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Chapter 2


professional, if there is one. You may find differences of opinion regarding severity, frequency, and duration of symptoms. In these cases, the nutrition assessment may actually take place over the course of several meetings.


Interviewing Patients


RDNs may encounter patients with eating disorders who are comfortable with treatment and welcome your assis- tance. Other patients resent their need for an RDN’s help or carry a grudge from a past bad experience. The latter may require more time to “warm up” to you and to participate in your assessment. Patients who are ashamed of their eating habits may not be forthcoming about specific behaviors or may minimize or deny their eating disorder because of fear of punishment or other negative consequences. They may need a few sessions with you to build a relationship and rap- port before determining that you are dependable and worth trusting. Asking about an individual's past experiences with treat-


ment and treatment providers and allowing him or her to express what he or she did and did not like about past pro- viders can be informative. Resist the urge to mentally or verbally agree with derogatory remarks made about past caregivers or treatment programs. Keep in mind that effec- tive eating disorder treatment can be difficult, painful, and even involuntary; therefore a patient may harbor negative memories of what was in fact excellent treatment. How- ever, if you are concerned that an individual’s report of past treatment indicates a violation of law or ethical conduct, speak with your supervisor, who can follow your facility’s procedures for this type of situation. In some cases, your initial nutrition assessment will be


the first time an individual has ever spoken about his or her eating disorder or spoken about it to a professional. These situations carry additional significance, as the patient’s


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