ABSTRACT

Nutritional counseling is a central part of eating disorder (ED) treatment. However, the nature of this treatment has not yet been described from women’s perspectives. We conducted two studies exploring views of women regarding their ED nutritional counseling. In the first study, we used content analysis to reveal practices that registered dietitians (RDs) use in ED treatment. In the second study, we used phenomenological analysis to explore the nature of the client-dietitian collaboration. Data included 1,897 posts and 8,673 responses from 414 distinct female users, retrieved from a moderated ED Internet community website in Israel. Content analysis demonstrated six practices used by RDs: meal planning, weight monitoring, health assessment/consultation, establishing rapports, food logs, joint eating. Phenomenological analysis produced four positions demonstrating client-dietitian collaborations: “Silent dialogue,” “Cancelation and deception,” “Tough love,” “Containment.” Findings revealed women’s efforts to continue treatment despite their ambivalence about goals and recovery, and RDs’ efforts to help women, despite the women’s ambivalence, to move forward toward recovery.

摘要

营养咨询是饮食失调（ED）治疗的核心部分。然而，尚未从女性的角度描述这种治疗的性质。我们进行了两项研究，探讨女性对 ED 营养咨询的看法。在第一项研究中，我们使用内容分析来揭示注册营养师 (RD) 在 ED 治疗中使用的做法。在第二项研究中，我们使用现象学分析来探索客户与营养师合作的性质。数据包括来自 414 位不同女性用户的 1,897 条帖子和 8,673 条回复，这些数据来自以色列一个有节制的 ED 互联网社区网站。内容分析展示了 RD 使用的六种做法：膳食计划、体重监测、健康评估/咨询、建立融洽关系、食物日志、联合进食。现象学分析产生了四个展示客户与营养师合作的立场：“无声对话”、“取消和欺骗”、“严厉的爱”、“遏制”。调查结果显示，尽管女性对目标和康复存在矛盾心理，但她们仍努力继续治疗，尽管女性存在矛盾心理，但 RDs 努力帮助女性走向康复。