Nutrition Counseling

Nutrition has a large impact on recovery efforts, which is why nutritional counseling is beneficial in healing addiction and mental health conditions.

In the last decade, research has identified nutrition as a primary factor in how people think and feel. In addition to being a healthy daily practice, proper nutritional intake is critical in treating addiction and mental health conditions. Nutritional counseling from trained professionals can ensure that clients engage in the best evidence-based food practices.

What Is Nutritional Counseling?

The World Health Organization defines nutrition as “the intake of food, considered in relation to the body’s dietary needs.” But what is nutrition counseling, and how does it support the health and development of people who are in recovery?

Historically, nutritional counseling was only done by registered dietitians. These clinicians have extensive training in nutrition, physiology, food science and the effects of diet on health. Further, nutritional counseling was only for those who had medical problems like diabetes and people who were obese or at risk of obesity.

However, a significant body of research has identified the substantial impact of nutrition on mental health and addiction recovery efforts. Clinicians who treated this population had long suspected that poor nutrition is associated with poor mental health outcomes and worsened prospects for sobriety. Now, an increasing number of practitioners have received specialized nutrition training to help clients learn how to maximize the benefits of proper nutrition.

What to Expect During an Appointment

Nutritional counseling begins with a food intake assessment. A nutrition expert may ask about:

• Calorie intake
• Meal volume
• Meal frequency
• Percentage of plant-based calorie intake
• Percentage of carbohydrate, fat and protein consumption
• Supplement intake
• Medication intake
• Alcohol and drug usage

However, asking about food intake tends to be unreliable because of recall bias, psychological resistance and many other reasons. Instead, the nutritional counselor may ask a client to complete a food questionnaire or a daily food record.

Nutritional counselors must also assess a person’s body weight. This is most commonly achieved using the body mass index, or BMI. The BMI is a ratio of a person’s mass in kilograms divided by their height in meters (squared to estimate body surface area). A normal range of BMI is considered to be 20 to 25. People with BMI values under 20 are considered underweight, and those with values over 25 are considered overweight. Those with BMI values over 30 are considered obese.

Sometimes, BMI is not an accurate measure of a person’s body weight. Because it does not differentiate between fat mass and muscle mass, well-conditioned athletes often have a BMI over 25 and a person with a high body fat percentage may have a normal BMI.

This information about food intake and weight creates the basis of the nutritional counselor’s needs assessment. From here, the counselor can help a client understand why it is important to make changes in dietary intake. If the client is aware of this need, the counselor can help them initiate these changes. Experts recommend making small, manageable, sustainable and gradual changes to dietary intake while setting reasonable goals. However, it is common for both clients and therapists to initiate large scale changes to a client’s nutritional intake, especially around fasting holidays like Lent or Ramadan.

Who Can Benefit From Nutritional Counseling?

Nutritional counseling can provide extensive and lasting benefits to clients. The benefits of nutritional counseling include:

• Increasing awareness of dietary intake
• Increasing healthier type and volume of food intake
• Identifying food-drug interactions
• Prescribing supplements and/or therapeutic diets
• Promoting knowledge about the connections between nutrition and mental health or addiction

Goals of Nutrition Counseling

When nutrition consultants work with clients, they can create reasonable, manageable goals. Common goals of nutritional counseling include:

• Establishing new habits around food preparation, intake and monitoring
• Increasing accountability around food intake
• Properly managing a chronic condition
• Creating a healthy, flexible partnership with an expert around food intake

Nutrition Counseling In Addiction and Mental Health Treatment

The connection between nutrition and mental health is becoming increasingly well established. Over the last decade, research has made it clear that diets high in fat and sugar are associated with increased mental health issues. Similarly, addiction is more common in those who overeat or severely restrict food intake.

Fortunately, the benefits of nutritional counseling can help people who are recovering from a mental health condition or an addiction. Making dietary changes requires increased self-awareness and monitoring, a deep and honest survey of your intake, accountability from a     therapist or another partner and a willingness to confront psychological resistance. Nutrition and addiction recovery go hand in hand, as the same skills are needed to succeed in both.

Nutritional counseling is particularly important with medications that can affect diet. Some well-known medications that can cause weight gain include:

• Atypical/second-generation antipsychotics
• Valproic acid
• Paroxetine

Other medications are notorious for causing weight loss, including:

• Topiramate
• Levothyroxine
• Stimulants, including many attention deficit hyperactivity disorder medications

Proper nutritional counseling can help you calibrate your diet, reduce the risk these medications pose and provide a template for how to productively attend to your health. Reach out to The Recovery Village today to learn more about how a comprehensive treatment plan, including nutrition-based programs, can help you or a loved one with a substance use disorder and any co-occurring mental health conditions.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Kevin Wandler, MD

Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more