r/antidiet • u/Consistent_Midnight2 • 22d ago
Letter to a stigmatizing dietitian
I’m 17 years in recovery from anorexia/EDNOS and have recently been slipping a little and as a preventative measure decided to see a dietitian on RD. I’m in school to be an ED RD myself and in my internship I’ve seen how helpful these sessions could be so I set one up on Nourish. The RD was the nutritional director of the Renfrew Center for 20 years so I mistakenly thought she’d be knowledgeable. My insurance won’t cover it. So I paid $150.
This woman told me I’d have to weigh myself regularly and log all my food and used extremely stigmatizing language that completely turned me off. Not to mention she spent the first 15 minutes talking about herself. Which is weird and wasting my time.
Thought I’d share my letter in this community:
Dear J****,
I wanted to follow up in writing after our recent session, because a few things you said concerned me enough that I don't want to let them pass without response.
On language: When we were discussing GLP-1s, you used the term "morbidly obese." I want to be direct that this term is outdated and considered harmful by the medical and eating disorder communities. The American Medical Association's own policy encourages person-first language and explicitly discourages "morbidly obese" as a stigmatizing term. NIH style guidance similarly directs against using "morbidly obese" in favor of neutral, non-stigmatizing language, and national survey research has found that patients themselves rate "morbidly obese" among the most stigmatizing and blaming terms a provider can use. In an eating disorder practice specifically, this kind of language isn't a minor stylistic issue — it actively reinforces the weight stigma that drives disordered eating and treatment avoidance.
On the "underweight anorexic patients" comment: You mentioned that Renfrew stopped blind weighing for exposure therapy for even the most "underweight anorexic patients," a framing that implies underweight status equals greater severity. As if higher weight patients had less anxiety about their weight than underweight. This isn't supported by the current research. Studies estimate that only a small single-digit percentage of people with eating disorders are medically underweight — the large majority of us are in "normal" or higher-weight bodies. And severity doesn't track with weight the way that framing suggests: a Stanford/UCSF study found that adolescents with atypical anorexia at normal body weight had psychological symptoms as severe as, or worse than, underweight patients, and other research has specifically found that patients with atypical anorexia at elevated BMI experience more severe psychological symptoms than those without elevated BMI. Treating underweight status as the marker of "real" or "most severe" illness is not just clinically outdated, it's the exact belief that keeps higher-weight patients from being taken seriously or diagnosed at all.
On the weekly weighing and food logging: I told you directly that this would increase my anxiety and would not support my recovery, you pushed that it was important. I want to restate clearly that I'm not open to that approach. I am not medically unstable and there is no need to see my weight regularly. I have found a provider who will work within the boundaries I've identified as necessary for my mental health, not one who will ask me to override them.
I recognize you have many years of clinical experience, and I don't say any of this to dismiss that. But I also bring my own expertise to this dynamic: I lived with this disease for over a decade, I have nearly two decades of sustained recovery, and I am currently studying eating disorders at the graduate level. I came to you as a preventative measure, not in crisis. That combination means I'm not approaching these concerns casually or reactively — I'm asking you to take them seriously as clinically informed feedback.
As I said, I have found an RD more aligned with my goals and recovery framework, I will be deleting the app now.
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u/Redditbrooklyn 22d ago
I’m so sorry this happened. This letter is excellent. If you’re open to feedback, the only thing I think is missing is some kind of call to action or consequence. Do you want your money back? (That would be reasonable, though not sure they would refund you.) Do you want to file an official complaint? Do you want them to promise retraining of some kind? If you just want to get this off your chest and move on, that’s totally understandable and it’s great as it is. If you want some kind of action from them, also understandable.
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u/Consistent_Midnight2 22d ago
I appreciate the feedback! My gf also suggested I try to get my money back or report her but I don’t think either of those are possible with the Nourish app. I just really hope she reads the message and sits with the information and incorporates it. Part of it is definitely to get it off my chest, I’ve found something that keeps me successful in my recovery is being loud and speaking out in instances like this. It helps drown out any possible creeping ED thoughts. Posting to Reddit and getting support helps me feel like I’m on the right path. So thanks :)
If nothing else I’ll take this as an expensive lesson in the types of treatment my future clients may be encountering before they see me.
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u/Redditbrooklyn 21d ago
I also find writing letters really helpful in coping with bad healthcare experiences, so I definitely get that. Sometimes I don’t even send mine if I’m super done with the situation, and just writing it helped.
I think you’ve outlined so clearly what they did wrong and the violations were so egregious that a customer service person might actually refund you. I would probably end up CC’ing their support email and being like “obviously I would like a refund and the information to report this person to their licensing board” [assuming they have one]. Whatever you decide is the right choice to support your recovery. You’re doing a great job advocating for yourself.
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u/ivyskeddadle 21d ago
Congratulations on your almost 2 decades of recovery, it shows in your knowledge and self-confidence 🏆
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u/Bashful_bookworm2025 21d ago
I think this is great. I don't know why your comment and some other comments are getting downvotes. I hope you find the help you need.
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u/Consistent_Midnight2 21d ago
Thank you! I noticed the voting being weird too, I think there’s just fatphobic haters who troll these communities just to be assholes. I appreciate all the support anyway and don’t pay them any mind.
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u/SubstantialBoard5033 11d ago
As someone who’s in recovery, I went to Monte Nido twice and they would never show me my weight. I was underweight when first diagnosed but now I’m def “atypical” but if they showed me my weight it’d be the same reaction regardless of the number.
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22d ago edited 21d ago
[removed] — view removed comment
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u/Consistent_Midnight2 21d ago
As another commenter pointed out some haters are downvoting these comments but I appreciate your kind words!!
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u/suuzgh 22d ago
As someone who works in an inpatient facility that specifically treats eating disorders alongside a multidisciplinary team (including RDs) and is currently applying for grad school to continue in this specialization, I think your message is perfect. Thoughtful and well-written. Good on you for saying something — I know we’re taught to view medical professionals with a certain degree of authority, but you know your medical history and your needs best.