Eating Disorder & Nutritional Counselor

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“Specializing in eating disorders requires continuous training and collaboration with dieticians, physicians, and psychiatrists due to its complexity and the high mortality rates associated with some disorders.”

Marianne Miller, PhD, LMFT & Eating Disorder Treatment Specialist

Eating disorders affect a large share of the population—an estimated 20 million women and 10 million men in America, according to surveys from the National Eating Disorders Association. Eating disorders are caused by a range of biological, psychological, social, and cultural factors, so it sometimes takes someone specifically skilled in the treatment of eating disorders, or possibly even a team of people, to treat them. Eating disorders can have significant long-term health consequences, so adequate nutrition is one of the keys to recovery for most people.

Many professionals can offer eating disorder and nutritional counseling, including nurses, doctors, professional counselors, psychologists, registered dietitians, nutritionists, and even physical therapists. The level of education can range based on the profession, but most professionals in this field hold at least a bachelor’s degree.

Nutrition counseling is an ongoing process in which professionals trained in eating disorders and nutrition work with individuals to help them develop or regain a healthy and symptom-free relationship with food. Much as a mental health counselor addresses the specific needs that a client presents, an eating disorder and nutritional counselor does the same, except usually within the individual’s relationship to food, body image, eating and exercise habits, and whatever else is out of balance.

Read on for more information about career outlook, salary potential, and how to become an eating disorder and nutritional counselor.

Meet the Expert: Marianne Miller, PhD, LMFT

Dr. Marianne Miller is a licensed marriage and family therapist (LMFT) specializing in treating eating disorders. With more than 25 years of experience as a psychotherapist, she has dedicated her career to helping individuals struggling with eating disorders reclaim their lives and develop healthy relationships with food.

Based in San Diego, Dr. Miller offers in-person and online therapy sessions, supporting adults and teens in Scripps Ranch, Mira Mesa, and Miramar. She is renowned for her compassionate approach and commitment to providing personalized, evidence-based treatments.

Dr. Miller’s expertise extends beyond traditional therapy settings. She is an active educator on binge eating, regularly offering her insights and knowledge to wider audiences. This passion for education led her to launch virtual binge eating recovery programs, where she discusses various aspects of eating disorders and shares coping strategies for recovering. Her work continues to impact countless lives, guiding individuals toward recovery and fostering a healthier relationship with food.

CounselingSchools.com: Please tell us about a time when you helped a client make a breakthrough in their eating disorder recovery journey.

Dr. Miller: A highly professional female client of mine struggled with binge eating in the afternoon, specifically on what she categorized as “bad food.” We gradually exposed her to this “bad food” (e.g., candy) in a controlled setting. Through our time together in eating disorder recovery therapy, we were able to target the belief that this food was taboo. Over time, her impulse to binge on the candy decreased as it became less forbidden, and she went from daily binges to rarely feeling the urge to binge, even being able to keep the candy in her home without incident. A few years later, she told me she felt much happier and could experience food freedom, stating that the all-food-fits model really works for her.

CounselingSchools.com: What advice would you give to aspiring students of eating disorder recovery?

Dr. Miller: As a former professor of marriage and family therapy, I found the curriculum to be lacking in addressing eating disorders. To gain the necessary knowledge, I attended weekly trainings at the University of California at San Diego’s Eating Disorder Center, read extensively, attended conferences, and got supervised by an eating disorder specialist for about a year.

Specializing in eating disorders requires continuous training and collaboration with dieticians, physicians, and psychiatrists due to its complexity and the high mortality rates associated with some disorders.

How to Become an Eating Disorder and Nutritional Counselor

Many people interested in becoming an eating disorder and nutritional counselor have some lived experience with disordered eating, or they have been exposed to someone who did. Or, they may be interested in helping people develop healthy eating habits. While some education in nutrition and dietetics is important, of equal importance is the general foundation of counseling or psychology education.

Education of an Eating Disorder and Nutritional Counselor

Admission to any college typically requires a high school education or the equivalent. Acting on any interests in nutrition or eating disorders while in high school or pursuing an undergraduate degree could give a student an advantage. For instance, joining or forming an eating disorder healthy diet support group could show interest in the form of volunteer experience.

At the associate degree level, students could opt for any courses in the realm of nutrition or fitness. At the bachelor’s level, students may be able to specialize even more by earning a bachelor’s in dietetics, fitness, or nutrition. Many schools offer bachelor’s of science degrees in nutrition and wellness; general dietetics; human nutrition; or similar compatible areas. For instance, Colorado State University offers a bachelor of science in nutrition and food science, and a master of science in food science and nutrition.

At the master’s level, students can select a degree program that offers a foundational general mental health counseling program with the opportunity to specialize in eating disorders and nutrition counseling. Many schools offer graduate degrees in health education. Arizona State University, for instance, offers several health-related bachelor’s degrees along with three master’s of science degrees in either medical nutrition, dietetics, or nutritional science.

Some schools also offer post-graduate certifications in the treatment of eating disorders. For instance, Northern Illinois University offers an online certificate of graduate study in eating disorders and obesity. To achieve this certificate, students should already have experience in nutrition and dietetics and complete 12 specialized credits.

Some substance abuse counselors can also be trained in treating food disorders because eating can be an addictive behavior such as drug or alcohol abuse. Becoming educated as a substance abuse counselor requires a master’s degree in general counseling, typically a specialization in substance abuse, passing the state examination, and meeting the state licensing board’s requirements.

The International Association of Eating Disorder Professionals (IAEDP) also offers certification as a Certified Eating Disorders Specialist (CEDS), Registered Dietitian (CEDRD), Registered Nurse (CEDRN), and Creative Arts Therapist (CAT).

Supervised Hour Requirements for Eating Disorder and Nutritional Counselors

Supervised hour requirements for eating disorder and nutritional counselors will vary depending on their profession and what educational program they have completed. For example, some students may complete an Accreditation Council for Education in Nutrition and Dietetics (ACEND) accredited nutrition or dietetics program to become registered dieticians.

ACEND-accredited programs must include, at a minimum, 1,200 supervised practice hours to become a Registered Dietitian Nutritionist, or 450 supervised practice hours to become a Registered Nutrition and Dietetic Technician.

Certification may also require additional supervised hours. Pursuing the CEDS through the IAEDP requires 2,500 supervised direct patient care hours, completion of four core courses, and passage of the IAEDP certification exam, among other requirements. Licensed professionals or registered clinicians who have been practicing in the field of eating disorders for five or more years in good standing are eligible to pursue the Equivalency Certification.

Lastly, each state may require aspiring eating disorder and nutritional counselors to complete supervised hours after earning their degree to be able to practice independently. This varies depending on the profession but includes counselors, marriage and family therapists, and psychologists.

Licensure and Certification of Eating Disorder and Nutritional Counselors

Different states have different licensure requirements to practice as licensed mental health counselors. Education and registration/licensure requirements include at a minimum a master’s degree plus state and/or national licenses, registrations, and certifications. The educational program must meet core course requirements along with a required number of supervised patient care. Those looking to enter this field can complete their hours with patients with eating disorders. Once these educational requirements are met, the student must pass a certification exam.

Eating Disorder and Nutritional Counselor Licensure Renewal Requirements

Just as each state has its own licensure and certification requirements, each state has its own renewal requirements. The state of Arizona Board of Behavioral Health Examiners, for instance, requires 30 hours of continuing education every two years. A minimum of three of the 30 hours must be in behavioral health ethics and law, and three must be in cultural competency every two years. Each licensee should check their state’s requirements.

What Do Eating Disorder and Nutritional Counselors Do?

Eating disorder and nutritional counselors may work one-on-one with affected individuals, and they may work individually or as part of a treatment team. If an individual is struggling with an eating disorder such as anorexia, bulimia, or binge eating, they need help sorting out their irrational thoughts about their body image, what healthy food is, and what is a healthy weight. Depending on what is affecting them, they may have different symptoms, such as an overabundance of hours spent at the gym, depriving themselves of calories, or overeating in a self-destructive cycle.

As part of the treatment process, the eating disorder and nutritional counselor will work with a client to identify and come to terms with their abnormal behavior. This may mean a variety of treatment options depending on the challenge, but in essence, the goal is to create a healthy and non-symptomatic relationship with food, their body, and their overall health. The eating disorder and nutritional counselor may be responsible for designing a health-promoting meal plan for the individuals they are treating.

Many of their responsibilities will vary based on whether the treatment is part of an inpatient or outpatient setting. Responsibilities vary depending on the work setting. An eating disorder and nutritional counselor may be required to develop an individual meal plan, respond to callers to a hotline, provide immediate crisis intervention counseling, provide outreach to the community, or facilitate support groups and/or house meetings. Beyond that, they may observe family habits, speak with family members one-on-one, work with the resources of community programs, or visit family members at home. Eating disorder and nutritional counselors can work in the following environments:

Inpatient treatment centers
Outpatient treatment centers
Private therapy practice
Group therapy practice
Public schools
Community organizations
Public health organizations
Veteran’s or military organizations
Prisons
Addiction clinics
Religious organizations
Hospitals

How Much Do Eating Disorder and Nutritional Counselors Make?

These numbers represent data from the U.S. Bureau of Labor Statistics from May 2022—the latest figures available as of March 2024.

Substance Abuse, Behavioral Disorder, and Mental Health Counselors

Number employed in the U.S.: 344,970
Average annual salary (mean): $56,230
10th percentile: $34,580
25th percentile: $39,810
50th percentile (median): $49,710
75th percentile: $64,400
90th percentile: $82,710

Eating Disorder and Nutritional Counselor Professional Associations & Resources

National Eating Disorders Association
National Association of Anorexia Nervosa and Associated Disorders
Academy for Eating Disorders
Binge Eating Disorder Association
Eating Disorders Coalition
International Association of Eating Disorder Professionals
Multi-Service Eating Disorder Association
BeyondHunger
Eating Disorder Network of Maryland
Reaching Out Against Eating Disorders
Eating Disorder Foundation of Orange County
The Austrian Society on Eating Disorders
British Association for Counselling and Psychotherapy
BulimiaHelp.org
Eating Disorder Jobs
FreedomFromED.com

Rachel Drummond, MEd

Writer

Rachel Drummond has used her expertise in education and mindfulness to guide aspiring counselors since 2020. Her work emphasizes the importance of integrating reflective mindfulness into counseling techniques, helping readers understand how mental and physical well-being can enhance their professional practice and personal development in counseling.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.

Vanessa Salvia

Writer

Vanessa Salvia is an Oregon-based freelance writer and editor with a bachelor’s degree in chemistry. As fun as rigorous studies in math and science were, Vanessa took an independent path and developed a prolific career covering lifestyle and healthcare topics for magazines and newspapers, important industries such as concrete construction and building waterproofing, and even hard science. You can get in touch at Sage Media and Marketing.