Tag: Dietitian

The Use of Supplemental Shakes in Eating Disorder Recovery

Posted on by drmuhlheim

By Lauren Muhlheim, PsyD and Katie Grubiak, RDN

Nutritional supplements in eating disorder recovery - shakes [image description: assortment of supplemental shakes on a table]

Restoring nutritional health is an essential part of recovery from any eating disorder, including anorexia nervosa, bulimia nervosa, and binge eating disorder. The process of nutritional rehabilitation involves eating sufficient food at regular intervals, which reestablishes regular eating patterns and allows the body to recover. In this post, we will discuss the role of supplemental nutritional shakes in eating disorder recovery. In our next post, we will taste-test the different brands and formulations of nutritional shakes on the market, share our opinions, and help you decide which to buy if you are considering using shakes in your or a loved one’s recovery.

Nutritional Rehabilitation

Since many eating disorder patients – even those who are not at low weights – can be malnourished, renourishment is an important step. Ideally it should take place under the guidance of both a medical doctor and a registered dietitian nutritionist (RDN) who can develop a meal plan uniquely suited to the needs of the patient.

Repairing a depleted body can require a very high caloric intake. The recommended rate of weight gain is usually one to two pounds per week – for many of our clients, this translates into required dietary intakes of 3000 to 5000 calories per day. However, it can be unsafe to increase intake to this level immediately due to the risk of refeeding syndrome, a serious condition caused by introducing nutrition to a malnourished person. Calories need to be increased incrementally under a doctor’s supervision and with an RDN’s guidance.

Getting Sufficient Intake

Many people with eating disorders will be able to restore their nutrition entirely with food. And while we always think it is best for patients to eat real food, and that is the ultimate goal, there are many situations in recovery in which the use of supplements can be invaluable. Sometimes, especially early in recovery, it can be hard for patients to get in enough calories via food alone.

During early recovery, when early fullness is a common issue, fortified shakes may be easier both physically and mentally to consume than food. And when getting in enough calories by eating calorically dense foods is too tough, we think the use of supplements is a perfectly good alternative. It is always better than not eating enough.

Supplement Products

Nutritional supplements, made by a number of different companies, contain nutrients in a calorically dense liquid or “shake.” Six to eight ounces of these products typically have between 200 and 350 calories, depending on the brand and formulation. Many large supermarket and drugstore chains sell shakes under their own names, some of which we tested as well. The best-known brands sold commercially in the US are Boost and Ensure, which come in different flavors and are usually sold in plastic bottles. The main lines are dairy based, but there are non-dairy versions known as Boost Breeze and Ensure Clear, which are packaged in juice boxes and may be ordered online. There are formulations with even higher caloric density (e.g. Boost Plus). In hospital settings, these products are used for patients who are unable to eat – following a stroke, for instance – or need extra nutrition. They can also be used in tube feeding.

In recent years, additional companies have emerged to compete with the Boost and Ensure brands. Several companies are developing products emphasizing organic and natural ingredients. Not all of these products are designed with the same goal in mind. Some are in fact marketed to a clientele that is concerned about losing or maintaining weight through low-calorie, “healthy” meal or snack replacement. These products could inadvertently displace foods, beverages, and other liquid supplements that would be much better suited for appropriate weight gain and eating disorder recovery, all the while delivering messages that could reinforce eating disorder thinking. We recommend thinking carefully about your objectives, researching the products you plan to buy, and proceeding with caution.

How to Use Supplements

Supplements taste better chilled than at room temperature. They can be added to a meal in lieu of a lower-calorie beverage, drunk as a standalone snack, or used in the preparation of oatmeal, smoothies, or milkshakes. They can be consumed more quickly than solid foods and can serve for quick convenient nutrition, especially on the go.

They can also be used as replacements. In some eating disorder residential treatment centers, three supplements would be considered the nutritional equivalent of a meal. A patient who refused to eat altogether would be offered three nutritional drinks; one who ate half the meal would be asked to drink two; one who ate most of the meal but didn’t finish would be asked to top off with a single supplement. Parents refeeding children at home can decide whether to offer an alternative meal or liquid replacement when a child refuses to eat or finish a meal or snack.

Instead of bringing home a multitude of varieties, select one supplement brand in perhaps one or two flavors. Limiting unnecessary choice will head off an opportunity for the eating disorder to assert itself in the form of pickiness.

Take Home

The take-home message: supplemental shakes can be a great tool for ensuring adequate nutrition during the refeeding process in eating disorder treatment. Finding the supplement best suited to you or your loved one from among the available options can be overwhelming. Substantial caloric density is your first concern – but finding one that suits your palate is essential to making sure it goes down. Fortunately, the major brands have made a variety of flavors and textures from which you can choose.

We look forward to sharing further recommendations on the nutritional aspects as well as the results of our taste test. We taste-tested many so you don’t have to. Stay tuned as our follow-up blog will delve into further supplement guidance.

Winter 2017 LACPA Eating Disorders SIG Events

Posted on by drmuhlheim

Glenys Oyston, RDN [image description: photo of Glenys Oyston]1.  Date: Thursday, January 26 at 7:30 pm

Speaker: Glenys Oyston, RDN

Title: The Dangers of Dieting

Description: Dieting for weight loss is a cultural norm – everyone does it, has tried it, or has been told to do it at one time or another. But is dieting for weight loss truly beneficial, or is it causing more harm than good? Registered Dietitian Glenys Oyston, discusses how intentional weight loss efforts are actually harmful to the physical, social and psychological well-being of people who engage in them, and what to do about it.

Bio: Glenys Oyston is a registered dietitian, size acceptance activist, eating coach, and blogger who runs Dare To Not Diet, a coaching business for long-timer dieters and weight cyclers who want to break free of food restriction and body dissatisfaction. She coaches people online or by phone through one-on-one and group coaching programs. She is based on Los Angeles, CA. You can find her at www.daretonotdiet.com.

Glenys Oyston, RDN

Dare To Not Diet

Dietitians Unplugged Podcast

@glenysoRD on twitter

Facebook

Location: The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

RSVP to: drmuhlheim@gmail.com

SIG meetings are open to all LACPA members. Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

 

abby22. February 10 at 11 am – LACPA Office (in conjunction with Sport and Performance Psychology SIG)

The LACPA Sport & Performance and Eating Disorders SIGs are pleased to announce our jointly held meeting for February, 2017:

Date: Friday, February 10, 2017

Time: 11:00 AM – 12:30 PM

Location: the LACPA Office, Encino

6345 Balboa Blvd. Building 2, Suite 126

Topic: When an Athlete Gets an Eating Disorder

Speaker: Abby McCrea, LMFT

More about our topic and speaker:

Clinical eating disorders cause significant problems for more than 40% of athletes. Subsequently, the subtleties between “good athlete” and “eating disorder” mindsets can become particularly tricky to discern after the onset of an eating disorder. Knowing the risks, possible causes, and how to support athletes with eating problems is essential for developing and sustaining athletic wellbeing. 

This talk is designed to help you:

  1. Explain how and why athletes get eating problems
  2. Recognize the subtle differences between a “good athlete” and an “eating  disorder” mindset
  3. Create ways to support athletes with eating problems

Abby McCrea is a Licensed Marriage and Family Therapist who has a private practice in Sierra Madre, CA. She graduated from Fuller Theological Seminary with a Master’s of Science degree and a clinical focus on the integration between psychology and spirituality. 

With over 13 years of experience in a variety of mental health settings including inner city gang rehab community programs, college counseling centers, and eating disorder residential centers, she brings a depth of understanding, experience, respect, and compassion to her work. In her private practice she specializes and works to empower teens, adults, and families that recovery from an eating disorder is possible.  Additionally, she is passionate about developing research and treatment for athletes with eating problems, and helps clients, families, and coaches in her practice to navigate and manage the delicate balance between life, sport, and recovery.

 Abby speaks nationally on the topics of eating disorders and athletes, eating disorder education, deconstructing social ideals of body image, spirituality and the rituals of eating problems, and identity development among teenagers in life transitions.

Please RSVP and/or direct any questions to Sari Shepphird at drshepp@msn.com

LACPA SIG Meetings are a LACPA member benefit and are open to all LACPA Members. For more information about LACPA Membership, SIG’s and other events, visit the LACPA events calendar: www.lapsych.org

Parking Information:

The LACPA office address is THE ENCINO OFFICE PARK, 6345 Balboa Blvd, Building 2, Suite 126, Encino, CA 91316 – second building from Balboa Blvd., conveniently located near ample free daytime/weekday street parking on Balboa Blvd, south of Victory Blvd.  Both sides of Balboa have all day free parking.  There is also plenty of free parking at the Sepulveda Basin Sports Complex on the west side of Balboa, south of Victory, 6201 Balboa Blvd. (2nd driveway past the Busway). 2-3 minute walk to the office door.  Wherever you park, please check the signs. 

Parking at The Encino Office Park lot between the hours of 9 a.m. – 6:30 p.m. is restricted to building tenants only.  Do not park in the lot at the building. 

 

Condiments, the Final Frontier of Eating Disorder Recovery

Posted on by drmuhlheim

By Katie Grubiak, RDN, Director of Nutrition Services

Katherine Grubiak is a Registered Dietitian with a focus on blending Western & Eastern philosophies regarding nutritional healing.

Condiments in Eating Disorder Recovery [image description: assorted condiments and butter]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In our work with clients with eating disorders, we help them to reintroduce recently eliminated and avoided foods that present as part of the eating disorder. We notice that as clients (both adult and child) reintroduce foods, it is often the condiments and sauces that are the last to be confronted. In some situations, clients never successfully spontaneously reintroduce these foods; we have to strongly encourage them.“Normal” eaters enjoy ketchup on French fries, mayonnaise on a sandwich, and dressing (with oil) on salads. In fine cooking, sauces such as Hollandaise are elements that complete the dish. Watch any cooking show and you will see how integral the sauces are to the meals.

In addition to adding needed flavor and creaminess to dishes, these sauces and condiments also add the necessary dietary fat that is essential to metabolic function, hormone balance, absorption of fat-soluble vitamins (Vitamins A, D, E, K), nerve coating, and ultimately brain healing.  It is said that even after weight restoration, for 6 months the body & brain are still recovering.  Gray matter, which is severely compromised in anorexia, only can be re-layered through the help of essential fatty acids. Recommendations are between 30-40% of total calories coming from dietary fat. How about we rename this macro-nutrient “essential fuels” (EFs) to honor its positive and real use in recovery?

We think it is worth pushing these condiments and sauces as one step towards a full recovery for our clients. If you are a person in recovery or a parent of a person in recovery, we hope you will consider the following suggestions:

  • Try one new condiment on a sandwich or side dish per week. This may include: ketchup, mayonnaise, mustard, aioli, etc.
  • Try dipping chips or vegetables in sauces such as Ranch dressing, salsa, or guacamole.
  • Experiment with one new creamy salad dressing (not fat free) on a salad.
  • Eat a meal that has one new sauce, such as a cream sauce on pasta, a sauce on steak, or an Asian curry.

Here are some recipes:

Chimichurri Sauce-with Argentinian roots its used as both a marinade and a sauce for grilled steak. Also try it with fish, chicken, or even pasta (like a pesto). Chimichurri also makes a great dipping sauce for french bread or a yummy spread on a sandwich! image description: slices of baguette with chimichurri on top

  • Prep Time: 8-10 minutes
  • Serves 4

Ingredients:

  • 1 cup firmly packed fresh flat-leaf parsley trimmed of stems
  • 3-4 garlic cloves
  • 2 TBSP fresh or 2 TSP dried oregano leaves
  • 1/2 cup olive oil (extra virgin cold pressed)
  • 2 TBSP red or white wine vinegar-maybe a rice vinegar
  • 1 TSP sea salt
  • 1/4 TSP ground black pepper
  • 1/4 TSP red pepper flakes (amount depending on level of heat desired)

Finely chop the parsley, fresh oregano, & garlic or place all in a food processor with just a few pushes. Place in a small bowl. Stir in the olive oil, vinegar, salt, pepper, and red pepper flakes to taste. Serve immediately or refrigerate. Perishable-so avoid keeping longer than two days.

Chili Aoli

Condiments in eating disorder recovery [image description: chili aioli in a dish]Use on top of meatloaf, meatballs, or on a sandwich.

Total time: 10 minutes | Makes 1 cup.

  • 1 cup mayonnaise
  • 2 cloves garlic, peeled and minced
  • 3 1/2 tablespoons canola oil
  • 1/2 teaspoon ground cumin
  • 3/4 teaspoon lemon juice
  • 1 1/2 tablespoons dark chili powder
  • 3/4 tablespoon paprika
  • Salt and pepper

In a small bowl, whisk together all ingredients until smooth. Taste and season as desired with salt and pepper.

Trader Joe’s Wasabi Mayo can really spruce up a turkey sandwich!  image description: jar of Trader Joe's wasabi mayonnaise

I’m not the villain! My side of the story… by Starch

Posted on by drmuhlheim

Starch in Eating Disorder Recovery [image description: cartoon of a slice of bread dressed like a pirate]
Winter Artwork Illustrations
By Katie Grubiak, RDN

Hey, I have something to say!

Don’t forget my importance!

Although maligned by Atkins and many others, I’m not really the bad guy.

This is why:

  • I contain the falsely feared primary energy source in the diet: carbohydrate.  My carbohydrates along with those found in the fruit & milk groups should make up 50-65% of total calories consumed. I supply 4 calories per gram.  If you are very physically active I encourage you to use my power and consume me to reach the higher percentage so you have plenty of energy to soar!
  • As a carbohydrate, I am the preferred source of energy or fuel for biologic work in humans:
  • I contribute to the mechanical work of muscle contraction
  • I provide chemical work that synthesizes cellular molecules
  • I help transport various substances in the intracellular & extracellular fluids
  • I provide fuel for the central nervous system.
  • I enable metabolism of dietary fat (the other macronutrient you likely fear).
  • I prevent protein (likely the only macronutrient you perceive as safe) from being used for energy thereby allowing protein to be used for what it’s intended –building & repairing body tissue & making antibodies, hormones, and enzymes.
  • I become glycogen (stored glucose) for readily-available energy to support physical activity.
  • I’m in your favorite meals and come around often frequently since so many foods include me.  It’s hard to get rid of me!
  • Meals are not the same without me & you know it!
  • The foods that contain me provide vitamins/minerals/phytochemicals that you have been taking via a daily multi-vitamin pill.  Actually, my nutrients are in food form and are therefore better absorbed & utilized such as:  B Complex Vitamins, Vitamin A/E/C, Choline, Inositol, Calcium, Cooper, Iron, Magnesium, Phosphorus, Potassium, Selenium, Zinc.
  • Without me, you may experience strong urges to binge. I help to create satiation.  Blood sugar regulation requires all three of us macronutrients: carbohydrates, protein, & fat in just the right combination.  We help each other out to help you have the most optimal blood sugar & metabolism.  We also together prevent the HANGRY feeling!
  • Believe it or not, some vegetables also include me even though many think they escape me.  Thank goodness I still have a presence in people’s lives even if they don’t acknowledge me.

The average recommended number of daily servings of starch for adults ranges from 9-12 exchanges for a 2000 to 2500 calorie meal plan.

Check out these excellent starch foods.

Each serving or one “exchange” of a bread/grain/cereal/starchy vegetable listed equals 15 grams of carbohydrates:

  • 1 regular slice of bread (white, pumpernickel, whole wheat, rye)
  • ½ English muffin
  • ½ hamburger bun
  • 1/4 bagel or 1 ounce (can vary)
  • ½ pita-6 inches across
  • 1/3 cup cooked rice, brown or white
  • ½ cup cooked pasta
  • ½ cup cooked legumes (beans, peas, lentils)
  • ½ cup cooked barley or couscous
  • ½ cup cooked bulgur
  • 3oz potato, sweet or white
  • ½ cup mashed potato
  • ½ cup sweet potatoes, plain
  • 1 cup winter squash (acorn or butternut )
  • ½ cup corn
  • 4-6 crackers
  • 1 tortilla -6 inches across
  • ½ cup cooked cereal
  • Âľ cup dry cereal
  • 3 cups popcorn
  • Âľ ounce pretzels
  • 1 plain roll-1oz

Recipes Featuring Starch

Some easy & quick ways to make sure you get enough starch (notice that the other macronutrients -protein & fat- just come around naturally):

Microwavable French Toast

Starch in Eating Disorder Recovery [image description: microwave french toast with side of strawberries]Ingredients:

ÂĽ cup milk

1.5 TB syrup

1 tsp cinnamon

1 egg

pinch salt

1.5 slices any bread

1 TB butter

Directions:

Spread butter on bread and slice into cubes. Put cubes into mug and whisk together wet ingredients and then pour them over the bread and stir to cover bread cubes with liquid. Microwave on high for 2 minutes. Top with sliced bananas or berries and it’s a balanced breakfast.

Tuna Pesto English Muffin Open Faced Sandwich

image description: tuna pesto english muffin sandwich]Ingredients:

1 whole separated English Muffin

Tuna 3oz

Mayo to taste-I like Trader Joes Mayo with expeller pressed oils

Himalayan pink salt & lemon-pepper to taste

Pesto to taste

Heirloom tomato-sliced

Lettuce of choice-2 leaves

Directions:

Make tuna salad by adding mayo, salt, lemon pepper to taste in bowl.

Toast the separated English muffin to preferred goldenness.

Spread a layer of pesto on each half of toasted muffin.

Add the tuna salad to the English muffin with pesto.

Garnish with a lettuce leaf and sliced tomato.

Katie Grubiak, RD is a Registered Dietitian and Director of Nutrition Services at Eating Disorder Therapy LA.  You can read more about her here.

Thank you to Winter Artwork Illustrations for use of the photo.

Presentation at NEDA 2015 conference

Posted on by drmuhlheim

image description: Lauren and Katie presenting NEDA 2015

Katie and I had the honor of presenting in the Individual, Family, and Friends track at the National Eating Disorder Association Conference in San Diego yesterday.  The title of our talk was:  Family Based Nutrition Therapy:  Creating A Supportive Environment.  It was a chance to share the way we work to support families who are helping children with eating disorders.

Here are some of the key points of our talk:

The Hidden Benefits of Full Fat Dairy by Katie Grubiak, RD

Posted on by drmuhlheim
Galbani Whole Milk Mozzarella Cheese
full fat dairy
Galbani Whole Milk Ricotta Cheese
Greek Gods’ Greek Yogurt

History of the Low-Fat Movement

Since the 1980s, physicians, the federal government, the food industry, and popular media have championed the low-fat approach to dieting and weight control. The idea stemmed from a few studies published in the 1940s, which showed a correlation between high-fat diets and high-cholesterol levels. Because high-cholesterol levels were known to be a major risk factor for heart disease, low-fat diets were highly recommended as a preventive measure for at-risk individuals, and eventually for the entire nation. This advice became so widespread by the 1980s that reduced-fat and low-fat options dominated the diet-related product market.

The Argument for Low-Fat Dairy

Although this national preoccupation with low-fat products has waned since the 1990s, low-fat dairy products have sustained their popularity. Low-fat dairy products are lower in calories and saturated fat than their full-fat counterparts, while still boasting substantial amounts of protein and calcium. To experts worried about slowing the impending “obesity epidemic”, low-fat dairy at first seems an obvious choice – especially if choosing low-fat products can help prevent heart disease.

The Issue with the Low-Fat Dairy Argument

There’s just one problem with this logic – according to a review article recently published in the European Journal of Nutrition, there is no conclusive evidence to suggest that full-fat dairy consumption is associated with increased risk of obesity, heart disease, or diabetes. In fact, in 11 of the 16 studies reviewed, high-fat dairy intake was inversely associated with obesity risk. In a 12-year longitudinal study conducted in Sweden, researchers Dr. Sara Holmberg and Dr. Andres Thelin found that men who reported a low intake of dairy fat (skim milk, no butter, etc.) had a higher risk of developing obesity in the 12-year period than were men who reported a high intake of dairy fat.

Why Whole Dairy?

Much of this research may come as a surprise to those familiar with the calories-in, calories-out model of weight maintenance. How could eating dairy products that are significantly higher in calories help people avoid weight gain?

Researchers aren’t certain why full-fat dairy may aid in healthy weight maintenance, but there are a few ideas gaining traction in the field: 

  • Fullness 
    • To produce low-fat dairy products, “excess milk fat” is separated out of whole dairy. Much of this “excess milk fat” is made up of fatty acids found in milk, which are thought to make people feel full sooner and stay full longer. Thus, low-fat dairy products simply don’t keep you as full as whole dairy products do.
    • The fatty acids in whole milk also make whole dairy products richer, thicker, and more satisfying, which can add to the experience of fullness, and keep you full for longer.
  • Role in Gene Expression & Hormone Regulation.
    • The fatty acids found in whole milk may be involved with gene expression and hormone regulation in the body. Though these relationships are unclear, it is possible that fatty acids speed up metabolism or limit the body’s storage of fat.
  • Real Food, Not Just Nutrients.
    • Though macronutrient content can tell us a lot about the health benefits of food, whole fat dairy is more than just the sum of its (major) parts. Real food is a complex mix of macro (fat, carbohydrates, protein) and micro (vitamins and minerals) nutrients. Absorption of all of these macro and micronutrients is dependent upon several factors, so altering the macronutrient breakdown of dairy products (by removing fat) changes the way these products are metabolized by the body.For instance, Vitamins A, D, E, and K are fat soluble nutrients, which means that absorption of these nutrients is compromised when no fat is present.

When I have helped my clients with eating disorders to add full fat diary products back into their diet after a period of having avoided them, positive changes take place.  They often notice a decrease in food obsession and a reduction in volume of intake. Although most clients fear overeating whole full fat (and higher calorie) products, this does NOT happen. Instead, portion control often occurs more naturally since satiety comes from the taste, texture, & actual full fat macronutrient presence.  Clients recognize that they CAN feel in control but still go to their favorite real full fat foods which they previously feared and avoided. In reality, the low fat foods were the ones that they could not limit.   I have only seen satiety benefits as well as metabolic benefits of a diet higher in fat, 30-35% of total calories. To try it for yourself, I suggest:

Some recipes incorporating whole fats

  • *Maple Hill Creamery 100% Grass-Fed Organic Milk Creamline Yogurt-Lemon flavored with granola & banana for breakfast
  • *The Greek Gods Greek Yogurt-Honey Strawberry flavored with cut up pear for a snack
  • *Toasted Caprese Open Faced Sandwich-
    • French Sandwich Roll-cut in half
    • Expeller Pressed Extra Virgin Olive Oil
    • Fresh Basil Leaves
    • Heirloom Tomatoes Sliced

    • Galbani Fresh Whole Milk Mozzarella or Galbani Whole Milk Low-Moisture Mozzarella Cheese

    • Pink Himalayan Salt

  1. Drizzle the olive oil over each half of the sliced French roll
  2. Place sliced Whole Milk Mozzarella Cheese over the French roll with olive oil
  3. Lay Basil Leaves on top of the Mozzarella
  4. Lay sliced Heirloom Tomatoes over the Basil
  5. Grind & sprinkle Pink Himalayan Salt over the Tomatoes
  6. Opened faced-Toast in toaster oven for 3-5 minutes or heat in oven 350 degrees F for 5-8 minutes

Sources:

  • The full article from European Journal of Nutrition can be found here.
  • The full article from the Scandinavian Journal of Primary Health Care can be found here.
  • For a through and clear explanation of this topic, refer to this TIME Magazine article.
  • An additional study in the American Journal of Clinical Nutrition can be found here and is summarized here.
  • Another article is here.

Research Assistant, Erin Standen contributed to the writing and research of this post.

Deliciousness! by Katie Grubiak, RD

Posted on by drmuhlheim

deliciousness [image description: a dog licking its face]

Deliciousness! Yes, that is what this pup Moose is expressing in this photo.  It is deliciousness that we seek in food and in life, isn’t it? Well maybe we forgot one or both of these pursuits along the way.

Consuming delicious food, selected by our taste buds in our weight-shaming thin-obsessed society is sometimes associated with gluttony and guilt. Delicious food is labeled as “cheating” or “bad.” But our furry friends don’t have such ideologies.  They only go to what is pleasurable, what is delicious, what they love.

I believe in looking to the beloved hounds in our lives to help evaluate own attitudes and behaviors and see if they are well-serving.  It has been a privilege to meet my clients’ animal companions during home visits and office yoga and nutrition sessions.  I am always amazed at how much insight they bring to sessions.

During yoga, the dogs are so present and attuned that we can see where our own energy is stirred and stilled just by watching their behavior.  They do downward dog when we do downward dog, they come and lie next to us when we are opening our hips, and they are ever present front and center at the end of class helping us seal in our practice and genuflecting with us to the heart.

During nutrition sessions, they provide comfort, especially when discussions about food raise anxiety. I find that my own as well as my client’s mood lightens and thinking becomes more flexible in the face of their wagging tails.  We simply become more open and more centered when the pets are around.

Why do we feel more relaxed around them? Why does compassion and empathy pour out of us in their presence? How do they make us more human when they are not? These are questions that I believe can be answered by the very fact that they are exactly who they are without any agenda or thought of anything else other than the loving present moment. They actually ground us to that very thing.  We then are reminded to take one loving breath at a time and to choose to be our very selves one breath at a time. We can then naturally seek what is joyful and what will serve that joy in our lives.

When we are grounded, living in the moment, and being true to ourselves, seeking deliciousness in food and life can then look different.  No longer is there judgment and guilt, but there is pure joy. Just look at Moose.  His deliciousness is infectious! His deliciousness is so sweet and tender. His deliciousness can be our deliciousness, too!  Thank you, Moose, and all the other dogs that have come into my practice and shared their deliciousness of heart!

image description: collage of 3 photos of different dogs

“Watch any plant or animal and let it teach you acceptance of what is, surrender to the Now. Let it teach you Being. Let it teach you integrity-which means to be one, to be yourself, to be real. Let it teach you how to live and how to die, and how not to make living and dying into a problem.”…The Power of Now by Eckhart Tolle.

Katie Grubiak, RD is Director of Nutrition Services at Eating Disorder Therapy LA.  She is a registered dietitan with a focus on blending Western and Eastern philosophies regarding nutritional healing.  She provides nutritional counseling and movement/yoga therapy.   Read more about Katie.

Dog photos used with permission.

Katherine Grubiak, RD

Posted on by admin
Katherine Grubiak, RD
Katherine Grubiak, RD

On the occasion of the one year anniversary of my affiliation with the awesome, Katherine (Katie) Grubiak, RD, I want to highlight her fabulous work and contribution to my practice.

Eating disorders are best addressed by a multidisciplinary approach.  Thus, I was extremely excited when, one year ago, I moved to a larger space and arranged an affiliation with Katherine Grubiak, RD, who works part-time in my suite.  Ms. Grubiak brings a wealth of experience with eating disorders in both adolescents and adults, and her approach is consistent with the latest evidence-based treatments.

Our clients benefit from our integrated approach for eating disorders and we tailor treatment to each client or family.  Additionally, we offer services as a team or individually. This benefits our clients who already have a dietitian or therapist and are seeking to add one member to their treatment team.

Ms. Grubiak, in addition to nutrition counseling sessions at the office, also provides additional support to those seeking help with preparing, portioning, or eating meals.  These may occur in the client’s home, office, school, or location of choice (restaurant, supermarket, etc.).  

Katherine Grubiak, RD/Biography

Katherine Grubiak is a Registered Dietitian with a focus on blending Western & Eastern philosophies regarding nutritional healing.  She graduated from the University of Texas at Austin and first pursued a career in public health surrounding herself with different cultures and a mission to honor all those seeking healthcare nutritional support.

Ms. Grubiak began her Nutrition career working in Maternal Child Health Nutrition with a focus on Gestational Diabetes Management & breastfeeding support as a Certified Lactation Educator (CLE).  She later became a dietitian for the UCLA Arthur Ashe Student Health & Wellness Center seeing students with various medical issues.  In this position, she worked closely with the UCLA Counseling and Psychological Services Center to provide treatment for college students with eating disorders and was involved with the Health Center’s Weight Management and Diabetic Programs.

This experience led Ms. Grubiak to pursue her next position as full time Registered Dietitian and Director of Clinical Services for California Center for Healthy Living, an innovative and comprehensive center promoting healthy relationships with food, fitness, and body image for children, teens, and adults of all ages. The focus here was on prevention and treatment of eating disorders and family involved therapy.  She enjoys working within a multi-disciplinary team believing that holistic care means having all areas of health supported.

Ms. Grubiak also has a professional dance background and taught for the non-profit dance school Everybody Dance in Los Angeles.  She utilized nutrition and alternative medicine including yoga to heal herself from dance injuries and spread the word to her students.

Ms. Grubiak’s belief is that a practitioner needs knowledge, compassion, patience, and creativity to inspire change.  The practitioner must honor the individuality and goals of each person who enters her care. There should be no limitations on their journey or their healing.  She has experience working with clients of all ages and across the spectrum of weight and wellness.  She is available to work with adults, adolescents, families, and parents.

She can be reached at 213-249-2110.

I’m moving my office

Posted on by admin

On August 1, my office is moving to

4929 Wilshire Boulevard, Suite 245!

(Only one mile east of my old office)

office moving flyer_Aug2013

Since eating disorders are best addressed by a multidisciplinary approach, I am excited to be able to offer expanded services at this new and larger space.  I am pleased to announce my affiliation with Katherine Grubiak, RD, who will be working in my suite part-time.  Ms. Grubiak brings a wealth of experience with eating disorders in both adolescents and adults, and her approach is consistent with the latest evidence-based treatments.

Katherine Grubiak, RD/Biography

Katherine Grubiak is a Registered Dietitian with a focus on blending Western & Eastern philosophies regarding nutritional healing.  She graduated from the University of Texas at Austin and first pursued a career in public health surrounding herself with different cultures and a mission to honor all those seeking healthcare nutritional support. Continue reading “I’m moving my office” →