Working with a dietitian to recover from no periods / hypothalamic amenorrhea

For many women trying to recover from no period (aka hypothalamic amenorrhea), working with a dietitian to get specific food advice tailored to your likes/dislikes/individual needs/energy intake and expenditure, can be a helpful addition to the advice in No Period. Now What?.

It’s really important as you think about whom you would like to help guide you on this path, that the the person you choose doesn’t follow the typical societal mandate of trying to have each person be the absolute smallest possible, that they be able to talk about weight in a neutral/positive manner – finding someone who is versed in HAES (Health At Every Size) or describes themselves as a non-diet dietitian is a great place to start.

RD Cynthia Donovan, who has herself experienced and recovered from HA, writes here to share her journey to becoming such a dietitian.

<3 Nico

How does a dietitian become a non-diet dietitian?

When I set out to become a dietitian, it was based on a sincere desire and passion to help others with their health, using food and exercise as a foundation. After years of working as a registered dietitian (RD) in a clinical/hospital setting and seeing hundreds of individuals, I found I wanted to help people before they got to the hospital. Preventative care was my passion, with weight loss as the base of my preventative care work – that’s how I’d been taught.

During this time I started a small private practice at my local gym. Most of the individuals I worked with were already “in good health” but wanted to “take their health to the next level.” As I worked with these clients, I found that women who desired weight loss had a huge divide in their relationship with food, exercise, and their body. I began to realize where my heart really was in my profession. It wasn’t helping people lose weight or getting them to stick to a “diet.” It was helping them become at peace with their body and heal their relationship with food.

Flash-backward to my own battle with weight, resolvable health issues (hypothalamic amenorrhea / no period) and body image crap. My personal journey was what REALLY changed my perspective on health and nutrition. As I worked to gain weight instead of losing, cut down on high intensity exercise instead of increasing it, and struggled with my changing body, to try and recover my missing periods, I began to see that the conventional approaches and weight focused paradigm I was taught (and used to follow myself) to “help” was doing much more harm than good. I realized *I* was contributing to societies screwed up definition of health. “You have to be THIN, you have to eat CLEAN, you have to have a regimented exercise plan.” I found myself asking: How could food and our bodies, both created to be honored, loved, and celebrated, become so complicated, distressing, painful, and confusing?

During this time, I stumbled upon Intuitive Eating. This led me to look for better, more effective ways to help people – healing their relationship with food and their body rather than beating their body into submission. Learning how to intuitively eat personally changed my life, and I now deeply practice what I preach to others. Intuitive Eating was not something I was taught during my training; hopefully soon it will be included in curricula as there is a large body of evidence to support its principles and application (References here and here). When I began to apply the Intuitive Eating principles in my practice, I discovered a much more rewarding way to work with clients that truly aligns with my values, both personally and professionally. I also began to see my clients lives transformed in positive LONG lasting ways that I never saw with the conventional approaches.

A growing number of dietitians are seeing the benefits of a non-diet, weight neutral approach. We no longer put people on medically unnecessary, restrictive, macro counting, portion tracking, food journaling, weight micromanaging “diets” that are not sustainable long-term and often cause significant psychological and physical harm. Instead, we work with you on accepting your body where it wants to be – size is not a good gauge of health. We guide you on listening to your body’s energy needs and fueling those needs appropriately (note I’m not saying “healthy” here because that has become such a loaded word). We help you create and maintain a happy, free, and joyful lifestyle that will open up avenues closed before because of the unending focus on food and exercise to the detriment of the rest of your life.

How do non-diet dietitians and traditional dietitians differ?

A non-diet dietitian will never recommend a “diet” for you. We will never tell you any food is off limits. All foods CAN fit into a healthful diet. We work to get to the bottom of why you eat the way you eat, and address those underlying issues that cause disordered eating (in whatever form that may take).

A non-diet dietitian wants you to honor your hunger. We help you regain your ability to know when you’re hungry and when you’re satisfied. We want you to be nourished! True nourishment is giving your body and mind what they want and need to thrive. We help you feel comfortable with eating all the foods, including foods you enjoy that may or may not be considered “healthy.” This is a practice of intuitive eating that helps reduce many type of negative behaviors around food.

A non-diet dietitian encourages joyful movement. We are all about encouraging healthful behaviors and we know movement is good for mental and physical health. It doesn’t have to be structured exercise to “count.” Personally since I have changed my mindset around movement, the movement itself is SO much more enjoyable. I no longer feel like a prisoner to the gym or guilty if I don’t go. Movement can be a peaceful walk in the sunshine or your favorite fitness class. Yoga, cleaning your house! (although does anyone really find that enjoyable??), or a good hard run that leaves you feeling invigorated. The  movement that is right for you depends on many factors that we will delve into.

A non-diet dietitian understands food and exercise are complicated.  We know that food isn’t just fuel for the body. Food and exercise create community. Food provides comfort when we lack other coping skills. We often turn to food or stray away from food to deal with stress. We often use exercise to compensate for being stressed about what we just ate and try to

A non-diet dietitian will never focus on your weight. Weight does not define your health or who you are. You could be “thin” and yet unhealthier than a person on the opposite side of that silly BMI scale. And as you work to let go of food and exercise rules, you will find yourself again in the time and mental energy that are now available to you.

As a non-diet dietitian, what I want you to know the most is this:

Food and exercise are VERY small pieces of the health puzzle. The road to health starts with healing your relationship with food and exercise. I personally can attest to this. Loving yourself, your body, and healing your relationship with food will get you one step closer to being all-around healthy instead of just looking the part.

The best word to sum up letting go of weight and healing my relationship with food and exercise is – FREE! I feel SO free and I and other non-diet dietitians want to help you feel this too!


P.S. You can find me at and on Instagram, @myrealisticrd

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