Hi everyone! This week I’d like you to meet San Diego eating disorder dietitian Theresa Carmichael, RD. Theresa is a dietitian at Center For Discovery’s partial hospitalization program and intensive outpatient program in Del Mar. She also treats clients in her private practice in Mira Mesa in San Diego. She is a lovely person who really advocates the Health at Every Size (HAES®) and Intuitive Eating approaches, which I also uphold. She also does amazing work with her clients!
Why did you choose to become an eating disorder specialist in San Diego?
This question is kind of funny to explain because I have a saying- "I didn't find eating disorder work, eating disorder work found me!" My clients ask me this all the time and I give them the most honest answer. In college at San Diego State University, I was an executive board member of the Student Nutrition Organization. It was in this organization that I found out about a diet technician job opening with Center for Discovery (CFD) at one of their residential treatment centers for eating disorders in La Jolla, CA. I thought to myself... "what I great job to put on my resume!" I scored an interview and the RD at the time asked, "what is your nutrition philosophy?" Again, I answered very genuinely. I was not yet at that place in my schooling where I had a beautiful elaborate answer.. so I said "ummmm I am not sure. I mean.. I love all types of foods. I just love food." The RD interviewing me said "you are perfect for eating disorder treatment!" So that is how I got introduced to eating disorder treatment. I had no prior experience in the field but thought why not? However, it was within my first few weeks as a diet tech with CFD that I realized this was my passion. It was at that time when I decided this is what I was going to do. Now I have been working in the field since 2014, and I wouldn't have it any other way. My favorite part of this job is the complexity of the work as well as the wonderful therapeutic relationships I get to make with clients during their road to recovery.
What kind of treatment do you provide?
I provide dietary services for those struggling with disordered eating. I have treated clients with disordered eating patterns related to an eating disorder diagnosis as well as those secondary to other mental health or substance abuse disorders. I complete nutrition counseling and medical nutrition therapy in my private practice in Mira Mesa, CA (San Diego area). I also work as part of the treatment team at Center for Discovery's PHP/IOP eating disorder program in Del Mar, CA and spear head our new Binge Eating Disorder Program.
Do you only work with eating disorders?
I work mostly with the eating disorder population but also enjoy working with clients who may have disordered eating patterns secondary to other mental health and substance abuse disorders.
How long have you been working with eating disorders overall, and how long have you been in San Diego?
I have been working with eating disorders since 2014 in San Diego with no intention to leave anytime soon!
Who are your favorite types of clients to work with?
This is the hardest question! Providers ask me this often and I realized I have thoroughly enjoyed working with clients of all ages and diagnoses. However, I have increasingly gained even greater passion working with clients diagnosed with binge eating disorder. Through out all my work I am constantly relaying back to Health at Every Size and Intuitive Eating principles. My inner advocate is fueled by attempts at ending weight stigma and I find that many of these clients (but not all) experience this trauma. Although due to my privileges I will never know what that fully feels like, I have made a point to advocate for appropriate and optimal health care for clients of all sizes.
What happens during a first appointment with you?
The initial dietary assessment is completed first in order to get an understanding of how I can help. I think it is so important to know that I am interested in much more than just the disordered eating! At the beginning of the first appointment, I actually ask the client to share a little bit about themselves outside of the disordered eating they experience (ex. where are you from, do you have any pets/kids, what are your hobbies). I think it is so so important to make sure each and every client understands that they are more than just a disorder. I also find that this helps lead into the more serious questions about their overall health and disordered eating that have to be done in the initial assessment as well.
You work both in partial hospitalization/intensive outpatient programs (PHP/IOP). Would you explain the difference between your work as a dietitian in those programs versus your outpatient work in private practice?
Great question! They are different but also similar in many ways. The biggest difference is that the work completed in my outpatient work consistently works at the pace of the client. Although dietary treatment goals are made, the client and I get to collaborate on what their reality is and at what pace they feel is doable (this does not go without those challenging, hard sessions though!). Now, this is not to say that PHP/IOP does not lend an ear to the client because IT DOES! However, more frequently we find that clients at this level of care may be facing even greater medical complications that require resolve quickly... sometimes feeling as though things are happening more quickly. Although it is normal to feel overwhelmed at the pace of PHP/IOP... it is worth it! Working with an interdisciplinary team for three-to-six days a week for three-to-seven hours a day is intense work. But the effectiveness is incredible.
What do you wish people knew about getting treatment for eating disorders?
I could probably go on for days about this. I have even completed a group with clients where we made a list of things they wish they knew about treatment before getting started. Here were their findings:
1. It will be hard but worth it
2. It isn't necessarily what movies and other stigmatized views of treatment look like
3. It is full of connection vs. shame-based
4. Sometimes things get worse before they get better
5. That full recovery is absolutely possible!
How can people learn more and contact you?
I love teaching! Any opportunity to lend a helping hand I am all ears for. Check my Media page on my website to learn more. Also follow me on Instagram where I share positive messages about food and our bodies. It is on this social media platform where I get to practice my inner advocate and also share some of the work being done in a treatment center. It is also a great way to get connected to other "All Foods Fit" philosophy peeps and start creating your own "positive special media bubble." If interested in dietary services, feel free to contact me by phone or mail as shown below:
Theresa Carmichael Nutrition
5405 Morehouse Dr. Ste 330
San Diego, CA 92121
*Virtual counseling available
Thanks so much for reading my blog! Have a wonderful week!
If you are struggling to find eating disorder treatment in San Diego give me a call for your free 15-minute phone consultation at (858) 699-3754, and I will help you get where you need to be!