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How Nutritional Counseling Helps You Navigate Emotional Eating Without Shame

Emotional eating gets a bad reputation and is often thought of as a negative thing. Blogs, books, even other medical professionals often talk about it as something to be controlled, stopped or overcome. They tell you to “stop stress eating” or “control emotional eating”. As if the act of finding comfort in food is something to be ashamed of. Yet, food and emotions are deeply connected. They can remind you of home, provide solace during difficult times, and even bring people together. So, why is this made out to be a bad thing?

The idea that eating should only be about fueling your body, never for comfort, joy, or connection? That just doesn’t reflect how we actually live. Food is a part of your memories, our daily experiences. Even your body can crave certain foods to help you feel better. That’s why nutritional counseling can be so helpful in navigating emotional eating without shame. Nutritional counseling gives you a safe space to dive into your emotional eating. Without any judgment or the need to “fix” anything. It allows you to better understand your patterns. But it also allows you to unpack the deeper reasons behind them, and develop a more attuned relationship with food. One that honors both your body and emotions.

Creating a Safe Space to Explore Emotional Eating Two women smile and collaborate while working on a laptop, highlighting the supportive approach of nutritional counseling in Raleigh, NC with a nutritionist in Raleigh, NC to create personalized, sustainable wellness strategies.

One of the most powerful aspects of nutritional counseling is that it’s not about restriction, guilt, or control. It’s about understanding, validation, and empowerment, all in a space that’s free of judgment. Often people don’t talk about their emotional eating because of the shaming and judgmental messages around it. It makes sense that you would fear talking about this. Especially when you’re constantly told that it’s “wrong” or that you just need more willpower. But the reality is that emotional eating is a coping mechanism. And like any other coping mechanism, it needs to be understood and addressed in a supportive way. Plus, food isn’t just fuel to our bodies. It has cultural, social, and emotional significance, especially during difficult times. And, it can be a big part of how you care for yourself.

Nutritional counseling gives you the space to talk with a registered dietitian. It gives you the time and space to be curious about the reasons behind your emotional eating. Together, you can begin to recognize what’s happening beneath the surface when you reach for food in response to emotions. Maybe your emotional eating has been your way of coping with stress, anxiety, or loneliness. Or, maybe it’s been a form of self-soothing that’s helped you feel safe and comforted in the past. Whatever the reason, instead of focusing on stopping emotional eating, counseling helps you explore why it’s happening. Along with the what your body and mind are truly asking for.

Understanding the Root of Emotional Eating

Emotional eating isn’t just about the food. It’s about how you connect with yourself. Everything in life is a relationship, and food is no different. When you turn to food for emotional reasons, it’s a way of trying to fulfill an unmet need or soothe uncomfortable emotions. This could be due to past experiences, beliefs about yourself and food, or simply not having the tools to cope with difficult emotions. But with the support and guidance of a registered dietitian or nutritionist, you can dig deep and uncover the root causes of your emotional eating. Then you start addressing the underlying issues instead of focusing solely on the food aspect. When you’re working with your registered nutritionist in counseling, you can unpack your relationship with food by reflecting on questions like:

  • What feelings usually trigger emotional eating for you? 
  • How did your relationship with food develop as you grew up? 
  • When you eat for comfort, what emotions are you trying to soothe or avoid? 
  • Are you listening to your hunger cues during the day, or are restrictions causing you to turn to food later on?

In a safe, supportive space, you can start shifting from guilt to understanding. Emotional eating isn’t a failure on your part nor is it wrong. It’s a signal from your body that something isn’t right and needs to be addressed.  This can be a signal that something deeper, like stress, exhaustion, or loneliness, needs your attention and care. By exploring the root of your emotional eating, you can develop a stronger sense of self-awareness and work towards making choices that truly align with nourishing your mind and body.

Moving Away from Diet Culture & Shame A man prepares a nutritious meal with fresh ingredients, highlighting the benefits of nutrition therapy in Raleigh, NC with guidance from a nutritionist in Raleigh, NC for a balanced and mindful approach to eating.

Ever been told to “just have more discipline” or “cut out trigger foods”? That’s diet culture talking. It makes emotional eating seem like a flaw. It says eating when you’re not physically hungry is bad. That finding comfort in food is wrong. That resisting cravings and cutting out certain foods will somehow “fix” everything. Yet, here’s the thing, taking away food doesn’t take away the need your body has for comfort and nourishment. It only adds more pressure and shame, leading to a vicious cycle of restriction followed by bingeing. If you’ve been turning to food for emotional comfort, trying to restrict it will only make things harder. The goal of nutritional counseling isn’t to control your eating, it’s to help you reconnect with your body in a way that feels safe and supported.

That’s why our approach focuses on curiosity, not control. Instead of viewing emotional eating as a problem to be solved, we see it as a conversation your body is having with you. Nutritional counseling can help you break free from the guilt that often comes with emotional eating and replace it with self-compassion. Society tells you this is something to feel guilty about or that it’s “wrong”. But in reality, emotional eating can be a form of self-care. It’s a way to cope with difficult emotions and provide comfort when you need it most.

By acknowledging this and treating yourself with kindness, you can begin to transform your relationship with food. That’s why we start by recognizing the patterns. When and why do you turn to food for emotional reasons?  What emotions are you trying to cope with? By bringing awareness to these triggers, we can work towards finding coping mechanisms that work for you and your lifestyle while still nourishing your body. It’s not about eliminating emotional eating altogether, but rather finding balance and creating a positive relationship with food and your body.

It’s not about restricting certain foods or labeling them as “bad”.

Often, other medical professionals, social media influencers, and diet trends may promote restrictive diets or labeling certain foods as “bad”. However, food is not a moral issue, and we do not believe in restrictive eating. Our approach to nutritional counseling is rooted in the belief that all foods can fit into your lifestyle. We encourage you to listen to your body’s cues and honor its cravings, while also incorporating nutrient-dense foods to nourish your body. By removing the guilt and shame associated with food, you can begin to make choices that truly serve your body’s needs. We believe in empowering individuals to trust their bodies and make informed decisions about their health.

Our goal is to empower you and provide tools for long-term success. This is why at Nutritious Thoughts our team of registered dietitians encourage a non-diet approach that focuses on intuitive eating and honoring your body’s natural cues. This means listening to your body’s signals of hunger and fullness, rather than following strict rules or restricting certain foods. We also believe in incorporating joyful movement and finding ways to enjoy physical activity, rather than viewing it as a punishment for food choices.

The Role of Attuned Eating in Emotional Well-Being A woman enjoys a meal while listening to music, embracing a balanced approach to eating with guidance from a dietitian in Hendersonville, NC and a nutritionist in Raleigh, NC.

Attuned eating is all about tuning into your body’s cues, respecting both your physical and emotional needs, and ditching those external food rules. It’s a key part of nutritional counseling that helps you rebuild trust with your body. You learn to trust that your body knows what it needs, that all foods can fit into your life, and that emotions don’t have to take over. Attuned eating shifts the focus away from labeling foods as “good” or “bad” and instead asks, what feels nourishing and supportive right now?

It’s about learning to tell the difference between emotional and physical hunger, but also about allowing yourself to eat emotionally without guilt. Emotional eating isn’t inherently harmful, it only becomes an issue when it’s the only tool you have to cope. We know this can be a vulnerable process, and it’s so important to create a safe, supportive space for you to explore your relationship with food and body image. Emotional eating and curiosity are closely connected, which is why building trust with your nutrition counselor matters so much.

Diet culture has taught us to feel guilt and shame around food, but in nutritional counseling, the focus is on creating a relationship where you feel seen, heard, and understood. We’re not here to give you a list of rules or tell you what to eat. Instead, we’re here to offer an open, supportive space where you can explore your relationship with food without fear of judgment. This is a place to share your experiences with emotional eating, get guidance tailored to your unique needs (not some one-size-fits-all diet advice), and feel supported as you move at your own pace. Healing your relationship with food isn’t about willpower or discipline—it’s about creating safety around food, noticing patterns with curiosity, and building coping skills that truly work for you.

Finding Peace in Your Relationship with Food

Emotional eating doesn’t have to feel like a constant struggle, and it’s definitely not something you need to “fix” or feel bad about. Instead, it can be a chance to pause, reflect, and discover what you really need in a way that feels nourishing and satisfying.   If you’re ready to build a healthier relationship with food, one based on self-trust, awareness, and compassion, nutritional counseling in Raleigh & throughout North Carolina can help. We’re here to guide you through emotional eating without judgment, so you can feel more confident, clear, and at ease. Because food should be about self-care, not self-criticism. You deserve support that truly helps you take care of yourself, mind, body, and soul.

Compassionate Support for Emotional Eating Through Nutritional Counseling in Cary/Raleigh, Asheville, Hendersonville, and Across North Carolina

Emotional eating isn’t something to “fix”, rather it’s something to understand. At Nutritious Thoughts, our registered dietitians and nutrition counselors help you explore your relationship with food in nutritional counseling, which is a non-judgmental space, free from diet culture. Instead of shame, we focus on compassion, curiosity, and lasting change that honors your needs. With locations in Asheville, Hendersonville, and Cary/Raleigh, plus telehealth services across North Carolina, we make accessible, shame-free support available wherever you are. Whether you’re untangling emotional eating, chronic dieting, or just want a healthier relationship with food, we’re here to walk alongside you. So why wait? Take the first step towards a healthier relationship:

  • Contact us at (828) 333-0096 or email us at info@nutritious-thoughts.com
  • Tell us more about yourself
  • You deserve a relationship with food that feels safe, intuitive, and free from guilt.

Expanded Counseling Services at Nutritious Thoughts

At Nutritious Thoughts, our support extends far beyond individual counseling. Through our Community Wellness & Education programs, we engage with schools, workplaces, and recovery centers to bring tailored nutrition counseling, workshops, and educational presentations directly to your community. Whether delivered on-site or virtually, our goal is to provide accessible wellness tools where they can make the greatest impact. Reach out to learn more about our services and pricing.

Is Seeing a Registered Dietitian Worth It?

As a practice of registered dietitians, our answer is: of course, seeing a registered dietitian is worth it! But also it’s not simply about booking an appointment with the first one you find. The real value lies in finding someone who excels in nutritional counseling and takes time to truly understand your unique needs and experiences. A skilled registered dietitian won’t just give you generic advice or craft a generic plan. They’ll listen closely, and consider your life, preferences, and goals, to develop strategies that work for you. Because truth be told, you know what is best for your body.

When it comes to nutrition and well-being, there is no one-size-fits-all solution. Each person has different goals, challenges, and lifestyles that need to be taken into account when creating a personalized nutrition plan of action. That’s why seeking the guidance of a registered dietitian, that centers you, can make all the difference. For those seeking nutritional counseling in Raleigh & throughout North Carolina, the right registered dietitian can be a game-changer. They will go beyond general nutrition education and will work with you to develop a plan that meets your specific needs.

What Makes a Registered Dietitian Different? A woman reads a cookbook in a modern kitchen, focusing on mindful eating and nourishment. Explore nutrition therapy in Raleigh, NC, and support for binge eating disorder therapy in Asheville, NC to build a balanced relationship with food.

Not all nutrition professionals are the same, and understanding the distinctions can help you make the best choice for your health. Registered Dietitians (RDs) stand apart because of their rigorous training and qualifications. They complete extensive education in nutrition science, undergo supervised practice, and are licensed to provide Medical Nutrition Therapy (MNT). This means they are uniquely equipped to support individuals managing chronic conditions like diabetes, heart disease, and eating disorders as well as general well-being. 

The term “nutritionist,” on the other hand, is not regulated in many states. Unfortunately, this means that anyone can call themselves a nutritionist, even without formal education or credentials. This lack of standardization can make it challenging to find someone with the right expertise for your needs.   At Nutritious Thoughts, our registered dietitians also take on the role of nutritional counselors. They go beyond meal plans and science-based recommendations to focus on education and emotional support. We believe healing your relationship with food requires more than just knowledge. It takes compassion, understanding, and a thoughtful, personalized approach. With us, you’ll find experts who are not only highly qualified but ready to walk this path with you.

A Tailored Approach: Why One-Size-Fits-All Doesn’t Work 

General nutrition education is everywhere—from websites to social media to well-meaning advice from friends. But just because the information is out there doesn’t mean it’s helpful or right for you. Nutrition is deeply personal, and cookie-cutter solutions often fail to address the complexities of your individual needs.  We are all different from each other, and your nutrition plan should reflect that.  That’s where the expertise of a registered dietitian (RD) makes all the difference.

Unlike broad, one-size-fits-all advice, registered dietitians at Nutritious Thoughts provide personalized care that truly meets you where you are. They take the time to get to know you—your unique relationship with food, your medical history, your lifestyle, and your personal values. This holistic understanding allows them to create a plan that isn’t just about what’s on your plate but what can fit into your life in a meaningful and sustainable way. Our RD’s help you approach change with a sense of possibility rather than pressure. That’s why our registered dietitians believe nutrition should never feel like judgment or punishment. Nutritional counseling should be a supportive and empowering experience that helps you build a positive relationship with both food and your body.

Are Registered Dietitians Covered by Insurance? A man prepares a homemade meal, focusing on balanced nutrition. Discover nutrition therapy in Raleigh, NC, and explore nutritional counseling in Raleigh, NC to build sustainable, mindful eating habits.

Many people hesitate to book an appointment with a registered dietitian because they assume it’s an out-of-pocket expense. But the truth is, that most major health insurance plans include coverage for nutrition counseling. This can be a game-changer in making personalized nutrition care accessible and affordable.  At Nutritious Thoughts, we’re proud to be in-network with a wide range of insurance providers, helping to remove one of the most common barriers to seeking care. If you’re unsure about your benefits, it’s always worth taking a moment to check with your insurance provider, or feel free to give our office a call.

You might discover that seeing a registered dietitian is covered, which opens the door to expert guidance without the added financial stress.   Investing in your nutrition is one of the best decisions you can make for your overall health and well-being. Whether you’re managing a medical condition, healing your relationship with food, or just looking to build healthier habits, working with a registered dietitian can help. They provide the tools, knowledge, and support needed to make lasting changes.

How Seeing a Registered Dietitian Can Change Your Life

When it comes to our health, we often overlook the importance of nutrition. Usually, this is because you might hear generic advice or confusing messages about what you should or shouldn’t do. A registered dietitian offers personalized and evidence-based recommendations that take into account your unique needs, preferences, and goals. Not only can a registered dietitian help you achieve your health and wellness goals, but they can also improve your relationship with food. Here are ways seeing a registered dietitian can positively impact your life:

For Chronic Conditions 

Living with a chronic condition like diabetes, IBS, high cholesterol, or PCOS can be tough, especially when you’re juggling dietary needs with everything else in life. That’s where a registered dietitian (RD) comes in. They’ll help you break it all down into simple, doable steps. No overwhelming rules, just real solutions. Instead of focusing on what you can’t have, an RD shows you what you can enjoy while working towards better health. The best part? They’ll create a plan that fits your life, so you feel confident in the process.

For Eating Disorders & Disordered Eating 

Feeling stuck in cycles of binge eating, restriction, emotional eating, purging, or chronic diet burnout? You’re not alone, and you don’t have to do this alone either. So many people feel trapped by challenging patterns of eating (disordered eating), but a registered dietitian can help. With support that’s kind and free of shame, they’ll help you rebuild trust with your body and develop a healthier, more peaceful relationship with food and your body. It’s not about strict rules or quick fixes, but rather finding balance and making sustainable changes that serve your overall well-being.

For Everyday Wellness 

You don’t need a medical condition to work with a registered dietitian. Maybe you want to move away from diet culture, improve your relationship with food, or just feel stronger and more at ease in your body. Our RD’s are here to support you, not to set rigid rules. They’ll meet you where you are and help you feel confident about making food choices that align with your needs and desires. Taking care of yourself isn’t about being perfect. It’s about progress, self-care, and having the right support.

Is It Worth It? A woman prepares a homemade meal with care. Learn how nutrition therapy in Raleigh, NC, and working with a dietitian in Hendersonville, NC, can support a balanced and sustainable approach to nourishment.

100%—if you find the right fit. Working with a registered dietitian is about so much more than just food. It’s about healing the parts of you that feel stuck, gaining a deeper understanding of your unique needs, and feeling empowered to make choices that truly support your well-being. Not all RDs are the same, and finding someone whose philosophy and approach align with your values is essential.   If you’ve ever felt overwhelmed by conflicting nutrition advice, lost in what actually works for your body, or frustrated by rigid, one-size-fits-all solutions, this could be the turning point you’ve been looking for. Nutritional counseling in Raleigh & throughout North Carolina can give you clarity, support, and the tools to nourish yourself with confidence and self-compassion. You deserve care that meets you where you are and helps you move forward.

Discover Nutritional Counseling in Cary/Raleigh, Asheville, Hendersonville & Across NC

Nutritional counseling is an investment in yourself and your future. By working with a registered dietitian, you’re investing in your physical, emotional, and mental well-being. With locations in Asheville, Hendersonville, and Cary/Raleigh, as well as telehealth services for those across North Carolina, Nutritious Thoughts is committed to providing accessible and compassionate care. We believe that everyone deserves the support and guidance to live a nourished life, and we’re dedicated to helping you get there. Together, we’ll help you create a sustainable, personalized approach to nutrition that honors your unique needs and empowers you to thrive. So why wait? Take the first step towards a healthier relationship:

  • Contact us at (828) 333-0096 or email us at info@nutritious-thoughts.com
  • Tell us more about yourself
  • Find a registered dietitian to create a personalized nutrition plan for your lifestyle and goals!

Expanded Counseling Services at Nutritious Thoughts

At Nutritious Thoughts, our support extends far beyond individual counseling. Through our Community Wellness & Education programs, we engage with schools, workplaces, and recovery centers to bring tailored nutrition counseling, workshops, and educational presentations directly to your community. Whether delivered on-site or virtually, our goal is to provide accessible wellness tools where they can make the greatest impact. Reach out to learn more about our services and pricing.

What to Expect from Your First Session with a Registered Dietitian in Cary/Raleigh, NC

Embarking on a journey toward a balanced and compassionate relationship with food can be both exciting and intimidating. If you’re considering working with a registered dietitian, you might be wondering what the first session will look like and how the process unfolds. At Nutritious Thoughts, we understand that each person’s experience with food, health, and their body is deeply personal. Our approach is grounded in the Health at Every Size® (HAES) philosophy, which means we prioritize care that respects your autonomy, supports self-compassion, and values your body exactly as it is right now.

The first session with a registered dietitian in our Cary/Raleigh office is more than just a consultation—it’s an opportunity to begin building a supportive partnership that’s rooted in your goals, needs, and values. In this blog, we’ll walk you through what you can expect during that initial session and how our approach to nutrition counseling creates a safe, respectful space for exploring what nourishment means to you.

Creating a Welcoming Environment

At Nutritious Thoughts, we know that coming to a first session may bring up nerves or hesitation. Whether you’re dealing with a chronic condition, recovering from disordered eating, or just exploring a healthier relationship with food, we want you to feel welcomed and supported from the moment you step in. The office environment is designed to be warm and non-judgmental, reflecting our commitment to creating a safe space where every body is valued.

This session is not about rigid assessments or quick fixes. Instead, it’s a gentle beginning to a partnership where you’re in the driver’s seat, and we’re here to support your journey. Every individual who walks through our doors comes with their own story and experiences, and we’re here to listen, learn, and offer guidance that aligns with your unique path.

The Initial Conversation: Learning About You

The first session is primarily a conversation. We’ll take time to get to know you—your background, your health history, and your relationship with food and your body. Unlike conventional diet-focused approaches that emphasize weight or restrictive behaviors, we want to understand your broader experiences and what’s led you to seek support.

During this session, we may ask about your medical history, dietary habits, and any particular health challenges you’re facing. You might share as much or as little as you feel comfortable with, knowing that everything you bring up is treated with respect and confidentiality. Our focus is on creating an open dialogue that helps us understand where you are and where you want to go, rather than setting specific dietary restrictions or “goals” that feel limiting. A family of three eating together at the dinner table & cheering their glasses together. Nutrition therapy in Raleigh, NC can help with disordered eating, diabetes management & more. Call today to get started with our dietitians.

Exploring Your Relationship with Food and Body

In the HAES-aligned approach, we recognize that food and body relationships are multifaceted and impacted by a range of social, emotional, and personal factors. Many people come to us with complex histories around food, often shaped by diet culture or compensatory behaviors like restricting or eating in response to stress. In this first session, you’ll have the space to talk about these experiences in a non-judgmental, understanding environment.

We’ll explore any specific challenges you face, such as stress eating, emotional connections to food, or perhaps a history of feeling disconnected from your body’s natural hunger and fullness signals. Together, we’ll begin to unpack these influences and discuss how they might shape your nutrition and well-being.

If compensatory behaviors—like restrictive eating, food avoidance, or over-exercising—are part of your experience, we will discuss how these behaviors can impact health and well-being, and how they might be addressed with compassionate strategies over time.

Setting Intentions That Honor Your Needs

Rather than imposing strict rules or rigid goals, we work collaboratively with you to set intentions that reflect your unique needs and values. This approach means that you won’t leave with a prescribed meal plan or list of “do’s and don’ts.” Instead, we’ll discuss what feels important to you, whether it’s stabilizing blood sugar levels, working toward gentle movement practices, or simply finding peace with your body’s natural cues.

For example, if your goal is to manage a chronic condition like diabetes or high cholesterol, we’ll explore ways to incorporate nourishing foods and self-care practices that support those goals in a flexible, sustainable manner. If body image or disordered eating is an area you’re working on, we’ll take time to explore how to reconnect with and honor your body in a way that feels affirming.

Understanding the Collaborative Nature of Nutrition Counseling

Our role as registered dietitians isn’t to “fix” or control your health but to work alongside you as a guide. Nutrition counseling is a collaborative process, meaning we adapt and adjust our support based on what’s helpful to you. This initial session is about starting that collaboration on a foundation of trust and openness.

By the end of the first session, you’ll have a better understanding of how our work together will evolve. We’ll outline a flexible plan that respects your autonomy and responds to your body’s cues, allowing room for change as your needs and goals evolve.

Regular follow-up sessions will offer ongoing support, providing a space to discuss progress, celebrate successes, and troubleshoot any barriers you encounter along the way.

Compassionate Care for Managing Chronic Conditions

For those managing chronic conditions, the first session may also include an introduction to Medical Nutrition Therapy (MNT). While we focus on holistic well-being, we also acknowledge that certain medical conditions benefit from specific nutrition support. If you’re managing diabetes, gastrointestinal concerns, or heart disease, we’ll work together to identify supportive nutrition and lifestyle practices that align with your medical needs without adding unnecessary restrictions.

At Nutritious Thoughts, we emphasize health-promoting behaviors rather than rigid dietary plans, allowing you to explore self-care practices that contribute to long-term well-being. We’ll discuss how nutrition can be used as a tool to manage symptoms, reduce inflammation, and improve your energy levels—all in ways that feel supportive and compassionate.

Building a Support System Rooted in Respect and Empowerment

Recovery and growth aren’t linear paths, and having a support system can make all the difference. Our dietitians recognize the importance of emotional and mental support, particularly for individuals who’ve navigated diet culture or disordered eating patterns. By connecting with us, you’ll have a consistent source of encouragement and guidance, helping you address challenges that may arise.

This support extends beyond the dietary recommendations. We’re here to help you navigate those moments when you feel challenged by external pressures, whether they’re from societal ideals or internalized beliefs about body image. We’ll work together to create strategies that reinforce self-compassion and respect, focusing on what makes you feel nourished, rather than pressured. A girl sitting down on a bench outside a cafe. If you're recovering from disordered eating, reach out to our registered dietitians in Raleigh, NC. We can support your recovery journey!

Taking Steps Toward a Balanced Relationship with Food and Body

Our approach is not about achieving a perfect diet or reaching a specific weight. Instead, we focus on helping you build a relationship with food that respects your body’s needs, preferences, and boundaries. You’ll learn to tune into your body’s natural signals, discovering a rhythm of eating that feels supportive rather than punitive.

Throughout the process, you’ll find yourself exploring self-care practices that go beyond food and that contribute to a sense of peace and connection. Whether it’s through gentle movement, mindfulness, or simply giving yourself permission to enjoy food without guilt, these practices are integral to creating a well-rounded and satisfying approach to health.

Moving Forward with Nutritious Thoughts

At Nutritious Thoughts, our mission is to empower you with the tools, understanding, and support needed to approach food and health from a place of self-compassion. This journey isn’t about quick fixes or superficial changes; it’s about meaningful growth that honors your entire self. We’re here to walk with you every step of the way, offering guidance and encouragement as you learn to trust your body and embrace nourishment in a way that aligns with your values.

Our Cary/Raleigh registered dietitians are here to support you wherever you are in your journey, whether you’re working through disordered eating, managing a chronic condition, or simply seeking a kinder approach to health. Your first session is just the beginning—a starting point for creating lasting, positive change that respects who you are and who you’re becoming.

Begin Your Journey with Compassionate, HAES-Aligned Nutrition Counseling in Asheville, Cary & Across NC

At Nutritious Thoughts, we believe that true nourishment comes from honoring your body with empathy and self-compassion. Our approach to nutrition counseling is centered around creating a supportive, judgment-free space where you can explore your unique relationship with food, body, and self-care at your own pace. Whether you’re working through disordered eating, building body acceptance, or simply seeking a more balanced and intuitive approach to health, our dedicated registered dietitians are here to support you. Offering both in-person sessions in Asheville and Cary/Raleigh, NC, along with flexible online options, we’re here to help you find what feels right for you.

  • Contact us at (828) 333-0096 or email us at info@nutritious-thoughts.com
  • Tell us more about yourself
  • Let’s walk this path together, creating a nourishing, respectful connection to food and body that empowers you.

Expanding Wellness with Community Programs at Nutritious Thoughts

At Nutritious Thoughts, we’re dedicated to making wellness accessible beyond individual sessions. Our Community Wellness & Education initiatives are designed to bring compassionate nutrition support directly to schools, workplaces, and recovery centers. Through tailored nutrition counseling, interactive workshops, and educational presentations, we aim to empower communities with tools for sustainable well-being. Available on-site or virtually, these programs are crafted to meet people where they are, fostering an inclusive, supportive approach to health. Reach out to learn more about our offerings and pricing options. Let’s create a healthier, more connected community together.

What Is Chronic Dieting?

Chronic dieting is the ongoing cycle of starting a diet (usually a popular or fad diet, or even a medically recommended diet), doing it for a little while, and then feeling like you “failed” at it, over and over again throughout the years. It usually involves constantly monitoring and restricting your food intake, or labeling food as “good” and “bad,” in an attempt to lose weight or control body size. Chronic dieting is a long-term cycle and is often called “yo-yo dieting,” because it’s a seemingly never-ending pattern of starting and “failing” diets. This type of dieting takes a toll on both physical and mental health, often disconnecting individuals from their body’s natural hunger and fullness cues. Over time, chronic dieting can lead to unhealthy relationships with food and a cycle of restriction followed by a feeling of loss of control over food or even binging.

At Nutritious Thoughts, we aim to shift away from rigid rules and diets, focusing instead on a more compassionate, intuitive approach to nourishment. Rather than viewing food as something to control, we encourage you to see it as a way to care for yourself, listening to your body’s cues and needs. Chronic dieting is exhausting and doesn’t serve your overall well-being—nutrition counseling can help you break free from this cycle. Two individuals sitting down at a coffee shop drinking coffee from yellow mugs. A nutritionist in Raleigh, NC can help you break up with diet culture. Get started with eating disorder therapy today.

Why Is Chronic Dieting Considered Harmful?

Instead of framing chronic dieting as simply “bad,” it’s more helpful to look at the likely impact it will have on your health and well-being. Chronic dieting often has unintended consequences that don’t serve your long-term physical or mental health. One of the main reasons it’s not beneficial is that it fosters a disordered relationship with food and self. When food is restricted or categorized as “off-limits,” it can create an intense focus on eating or not eating, followed by guilt or shame when those rules are broken.

Over time, the body’s natural response to restriction is often increased cravings and even binge eating as it tries to compensate for the deprivation. This can lead to a constant battle with food, making it difficult to trust your body’s hunger and fullness signals. In addition, weight cycling—the repeated loss and regain of weight—often accompanies chronic dieting, which can have serious effects on physical health, including higher risks of cardiovascular disease and metabolic issues.

From a mental health perspective, chronic dieting can lead to constant feelings of failure, frustration, and shame. This ongoing cycle takes up emotional and mental energy, leaving little room for joy or connection with food. Shifting away from dieting and toward an intuitive, body-inclusive approach to eating can make a significant difference in how you feel both physically and emotionally.

How Does Diet Culture Affect Mental Health?

Diet culture includes the societal belief that thinness is inherently better, healthier, or more valuable. This pervasive mindset impacts not only how we view our bodies but also how we approach food. It creates pressure to diet, restrict, and control our bodies, often leading to feelings of inadequacy when we don’t meet those idealized standards. This constant striving for an “ideal” body size can lead to feelings of low self-worth, anxiety, and stress.

Diet culture also encourages compensatory behaviors—like restricting food, over-exercising, or purging—as ways to “make up” for eating or to achieve a particular body size. These behaviors, rather than supporting your well-being, often harm both physical and mental health. Diet culture undermines the idea that health can exist at any size and perpetuates the myth that controlling your body size is the ultimate goal. A man holding his cup with both hands & drinking from the mug. Our registered dietitians in Raleigh, NC are here to support your recovery. Reach out to us today to get started with nutritional counseling.

Nutritional counseling can help you break free from the pressures of diet culture. Through a Health at Every Size (HAES) lens, we focus on helping you reconnect with your body’s cues and dismantle the harmful beliefs that diet culture imposes. Our goal is to create a space where you can embrace food as nourishment and your body as something to care for, rather than control.

How Does Restrictive Dieting Affect Mental Health?

Restrictive dieting not only disconnects you from your body’s signals and needs but can also take a toll on mental health. When food is restricted, it’s easy to become preoccupied with what you can and cannot eat, leading to an obsessive focus on food. This mental load can lead to feelings of deprivation, frustration, and guilt, especially if restrictive food rules are broken. Over time, this preoccupation can cause anxiety, disordered eating behaviors, and a negative relationship with food. At Nutritious Thoughts, we recognize that food is deeply connected to emotions. Restricting food can increase feelings of stress, anxiety, and emotional exhaustion.

Restriction can also trigger compensatory behaviors, which only perpetuate the dieting cycle and emotional rollercoaster. Instead of restrictive dieting, nutrition counseling with Nutritious Thoughts focuses on finding balance and nourishment that honors your mental and physical health. Our approach helps you let go of the idea that food should be controlled or feared. Through compassionate support, we guide you toward listening to your body’s natural hunger and fullness cues, reducing compensatory behaviors, and rebuilding a trusting relationship with food. In doing so, you can move away from the mental strain that dieting creates and toward a more peaceful, nourishing way of eating.

What Is the Nutrition Counseling Process?

At Nutritious Thoughts, our nutrition counseling process is centered around individualized care that supports your physical, emotional, and mental health. We understand that everyone’s relationship with food is unique, which is why our registered dietitians take the time to get to know you, your health history, and your personal goals.

  • Initial Assessment: The journey begins with an initial assessment, where your dietitian will gather information about your medical history, eating habits, and lifestyle. This session allows you to share your relationship with food, any compensatory behaviors you may be engaging in, and your goals for nutrition counseling. The initial assessment sets the foundation for personalized, compassionate care.
  • Collaborative Goal Setting: After the assessment, during your follow-up session, we work together to set achievable goals that support your well-being. Whether you want to reduce compensatory behaviors, break free from restrictive dieting, or simply find more balance in your eating habits, your dietitian will help you create a plan that aligns with your body’s needs and overall health. The focus is on sustainable, supportive changes—not quick fixes or restrictive rules.
  • Ongoing Support: Nutrition counseling is a dynamic, ongoing process. We provide continuous support through regular follow-up sessions, where we assess your progress, make any necessary adjustments, and address new challenges as they arise. The goal is to empower you to make choices that nourish both your body and mind while reducing the emotional burden of food and body preoccupation.

At Nutritious Thoughts, we believe that true nourishment comes from within. We guide you toward intuitive eating practices that honor your hunger and fullness cues and foster a positive relationship with food. Whether you’re working through disordered eating, an eating disorder, compensatory behaviors, or simply seeking more balance, our team is here to walk alongside you every step of the way. A man sitting in a meditated pose on a blue couch. Our nutrition therapy in Raleigh, NC can address chronic dieting & disordered eating. Call today to get started.

Reclaiming Your Relationship with Food

Chronic dieting doesn’t serve your overall well-being. Instead of viewing food as something to control, nutritional counseling at Nutritious Thoughts invites you to explore a more nourishing relationship with food and your body. Our approach helps you move away from the cycle of restriction and compensatory behaviors and toward a space of balance, trust, and well-being. Let us support you on this journey, creating a path toward self-compassion, nourishment, and health that honors your unique needs.

Experience Compassionate Nutrition Counseling Across Asheville, Cary & NC

At Nutritious Thoughts, nutrition counseling goes beyond what’s on your plate—it’s about reconnecting with your body, finding peace with food, and fostering true well-being. Whether you’re managing a chronic health condition, healing from disordered eating, or simply looking to break free from the cycle of chronic dieting, our registered dietitians are here to guide you with empathy and respect for your unique journey. With in-person sessions available in Asheville, Hendersonville, and Cary/Raleigh, NC, as well as convenient online options, we’re committed to meeting you where you are. Together, we’ll explore how to nourish your body and mind in a way that feels supportive and sustainable.

  • Contact us at (828) 333-0096 or email us at info@nutritious-thoughts.com
  • Tell us more about yourself
  • Let’s work together to create a balanced and compassionate path toward your health and well-being.

Expanded Counseling Services at Nutritious Thoughts

At Nutritious Thoughts, we extend our support beyond individual counseling to serve entire communities through our Community Wellness & Education initiatives. We provide both on-site and virtual nutrition counseling, along with tailored workshops and presentations for schools, workplaces, and recovery centers. Our goal is to bring accessible wellness tools to the spaces that need them most. Get in touch with us to learn more about how our services can support your community and for details on our rates.

Reclaiming Your Body After Abuse and Assault

Trigger Warning: Impact of abuse and assault on physical, mental, and emotional health. Reader discretion advised.

au·ton·o·my
/ôˈtänəmē/
noun

You may ask: Where does the voice of a registered dietitian treating eating disorders/disordered eating belong in a conversation about the impacts of abuse and assault?

Our answer: Front and center.

Experiencing a loss of body autonomy through traumatic events such as abuse and assault is a topic that is becoming more openly discussed in media and research. Finally! – a realm of experiences that many (most) of us can relate to on some level is no longer “hush-hush”. With the growing amount and variety of community support for survivors, where does the non-diet, body neutral dietitian fit in?

Trauma affects everything. Survivors often experience changes in their physical, mental, and emotional health (sometimes gradually, sometimes suddenly).* Many of these changes are intricately weaved with digestive health and eating behaviors. Cue the non-diet, body neutral dietitian!

It is our hope to help survivors of trauma move forward in their healing journeys by encouraging a reclamation of body autonomy and educating on the specific ways traumatic events can alter the how we feed ourselves. This. Takes. Time. All the time one may need. Some ways in which a dietitian at Nutritious Thoughts** may support you in reclaiming your body autonomy include the following:

  • Restoration of balanced and adequate nourishment
  • Rehabilitation from eating disorder/disordered eating behaviors
  • Attunement to bodily cues (hunger, fullness, other digestive and emotional cues related to eating)
  • Creating a self-care plan
  • Cultivating a space where your voice and experience is heard and respected

If you or someone you know needs support around the topics of abuse and/or assault, please consider reaching out to or providing them with the following resources:

  • National Domestic Violence Hotline – 1-800-799-7233
  • National Sexual Assault Hotline (RAINN) – 1-800-656-4673
  • Our Voice (local Western NC support!) – 828-255-7576
  • For crises, medical emergencies, etc. – Dial 911

*Details on these changes can be found via Dialogues of Clinical Neuroscience here: Traumatic stress: effects on the brain

**A registered dietitian is an important part of a treatment team for survivors with dis-regulated eating behaviors but they cannot be the entire team. Survivors deserve a team that involves multiple clinicians and at minimum, the addition of a therapist and physician.

‘Clean’ Eating: Magic or Mayhem?

This month, we feature an article published by Outside Magazine that discusses the clean eating trend in depth.

Bonus: the article includes perspective from one of our own here at Nutritious Thoughts – Margaret Ruch, MS, RD, LDN!

Is ‘Clean Eating’ Good for You? Not Really.

Trying to eat perfectly all the time is a losing battle

The clean-eating trend isn’t new, but it is ever present. It’s a hashtag on Instagram, a hot topic on Twitter and Reddit, and a whole category of food blogs, cookbooks, and magazines. While this approach to eating looks a little different for everyone, it always promotes whole foods and warns against processed options and added sugars. Some clean-eating plans even eschew whole-food staples like dairy, grains, and naturally occurring sugars. Despite the trend’s prevalence—and the fact that “eating clean” as a term sounds benign enough—health experts are wary of the approach for a handful of reasons. Here’s an overview of why athletes should steer clear of the trend.

“Clean Eating” Is an Ambiguous Term

There’s no agreed-upon definition of clean eating. “Generally, it’s about eating foods that are less or not at all processed. It’s always a form of restrictive eating, and for some people, it leads to avoiding whole food groups,” says Margaret Ruch, a registered dietitian who specializes in sports nutrition and disordered eating. The paleo version of clean eating, for example, emphasizes protein, vegetables, nuts, seeds, and some fruit, but it cuts out dairy, grains, legumes, added sugars, and processed foods.

The flexibility of what constitutes clean eating can lead adherents down a path of increasing restriction. The diet promises to be the cure for all kinds of ailments: fatigue, bloating, acne, weight gain, and even some chronic illnesses. If someone adopts of a couple of rules (like cutting out sugar and processed carbs) and doesn’t see benefits, it’s likely they’ll keep adding rules and cutting out foods until they do. “It’s a slippery slope—you want to eat healthier, but there’s really no end goal for clean eating, no way to know you’re doing a good job with it,” says Heather Caplan, a registered dietitian, distance runner, and former running coach.

Plus, while diet certainly impacts health, it’s unrealistic to give it so much power. Factors that are totally out of our control (genetics, for one) play a huge part in our health outcomes, as do things like our relationships, location, and socioeconomic status. “I say that to comfort people, but it’s often jarring. Just because you eat ‘perfectly’ doesn’t mean you’re definitely going to be healthy,” says Caplan.

You Need More Calories Than Veggies Can Provide

“Proper nutrition can play a big role in sports performance, but proper fueling has more to do with getting enough—enough energy, enough carbs, enough protein, enough fat, and enough fluid,” Ruch says. In other words: prioritizing nutrient-dense food is good, but the most important thing is to make sure you’re giving your body the calories it needs to perform and recover properly.

“No matter how you define clean eating, it’s about cutting out certain foods, which makes it much harder to get enough food overall,” Ruch says. “If you’re not consuming as much energy as you need, that really can damage your body in the short and the long term.”

It’s Tough to Get Enough Carbs from Whole Foods 

Exactly how many carbs a person needs depends on several factors—age, gender, weight, activity level, genetics—but “for endurance athletes, carbs should generally be about 50 to 60 percent of your total food intake,” Caplan says.

“If you define clean eating as no processed carbs, it’s going to be really tough to reach your carb needs because of all the fiber that comes with unprocessed carbs,” she says. Fiber increases a food’s volume without increasing its energy, so it makes you feel full more quickly. If you’re also cutting out whole grains and legumes, it’ll be even tougher to fulfill your carbohydrate needs.

Processed Carbs and Sugar Are Great Workout Fuel

Complex carbohydrates from whole foods are great choices most of the time. They’re more nutrient dense than processed carbs, and they digest slowly for steady energy. They’re not a good source of quick energy, though. “I wouldn’t recommend that someone eat a sweet potato or a slice of Ezekiel bread right before working out—they will be slow to enter your bloodstream,” Ruch says.

“So many athletes aren’t getting adequate carbs, usually because they’re afraid of sugar,” she says. “Processed carbs and sugars are great when you need blood sugar quickly, like when you’re about to go on a run or do any kind of intense or long workout.”

Plus, whole carbs preworkout can cause an upset stomach. Fiber is resistant to digestion, which means you’ll likely deal with some bloating and a sensitive stomach while your body breaks down fiber-rich foods—inconvenient during, say, a long training run. “Some people need a low-fiber preworkout snack, like white bread or cereal,” Caplan says. “Other people, like me, can tolerate more fiber and be fine.” If your gut isn’t having it, don’t hesitate to switch to a processed-carb snack or sugar (like a honey stick) that’s easier for your body to break down.

Restrictive Eating Creates Nutrient Deficiencies

Nobody wants to get sidelined by a stress fracture, and diet plays a big role in bone health. Eliminating dairy affects your calcium and vitamin D intake. “If you’re not replacing that dairy with something else, you’re likely going to be deficient,” says Ruch. And relying on supplements won’t cut it; studies have consistently shown that these supplements don’t reduce the risk of osteopenia, osteoporosis, or fractures, and that your best bet for good bone health is getting adequate calcium through your diet. (If you have a dairy allergy, you can get calcium and vitamin D from fortified products, like nondairy milks.)

Whole grains also provide important micronutrients, including vitamin E and various B vitamins such as riboflavin, thiamine, niacin, and folate, that offer critical support to digestion, the nervous system, and more, Caplan says. “Most whole grains are fortified with folate or folic acid, and sometimes iron.” All of these nutrients are essential for good health, and while it’s possible to get them elsewhere, grains are an easy and inexpensive source.

Diet Can Cause Mental and Emotional Stress, Too

“When we talk about health, we have to take into account not only the nutritional value of what we’re eating but also emotionally how we feel when we’re eating a certain way,” says Breese Annable, a psychologist who specializes in disordered eating, chronic dieting, and body image. Although a less rigid style of clean eating might be fine for some people, too many food rules can have a big negative impact on overall health, Annable says. For example, if you avoid social gatherings for fear of not being able to eat “clean,” you’re isolating yourself, which can have its own negative consequences. Plus, chronic stress has been shown to impair sports recovery.

Stressors of rigid clean eating might include spending more money on food (whole foods are generally more expensive) and constantly denying yourself the foods you’re craving. “There’s a trade-off between any potential benefits of following a certain diet and the stress you put on yourself when you’re so rigid and inflexible,” Ruch says. “This is true even if you do manage to get enough energy and nutrition from a diet.”

The Bottom Line

Clean eating essentially paints foods as being good or bad. “It creates this sense of morality around food,” Annable says. But health isn’t black and white, and thinking of food that way won’t do you any favors. If anything, it sets you up for feelings of guilt and failure when you inevitably break whatever diet rules you’ve set for yourself.

“It’s harmful to put labels on your diet and yourself, instead of just saying you eat a flexible diet and you’re mindful about your food intake,” Ruch says. There’s nothing wrong with wanting to eat healthfully, but the best approach is to focus on eating mostly nutritious foods while thinking of the occasional less nutritious treats as just part of an overall healthy balance. In other words: ditch the idea of clean eating, and embrace the fact that no one meal or food choice will make or break your health.

Direct article link here: https://www.outsideonline.com/2391283/is-clean-eating-good

Is ‘National Nutrition Month’ a Recovery-Positive Campaign?

As registered dietitians dedicated to the prevention and evidence-based treatment of eating disorders and disordered eating, we found ourselves asking the following questions leading into National Nutrition Month®:

  • Does National Nutrition Month® (NNM) align with Eating Disorder/Disordered Eating (ED/DE) recovery?
  • As Health At Every Size® (HAES) informed professionals, to what extent might we ethically support participation in this month-long campaign focusing on nutrition and physical activity to our clients, our peers, friends, loved ones…ourselves?

The quick answers?

  • A little bit, kind of, sorta…
  • Proceed with caution

Here’s a more in-depth look at our perspective:

Let’s begin by explaining a little bit more about NNM!  NNM was created by the Academy of Nutrition and Dietetics (AND), the largest organization of food and nutrition professionals in the United States. AND defines NNM as follows:

What is National Nutrition Month®?

National Nutrition Month® is an annual nutrition education and information campaign created by the Academy of Nutrition and Dietetics. The campaign, celebrated each year during the month of March, focuses on the importance of making informed food choices and developing sound eating and physical activity habits.

– Academy of Nutrition and Dietetics (AND)

We’ve done a thorough review of the National Nutrition Month website for 2019 and wanted to share some thoughts with you.

What we appreciated about this year’s theme:

  1. The 2019 NNM theme is self-titled (“National Nutrition Month®”) which makes it more inclusive of many different topics of discussion – including eating disorders and disordered eating! Win!
  2. Many of the educational materials encouraged making sustainable changes towards achieving balanced food and movement routines that are individualized. We love this approach!
  3. Mental health and motivation for change (which are totally intertwined with eating and moving our bodies) were not excluded from the conversation!

What we could have done without:

  1. The language! Reviewing the NNM website brought up a much larger conundrum – the way we speak about nourishment in our society. The language we use to address nutrition and movement is morally charged. The “good/bad” or “right/wrong” polarization is not recovery-positive and continues to drive us farther away from seeing food as just food and moving our bodies as joyful and drives the shame wagon. Shame does not motivate people to adopt health-promoting behaviors.
  2. Weight management. Encouraging weight management through portion control and calorie tracking is not an approach that is respectful and accepting of all body shapes and sizes and promotes the message that larger bodies are inherently in need of “fixing” or must be controlled in some manner. Nah, nah, nah. Not buying it. Weight management is not weight neutral. It’s not HAES-informed. It’s not recovery-positive. It’s oppressive and unethical to prescribe disordered eating behaviors to people living in larger bodies. Also, there is a body of evidence against it.

*Caveat: National Nutrition Month was not created specifically for those in recovery from ED/DE, but for the general United States public.  However, even so, language equating terms such as “weight management” and “portion control” as being “right” can be harmful for at-risk populations and creates unnecessary vulnerability to developing ED/DE behaviors.

Suggestions for observing NNM in ED/DE recovery:

  1. Celebrate how far you’ve come! Take this opportunity to reflect on how eating and movement patterns have become more sustainable and balanced.
  2. Set goals. How might you propel your recovery forward this month? What would it look like to take steps to strengthen our relationships with ourselves and with food, movement, and recovery?
  3. Increase your food variety – try some new foods this month!
  4. Take up space and use your voice. Be in a larger body. Be fat. Exist as you are.

We love our field, our colleagues, and the wealth of valuable knowledge provided by AND, and we hope to continue to shift the way nutrition and wellness are presented to the general public to be more inclusive and less stigmatizing!

Check out what other ED/DE clinicians have said about NNM over the years:

https://marcird.com/my-take-on-national-nutrition-month/

https://veritascollaborative.com/blog/blog-national-nutrition-month/

https://www.sovcal.com/recovery/having-an-eating-disorder-during-national-nutrition-month/

 

 

 

What is “Health At Every Size”?

THE HEALTH AT EVERY SIZE® APPROACH:

Weight does NOT define Health.

The framing for a Health At Every Size (HAES®) approach comes out of discussions among healthcare workers, consumers, and activists who reject both the use of weight, size, or BMI as proxies for health, and the myth that weight is a choice. The HAES® model is an approach to both policy and individual decision-making. It addresses broad forces that support health, such as safe and affordable access. It also helps people find sustainable practices that support individual and community well-being. The HAES® approach honors the healing power of social connections, evolves in response to the experiences and needs of a diverse community, and grounds itself in a social justice framework.

The Health At Every Size® Principles are:

Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.

Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

OSFED & Additional Eating or Feeding Disorders: The Signs, Symptoms, & Impact

Other Specified Feeding or Eating Disorder

According to the National Eating Disorder Association

Formerly described at Eating Disorders Not Otherwise Specified (EDNOS) in the DSM-IV, Other Specified Feeding or Eating Disorder (OSFED), is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.

Examples of OSFED Include:

  • Atypical anorexia nervosa (weight is not below normal)
  • Bulimia nervosa (with less frequent behaviors)
  • Binge-eating disorder (with less frequent occurrences)
  • Purging disorder (purging without binge eating)
  • Night eating syndrome (excessive nighttime food consumption)

The commonality in all of these conditions is the serious emotional and psychological suffering and/or serious problems in areas of work, school or relationships. If something does not seem right, but your experience does not fall into a clear category, you still deserve attention. If you are concerned about your eating and exercise habits and your thoughts and emotions concerning food, activity and body image, we urge you to consult an ED expert.

Symptoms associated with anorexia nervosa include:

  • Inadequate food intake leading to a weight that is clearly too low.
  • Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
    • Self-esteem overly related to body image.
    • Inability to appreciate the severity of the situation.
    • Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.

Restricting Type does not involve binge eating or purging.

Symptoms associated with bulimia nervosa include:

  • Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge-eatingepisodes.
  • Self-esteem overly related to body image.

Symptoms associated with binge eating disorder include:

  • Frequent episodes of consuming very large amount of food but without behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge eating episodes.
  • Feelings of strong shame or guilt regarding the binge eating.
  • Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.

 

Additional Eating or Feeding Disorders

Avoidant/Restrictive Food Intake Disorder

  • Failure to consume adequate amounts of food, with serious nutritional consequences, but without the psychological features of Anorexia Nervosa.
  • Reasons for the avoidance of food include fear of vomiting or dislike of the textures of the food.

Pica

  • The persistent eating of non-food items when it is not a part of cultural or social norms.

Rumination Disorder

  • Regurgitation of food that has already been swallowed. The regurgitated food is often re-swallowed or spit out.

Unspecified Feeding or Eating Disorder

  • When behaviors do not meet full criteria for any of the other feeding and eating disorders, but still cause clinically significant problems.
  • Alternatively, when clinician is unable to assess whether an individual meets criterion for another disorder, for example, when there is a lack of information in an emergency situation.

Binge Eating Disorder: The Signs, Symptoms, & Impact

Binge Eating Disorder

According to the National Eating Disorder Association...

Binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. Binge eating disorder is a severe, life-threatening and treatable eating disorder. Common aspects of BED include functional impairment, suicide risk and a high frequency of co-occurring psychiatric disorders.

Binge eating disorder is the most common eating disorder in the United States, affecting 3.5% of women, 2% of men,1 and up to 1.6% of adolescents.2

The DSM-5, released in May 2013, lists binge eating disorder as a diagnosable eating disorder. Binge eating disorder had previously been listed as a subcategory of Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-IV, released in 1994. Full recognition of BED as an eating disorder diagnosis is significant, as some insurance companies will not cover an individual’s eating disorder treatment without a DSM diagnosis.

BED Symptoms and Diagnostic Criteria
The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder:

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  2. The binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.
  3. Marked distress regarding binge eating is present.
  4. The binge eating occurs, on average, at least once a week for 3 months.
  5. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Characteristics of BED
In addition to the diagnostic criteria for binge eating disorder, individuals with BED may display some of the behavioral, emotional and physical characteristics below. Not every person suffering from BED will display all of the associated characteristics, and not every person displaying these characteristics is suffering from BED, but these can be used as a reference point to understand BED predispositions and behaviors.

Behavioral Characteristics

  • Evidence of binge eating, including the disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.
  • Secretive food behaviors, including eating secretly (e.g., eating alone or in the car, hiding wrappers) and stealing, hiding, or hoarding food.
  • Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting; and developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, not allowing foods to touch).
  • Can involve extreme restriction and rigidity with food and periodic dieting and/or fasting.
  • Has periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling uncomfortably full, but does not purge.
  • Creating lifestyle schedules or rituals to make time for binge sessions.

Emotional and Mental Characteristics

  • Experiencing feelings of anger, anxiety, worthlessness, or shame preceding binges. Initiating the binge is a means of relieving tension or numbing negative feelings.
  • Co-occurring conditions such as depression may be present. Those with BED may also experience social isolation, moodiness, and irritability.
  • Feeling disgust about one’s body size. Those with BED may have been teased about their body while growing up.
  • Avoiding conflict; trying to “keep the peace.”
  • Certain thought patterns and personality types are associated with binge eating disorder. These include:
    • Rigid and inflexible “all or nothing” thinking
    • A strong need to be in control
    • Difficulty expressing feelings and needs
    • Perfectionistic tendencies
    • Working hard to please others

Physical Characteristics

  • Body weight varies from normal to mild, moderate, or severe obesity.
  • Weight gain may or may not be associated with BED. It is important to note that while there is a correlation between BED and weight gain, not everyone who is overweight binges or has BED.

BED Population and Demographics
Binge eating disorder is the most common eating disorder in the United States; it is estimated to affect 1-5% of the general population.1 BED affects 3.5% of women, 2% of men,1 and up to 1.6% of adolescents.2

Demographic Information

  • Binge eating disorder affects women slightly more often than men—estimates indicate that about 60% of people struggling with binge eating disorder are female and 40% are male.
  • In women, binge eating disorder is most common in early adulthood. In men, binge eating disorder is more common in midlife.
  • Binge eating disorder affects people of all demographics across cultures.

Physical and Psychological Effects of BED
Binge eating disorder has strong associations with depression, anxiety, guilt and shame. Those suffering from BED may also experience comorbid conditions, either due to the effects of the disorder or due to another root cause. Comorbid conditions can be both physical and/or psychological.

Physical Effects

  • Most obese people do not have binge eating disorder. However, of individuals with BED, up to two-thirds are obese; people who struggle with binge eating disorder tend to be of normal or heavier-than-average weight.
  • The health risks of BED are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:
    • High blood pressure
    • High cholesterol levels
    • Heart disease
    • Type II diabetes
    • Gallbladder disease
    • Fatigue
    • Joint pain
    • Sleep apnea

Psychological Effects

  • People struggling with binge eating disorder often express distress, shame and guilt over their eating behaviors.
  • People with binge eating disorder report a lower quality of life than those without binge eating disorder.
  • Binge eating disorder is often associated with symptoms of depression.
  • Compared with normal weight or obese control groups, people with BED have higher levels of anxiety and both current and lifetime major depression.

BED Treatment
Effective evidence-based treatments are available for binge eating disorder, including specific forms of cognitive behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavioral therapy (DBT), and pharmacotherapy.

All treatments should be evaluated in the matrix of risks, benefits, and alternatives. Decisions regarding treatments should be made after consulting with a trained medical professional and eating disorder specialist.

To find a treatment provider who specializes in binge eating disorder, please visit NEDA’s Treatment Referral database.

Social Stigma of BED
Many people suffering from binge eating disorder report that it is a stigmatized and frequently misunderstood disease. Greater public awareness that BED is a real diagnosis—and should not be conflated with occasional overeating—is needed in order to ensure that every person suffering from BED has the opportunity to access resources, treatment, and support for recovery.

NEDA’s shareable binge eating disorder infographic offers an easy way to spread the word about BED. It is important to underscore that BED is not a choice; it’s an illness that requires recognition and treatment.

Sources
1. Hudson, J.I., Hiripi, E., Pope, H.G. et al. (2007)The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol.Psychiatry, 61, 348–358.
2. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry. 2011;68(7):714–723