How I Became An Eating Disorder Dietitian – Katy’s Story

Written by Katy Harvey, MS, RD, LD, CEDRD Eating Disorder Specialist

The original plan

I suppose I was always drawn to suffering in my work. In fact, I originally thought I would spend my career in the world of oncology. The “C word” (cancer) is enough to bring most people to their knees. It was a field that felt important and meaningful. As a graduate student I did my master’s thesis on cancer, I flew myself out to the National Cancer Institute to attend a special conference on nutrition and cancer, I helped conduct research studies on cancer, and I was loving it.

Part of my graduate assistantship involved research studies on breast cancer survivors – women who had battled and overcome breast cancer. Talk about some bad-ass women. These women were the epitome of strength and courage. Yet they also felt like ticking time bombs, perpetually living in fear that their cancer would return.

The thing about breast cancer treatment is that it changes your body. For some women this means having their breasts surgically removed – essentially taking away their womanhood. For others this meant being put through menopause with the removal of their uterus and ovaries to decrease the amount of hormones in their body and reduce the risk of subsequent ovarian cancer. Menopause often leads to weight gain, especially in the abdominal area.

What scientists knew was that certain health-related factors increased a woman’s risk of breast cancer recurrence. Weight gain and the variety of increased hormones associated with it is one of these factors. So, what did we do? We conducted research studies on how to help breast cancer survivors lose weight, hypothesizing that this would decrease their risk of the cancer coming back.

And it worked, they lost weight, at least initially. The studies, which lasted 6 months, were basically a diet and exercise program where we restricted their calories by telling them they could only eat pre-packaged frozen entrees for lunch and dinner, 2-3 low- calorie protein shakes per day, and as many fruits and vegetables as they wanted (because we didn’t want them to feel hungry or deprived – ha, what a joke.). While on the diet they lost weight, a lot of it usually.

Then the study ended. We continued to follow them over the next 12 months during the “maintenance” phase. The problem was, almost none of them were maintaining their weight loss. Most were gaining it all back, often plus some. Also problematic was that they had lost some of their muscle mass during the diet (which is normal with any type of weight loss), but they regained the weight as mostly fat mass. As a result, their risk of cancer recurrence had increased.

My moral dilemma

Let’s recap – I had participated in putting a group of women, cancer survivors, on a diet. Their body image was poor to begin with after all of the physical changes from cancer treatment, including loss of their breasts and abdominal weight gain. They had no libido and often vaginal dryness and pain that was quite uncomfortable. Their sense of attractiveness and sexuality as a woman was gone.

So we put them on a diet, and they felt great about themselves while losing weight. Then they regained it.

When it was all said and done their body composition was worse than when we started because of the loss of muscle mass. They felt like they had failed the diet, and they feared their cancer would come back as a result.

Frankly, in my mind, they were better off before we got ahold of them. I couldn’t keep doing this. I couldn’t keep doing something that I believed was effectively increasing their risk of cancer.

So I started doing my own research of the literature around eating, body image, weight and health. I stumbled across this thing called “mindful eating” and a substantial amount of research to support it. Being the type A that I am, I organized it all into a binder and presented it to my boss, suggesting this is what we should be doing to help these women. She basically laughed at me.

Curiosity led me to shift gears

I couldn’t let go of this idea that our relationship with food is much more complicated than calories in/calories out. I wanted to understand why people who diet can’t stick with it. And I had incredible empathy for the struggles that these women were having.

The more I researched the psychology of eating and body image the more fascinated I became. It resonated with me so much. As a female in our society, I had always had my own body image concerns. And being a dietitian upped the ante because I wanted to “look the part” for my patients – which I assumed meant I had to be thin, fit, and “perfect” with my own eating. Looking back I see how unrealistic and inauthentic it was to try and be the holier-than-thou RD.

Then I stumbled upon the world of eating disorders. It was like I had finally found a place that felt like home. The day I first met over coffee with my mentor, another ED RD, I knew this was what I wanted to do with my career.

Where I am today

Several years later, here I am, a Certified Eating Disorder Registered Dietitian (CEDRD) in a private practice with a group of other RD’s and therapists who treat eating disorders.

I both preach and practice Intuitive Eating and lovingkindness towards our bodies. I am a non-diet practitioner, meaning that I don’t put clients on diets, because I know how harmful it is. I am both grateful and sad for the time I spent putting people on diets. Grateful for the insight it brought, and sad that women had to suffer because of it. I pray that they have since found healing.

Words of wisdom

If you have suffered from negative body image or disordered eating, or if you have been on and off of diets, please know that you absolutely can find inner peace.

It is resources like the Beautiful U Journey that are making a meaningful difference in the lives of countless individuals.

I would also encourage you to consider working with a dietitian and/or therapist who are specialized in eating disorders and body image concerns because they GET IT. Even if you don’t think your issues are severe enough to warrant such help, please consider it. I constantly work with people who both do and don’t meet full diagnostic criteria for an eating disorder. Anyone who has a dissatisfying relationship with food and their body can benefit from this type of specialist.

Thank you for taking time to read my story. I hope that it informs and inspires you in your own journey to embrace your beautiful self.

To learn more about Katy and her work, please visit her blog

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