Embolden Psychology is fortunate to collaborate with and learn from incredible professionals who encourage a treatment team approach. The most efficacious treatment for clients requires individuals in different professions to work together with communication, knowledge, respect, and compassion for our patients and consumers.
The Embolden Psychology interview series asked Sam Tryon, MS RD, a registered dietitian specializing in eating disorders, disordered eating, chronic dieting, and body image to speak about the work, and how it fits with psychotherapy and treatment that speaks to the whole individual and to individual needs.
– How does the work of a dietitian intersect with psychotherapy?
The work I do with clients is nutrition therapy which is very connected to psychotherapy. I help clients to heal their relationship with food and their body so that they can nourish themselves in a way that supports their physical, mental, and social health. Of course, I help assess what and how much a client is eating, but the real work comes when we look at why a person is choosing those foods and those amounts. Is it because they are listening to their body and honoring their hunger and fullness with foods that feel satisfying? Or, are the choices dictated by food rules and/ or shame that frequently, though not always, have to do with controlling their weight.
The issues that come up in my work with clients are almost always also present in other areas of their life. For this reason, collaborating with therapists is essential. I am very mindful of my scope and when it comes to areas outside of the person’s relationship with food and their body, I am able to encourage them to bring that up in therapy.
– Can you speak about Eating Disorders vs Disordered Eating?
In many ways, it is semantics as to whether a person meets the criteria in the DSM. Other than the code I am going to enter into the “diagnosis” box that will then be submitted to insurance and possible need for that person to be more closely monitored by a medical professional, it does not change anything about my work with a client.
In many ways, the goals of nutrition therapy are the same for everyone – regardless of diagnosis. It is to help the client heal their relationship with food and their body so that they can lead a full life free from food/ weight-fueled shame. The spectrum from healthy relationship to food to disordered eating and chronic dieting to eating disorder informs where we are starting on our journey, but does not change the destination of freedom.
– What is body positivity?
I actually am not necessarily a fan of the word “body positive.” I think that the idea of feeling positively about a body that a person judges in such a deeply negative way can feel so unattainable and leaves people feeling discouraged. Yes, of course it is incredible when a person can feel positively about and love their body. But, I argue that a goal of feeling “body neutral” is compatible with the freedom I have described.
In my opinion, the goal of body image work is not necessarily to think their body is beautiful. It is to no longer let their body keep them from fully living the life they want and deserve which includes eating the food they want, dating, sex, going to the beach, etc.
Body weight and size are largely determined by genetics and shaming ourselves for our genes and something that is out of our control is, if nothing else, really mean. I work with clients on radical acceptance that this is the body they have in this moment and encourage them to live their full life today in this body, even if they do not necessarily like it.
Body neutrality/ radical acceptance is complicated, especially in folks who are trans or nonbinary. I am not at all here to tell someone to feel comfortable in their body that is incompatible with their gender and how they want to express their gender. Radical acceptance does not mean feeling positively about their body. My job is to help my clients find a way to fuel this body as it is while I can help get them connected to resources that are gender affirming which may mean surgery or hormones.
– What are some main concerns that clients bring to you?
Some people are sent to me by their healthcare provider or therapist to address eating disorder behaviors such as restricting, binging, compulsive exercise and purging. These are very concrete concerns that are generally agreed upon as “disordered.”
Then there are the concerns that the individual often sees as some form of weakness or lack of willpower on their part. For example, “over eating” until they are physically uncomfortable, eating “too much sugar,” or feeling that they cannot have certain foods in the house without binging. Some people will also come in because they are tired of diets that don’t work and feeling constant shame about eating and their body.
People are not generally concerned with their restrictive eating. After all, they are “succeeding” at the diet-industry’s message that we should eat less and avoid “bad foods.” In this case, the concerns may be around their fear and anxiety surrounding eating, inability to comfortably eat at a restaurant, constant thoughts about food, etc.
– What are some strategies you use in your approach?
When it comes to actual food choices, I support clients to adequately fuel their bodies. Almost everyone’s idea of what they should be eating is not enough. This makes sense because our idea of portions and food choices is informed by the diet industry and public health messages that are centered around promoting weight loss. I help clients learn how to eat enough during the day to stabilize blood sugar and meet nutritional needs. This helps clients renew their connection to hunger and fullness and prevents any binge eating that results from physiological need for food.
Other strategies are aimed to help clients find motivation to more adequately fuel their body and include foods they previously restricted despite fear of weight gain or desire for weight loss.
Eating disorders and dieting hold people back from fully participating in life. Part of my job is to help clients develop a clear vision of what they want like to look like and then we see how their current ways of eating support or get in the way of that life. For example, if connecting with friends and family is important, does it really make sense to turn down a piece of birthday cake because it has “too many carbs?”
In the end it comes down to what is more important to the client. Is it possible to let go of the quest for weight loss in order to fully live the life they want? This is by no means an easy question to answer and can be even more challenging to put into practice. In session we will do a lot of pros/cons to help the client get more insight and find motivation to try things a different way.
– What brought you to your field?
While I was in my grad school nutrition program and dietetic internship, I actually felt pretty lost about what I was going to do when I became a dietitian. I didn’t connect to the idea of telling people to eat fruits, vegetables, and whole grains or to eat a certain number of calories and lose weight. It just didn’t energize me, something felt off. Towards the end of my internship, I spent time with a dietitian in private practice who worked with eating disorders from a non-diet, Health At Every Size approach. I was hooked. If all of the science shows us that dieting doesn’t work and even leads to weight gain, then why are we continuing to tell people to lose weight?
Eating disorders and diets make life very small. You cannot participate in social situations with food. Shame takes over when you “fail” the diet and body size and shape become a way of measuring self-worth. Diets are destined to fail. I get to support people in healing their relationships with food and their body and live their lives with less shame. It’s not a bad gig.
– Why are wildflowers symbolic?
About 8 years ago, I took my first trip to the west coast. As I drove and camped my way through Oregon and Washington state, I was surrounded by beautiful wildflowers. In particular, I remember driving down the highway and seeing bright fuchsia foxgloves, tiny purple asters, and so many other colorful flowers I had never seen before!
All I could think about was their natural beauty. No one put them there or groomed them to look a certain way. Their diversity in color, shape, and size was celebrated as they brightened my experience of life in that moment.
For me, wildflowers have become a symbol of body diversity and self acceptance. Every time I see these flowers I am reminded that we are all unique and intricate beings shaped by our life experiences. And, we are absolutely perfect, exactly as we are.
Sam Tryon MS RD
She/ Her/ Hers
Sam Tryon is a registered dietitian specializing in eating disorders, disordered eating, chronic dieting and body image. Sam takes a fully Health At Every Size, non-diet approach to nutrition. She celebrates the diversity of body shapes and sizes and focuses on helping each client learn to trust their body rather than abusing and fighting it.
Sam is passionate about working with transgender, non-binary, and queer individuals and serving the LGBTQ community overall. She knows how common body image struggles are and how multifaceted the barriers are when working towards healing a person’s relationship with food and their body.
Sam has a masters degree in Nutrition from Hunter College School of Public Health and completed her dietetic internship at the National Institutes of Health. She has also participated in professional trainings on Intuitive Eating and Dialectical Behavioral Therapy. Sam has a private practice in Silver Spring, MD in addition to seeing clients virtually.