nutrition information is plain myth versus fact. 

Can you share some examples of how you help clients explore their relationship with movement and its connection to body image and nutrition?

For many clients that are wanting to improve their relationship to movement, their internalized beliefs around physical activity need re-examination. Some common beliefs I hear are:

“I need to be active for a specific amount of time or else it doesn’t count.”

“The activity I enjoy isn’t worth doing since it’s not strenuous enough.”

“In order to eat a food I enjoy, I need to engage in certain physical activity for a certain amount of time.”

I support clients by helping them explore how these beliefs have come to be and how rigid thinking comes into play. Common strategies within this work are:

1. Finding types of movement that are intentional and sustainable

2. Figuring out realistic expectations around time and frequency when engaging in movement

3. How to incorporate nourishment before and after for repletion of energy stores and muscle recovery. 

What advice do you have for individuals struggling to find support groups or community resources to aid their healing journey?

If finding eating disorder or body image based support groups is challenging, it’s important to have some sort of space to feel connected with others and know that you aren’t alone. Challenges with food and body do not exist in a vacuum. Many individuals experience challenges around other aspects of their mental health, which influence one’s relationship with food. Finding a support group specific to one’s own mental health can be helpful. 

Outside of the group setting, having community is vital. A common suggestion I give clients is to call on their support system when needing encouragement to eat, meal plan, and or when having a hard day around food and their body. Clients will set up sessions with me because they need someone to talk to and don’t want to feel like they are navigating food on their own. Like dietitians, therapists can also be specialized in eating disorders. These providers help clients make meaning out of their eating disorders and cope with the underlying challenges that food challenges stem from. 

If you would like to find out more about Homeward Bound Nutrition, visit https://www.homewardboundnutrition.com/