Do you have kids who are extreme picky eaters? Have you been grappling with trying to figure out how to provide for their nutrition needs without turning every meal into a battle? It is so hard when you have children that struggle with eating a wide variety of nutritious foods. It is absolutely exhausting, especially in San Diego when you just want to pack some food and go to the beach and focus on enjoying the sun, sand, and water instead of worrying about whether you can get your kid to eat something. One of the newer diagnoses of eating disorders is Avoidant/Restrictive Food Intake Disorder (ARFID). It is basically extreme picky eating that can cause serious health issues.

One San Diego pediatric dietitian who specializes in ARFID, as well as in other types of feeding and eating disorder treatment is Rachel Rothman, RD (registered dietitian). She has a B.S. Food science from University of California Davis and a Master’s degree in nutrition education from Teacher's College, Columbia University. She has loads of clinical experience with feeding difficulties, feeding disorders, sensory processing disorder, and many other nutritional ailments. All in all, Rachel is a really smart woman who will do an amazing job working with you and your kids.

Why did you choose to become a pediatric dietitian who treats eating disorders and feeding disorders in San Diego? 

I began my career in the food industry, but was never very passionate about my work.  I went back to school to obtain my master’s degree in nutrition education and I was certain I had found my calling.  I became a registered dietitian in 2013.  I spent several years working at Rady Children’s Hospital seeing inpatient and outpatient cases, and I worked on a multidisciplinary feeding team, which solidified my path toward pediatric nutrition. I find working with this population truly challenging, yet rewarding.  I love collaborating with other healthcare professionals to provide a multidisciplinary approach to helping these families.  Now my private practice includes a wide variety of cases, such as children diagnosed with feeding difficulties and feeding disorders, including ARFID.

After studying some of the more difficult cases, I have been able to develop some practical strategies that address picky eating, and the mealtime frustrations of toddlers and preschoolers.  My hope is to help little ones to develop a healthy relationship with food.  

What kind of treatment do you provide? 

I provide medical nutrition therapy for pediatric patients, and families, which includes counseling and coaching.  This treatment is really tailored toward the child and his or her specific needs.

I also teach classes locally in San Diego, and on-line.  I teach an introduction to solids course (with locations throughout San Diego county) and as an on-demand online course. I also teach a class called Peaceful Mealtimes, which is a class for families of toddler and preschool age children.

In addition, I run an online coaching group for families with children that are more selective when it comes to their food intake, or who have been diagnosed with a feeding disorder. This approach combines my strategies and coaching with a supportive group that can help everyone stay motivated and accountable.

Do you only work with eating disorders? 

My specialty is a bit different; but I try to address some of the behaviors and preferences we learn as little ones that can turn into disordered eating later in life. When I was 10 years old, I remember being told by my pediatrician to “eat one more banana and one less candy bar per day.”  Prior to this I hadn’t thought about food I was eating, or body shape or body size. After this encounter: I felt ashamed and that I was “not good” because of my weight.  It was about all the feelings surrounding the food.   After this visit, on occasions I remember eating candy, those feelings of shame came back. Those foods began to have a forbidden connotation in my mind.  

As I continued to get older, I started to think more and more about my appearance, as many teenagers do, and the foods I was eating and choices I was making.  Food has always been a big part of my life (I have a BS in Food Science and an MS in nutrition education), but at this pivotal point in my young adult life, my relationship with food took a turn.  I had, what I can look back now and say, a not so great relationship with food.  It took me many years, to heal this relationship.

This approach has now become the essence of what I do and what I preach in my practice.  I collaborate with health professionals and pediatricians on the opportunities to encourage sustainable, healthy food behaviors that nourish without demonizing or judging particular foods.   My goal is to help children develop a healthy relationship with food from the start.

How long have you been working with eating disorders overall, and how long have you been in San Diego? 

I have been in practice for a little over 6 years.  I grew up in San Diego and received my bachelor's degree in Food Science from UC Davis.  I worked in the food industry for several years, which brought me to New York for a job.  I then went back to school and obtained my master’s degree in Nutrition Education. After that, I came back to San Diego and completed an internship at the VA San Diego Medical Center.  I have now been back in San Diego almost 7 years and have really come full circle.

Who are your favorite types of clients? 

I truly love every family that steps through my doors.  Prior to setting up a counseling appointment with a family, we have a 15-minute phone call to make sure we are a good fit.  I like working with a wide variety of clients, but really enjoy those that are open to learning and coaching.  When I talk with families about the importance of children developing a healthy relationship with food, many are hesitant at first. Health is about the things we do over and over, and they take time to learn. I like families that are open to coming up with a plan together to help feeding their family and their child.

What happens during a first appointment with you? 

We review a child’s feeding history and the family’s current feeding practices.  We talk about how those practices impact the child and the family, and work on goals the parents and caregivers have for the child and their family together.  Parents and caregivers leave that first appointment with actionable steps they can take to start a positive feeding journey path with their family.  Follow-up sessions can fine tune the approach, and provide support to keep everyone on track.

What do you wish people knew about getting treatment for eating disorders? 

I wish people knew that there are so many others going through the same journey that they are.  I meet with so many families with young children who are highly selective and they feel so alone on this journey.  I help them to normalize those feelings and provide resources so that they don’t feel so isolated.  I also want them to know there is hope and seeking out help is the best way to move forward.

How can people learn more and contact you? 

On my website, www.nutritioninbloom.com, via facebook: www.facebook.com/nutritioninbloom or  instagram: www.instagram.com/nutrition_in_bloom.

Share one fun fact about you.

It might not be surprising that as a dietitian, I like to cook and bake, but I wouldn’t call myself a chef or a baker.  My recipes are easy and family friendly.  Involving my kids in the kitchen has been one of my missions over the past couple of years, and I encourage this with most families I meet. I have two young daughters at home, 4 years and 1.5 years.  We are in the kitchen almost daily.  I recently wrote this post for families to get their kids in the kitchen.

It sounds like you have so much experience and have a lot of practical advice to give your clients. Thanks so much for participating in my blog!

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Hey everyone, I really appreciate you reading my blog!  Have a wonderful day. :)  

Marianne 

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! 

You can find more information about me on Instagram @drmariannemiller or on my Facebook page.

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Interview with UCSD Eating Disorder Psychologist Dr. Jennie Wang-Hall

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Interview with Addiction Specialist and Haven Hills* Director Dr. Reya Kost, LMFT