Do you work with people who haven’t been diagnosed with an eating disorder?
Yes! Our clients deal with a wide range of food and movement challenges and many have not been diagnosed with an eating disorder. However, most are experiencing some sort of discomfort when it comes to their “relationship” with food and their bodies. No matter the challenge, we always incorporate mindfulness and intuitive eating principles, as appropriate.
What types of people do you work with?
All kinds! We offer care to women, men, and folx of all ages. We also work with teens, children, and families. Our practice is LGBT-Q affirming.
How much does it cost to work with you?
Fees vary based on the RD you are working with or the appointment you’re scheduling.
Lindsay’s rate: $225
Kelsey’s rate: $175
50 min follow up
Lindsay’s rate: $150
Kelsey’s rate: $135
Rates may increase for family work.
You can pay with cash, check or card. A card is required to be on file. We charge a 3% processing fee for card charges.
We don’t offer a sliding scale but we do keep a couple of spots available for those who need help financially. Contact us to receive information.
Do you take insurance?
We can offer you a superbill that you can submit to your insurance in hopes of getting reimbursed. It is your responsibility to inquire with your insurance company regarding benefits and submit superbills (we can provide you with instructions when you schedule). The session fee must be paid to Nutrition Instincts, LLC at the time of service.
We are considered out-of-network with most PPO plans. We will provide you with instructions on how to inquire with your insurance company about medical nutrition therapy benefits when you schedule.
Blue Shield of California
We are officially listed as out-of-networked preferred providers with Blue Shield of California. This means you may be able to get some level of reimbursement if you have a PPO OR HMO (this is unique because HMO’s typically do not have out-of-network benefits). If you have a HMO, you’ll likely need a prior authorization with your referral from your physician. Contact the benefits department at Blue Shield to inquire about benefits, rate of reimbursement and what you’ll need to obtain reimbursement. Again, if needed, you’ll receive instructions on how to do this when you schedule.
Where are you located?
We now have two office locations (addresses can be found on our homepage). Kelsey primarily practices in our Sorrento Mesa office and Lindsay primarily practices in our Rancho Bernardo office. Our office locations are easily accessible from the following areas: Sorrento Valley, Sorrento Mesa, Mira Mesa, La Jolla, UTC, Encinitas, Del Mar, Carmel Valley, Rancho Santa Fe, 4S Ranch, Del Sur, Rancho Bernardo, Rancho Penasquitos, Poway, Scripps Ranch and more!
Questions About Intuitive Eating
What exactly is intuitive eating?
Intuitive eating is a unique, non-diet approach to wellness and one that we use extensively in practice – in many different ways. Many people understand it as an approach that focuses on using our own internal hunger and fullness cues to guide our eating choices. While that is a core tenant of intuitive eating, it’s important to know that this approach extends far beyond hunger and fullness cues. When you work with someone who is truly trained in this approach you will extensively explore what food and movement means to you. In our sessions we will sort through your food beliefs, self-talk, food behaviors, etc… to get to the bottom of why you do what you do when it comes to eating and moving. The real, central focus is always self-care and this looks different for every body. Using a counseling technique called motivational interviewing, we will help guide you towards your unique wellness by helping you reach a place of self-care and health that works for you – lifelong.
Will I lose weight? It seems like you think weight loss is a bad thing.
Intuitive eating is a non-diet, weight neutral approach. We work with clients to heal their relationship with food and their bodies and guide them in shifting the focus from weight loss to wellness. Some clients lose weight, some gain and some don’t notice much of a change at all. We will support you in reducing the focus on weight and discuss that challenges that you face when working to separate your weight from your health.
We don’t think weight loss is bad but we do see the intense harm that the pursuit of weight loss can bring. Weight changes that occur as a result of healing are very different than the pursuit of weight loss through “wellness” behaviors that actually manipulate the body and wreak havoc on your emotional well-being. Weight-loss is not a behavior; rather it’s an outcome. We believe that, for the majority of individuals, focusing on weight-loss impedes on our ability to confidently respond to our body’s needs and ultimately moves us further away from wellness and self-trust. For example, let’s say you decide you’d like to start getting outside and taking a nice walk on your lunch break. Sounds lovely! You make this decision because you would like to lose weight. As you begin this new walking routine you begin to monitor your weight change and notice that your weight is not changing in the way you expected it would. Let’s say you become frustrated with this fact and decide to stop walking all together. If it’s not “working,” what’s the point? Unfortunately, using weight change as an indicator of wellness and the perceived benefit of movement has ultimately caused you to decrease what may have been a supportive way to move your body. You may miss out on knowing whether or not you actually enjoy walking and if it feels good to you. If we were to take weight out of the equation and focus on other perceived benefits of exercise we may point out that you noticed better performance in the afternoon at work, a decrease in stress and an increase in energy. When we can be present enough to notice these side effects of self-care and make wellness choices that work for US (not the scale), we can be much more likely to seek movement and a relationship with food that truly feels supportive to us.
Will we talk about healthy eating?
Absolutely! Many of our clients feel so inundated with messages about nutrition and healthy eating that they aren’t even sure what it means anymore. Often times, they feel paralyzed when it comes to making choices for themselves and their families. We’ll start that conversation by taking a close look at what healthy eating currently means to you and what you hope you’re eating will look like after we work together. During our work together, we will likely look at expectations you have for yourself when you make a food decision, explore the common categorization of “good” and “bad” foods, look at how food impacts your mood, energy levels, ability to focus, etc…, just to name a few. Often times there are some other aspects of your eating that will need to be addressed before we can discuss nutrition in a neutral way without the diet mentality taking it and using it in a negative way. This will be something we discuss and assess when we meet.
Do you offer groups?
Yes, periodically, we will host groups such as my Postpartum Body Image and Nutrition Support Group, Prenatal Self-Care Class, Diet Rehab Workshops or Child Feeding Coaching series. If you’re interested in one of our groups sign up here to get news on new groups and discounts. You’re also encouraged to recommend or request that we host a group! We’ll hold a group for 3 or more individuals so if you have a group of friends who would like a special, private group, we’re happy to work with you on scheduling this. Also, the individual who initiates the group gets a discount!
Questions About Eating Disorder Treatment
What kind of experience and training do you and your team have working with people with eating disorders?
I (Lindsay) have been working in the eating disorder field for 7 years and have over 14 years of education and training in the areas of eating disorders, intuitive eating, nutrition science, and nutrition counseling. I am a Certified Eating Disorder Dietitian (CEDRD). That means I have completed at least 2,000 supervised patient hours (I’ve completed over twice that) in the individual and group settings. For 3 years, I received ongoing professional supervision from one of the leading CEDRD’s in the nation, Marci Evans, and continue to receive support and supervision as needed. As part of this credential, I was also required to take courses through the International Association of Eating Disorder Professionals (iaedp), pass an online exam and submit a case study. I have experience in the partial hospitalization, intensive outpatient and outpatient levels of care and provide education to students and professionals in the field. In addition, I regularly attend trainings and continue to seek education in the areas of eating disorder treatment methods and research, motivational interviewing, addiction recovery, mindfulness, body image, Health at Every Size ® and intuitive eating.
I see you’re an advocate for intuitive eating. I’m dealing with an eating disorder and I don’t think I’m ready for that. I’m not even sure I want my recovery to include intuitive eating. Are you ok with that?
I’m so glad you asked this question! First, I always discuss what vision my clients have for recovery. This is an important part of the recovery process. It’s also an ongoing conversation of which the outcome is constantly changing. If you don’t feel intuitive eating is where you’d like to head in your recovery, we absolutely will discuss what you do envision instead. If we’re mainly looking at intuitive eating as just listening to your hunger and fullness, there are many instances where that would not be appropriate in eating disorder recovery. There are complex brain processes that can inhibit one’s ability to do so, especially in early stages of ED treatment. As the body and brain heal, many will begin to identify cues of various degrees and we can work very thoughtfully on how to respond in a way that feels safe. We spend many sessions discussing your cognitive, physical and emotional reactions to these cues, fears you may have about their return and how to respond, factors that impact the senses of hunger and fullness, etc…
Our family has been using Family Based Therapy (FBT/Maudsley). Do you know what that is and can you continue to help us with feeding our child?
We are very familiar with FBT. I (Lindsay) worked for a treatment center that developed one of the leading FBT/Maudsley programs in the US. I have also attended many trainings and continuing education on this approach. Traditionally, dietitians are not used in FBT so, depending on where you received treatment, you may not have worked much with a dietitian. I share one of the core beliefs of FBT, which is that parents should be part of the treatment process and that they are the experts in their child. I’ve been saying this for many years and, now that I’m a parent, I really understand how true and important this is. I do believe parents should play a very active role in their child’s recovery. As a dietitian, I can be a support tool for you during this process. Re-feeding a child with an eating disorder is scary, draining, stressful, confusing and emotional. I am here to encourage, reassure and provide education as needed as you move through the stages of FBT with your child. I can also work with your family to help transition your child back to his or her role as an active participant in his or her self-care as the responsibility of self-feeding is re-introduced. This is a critical point in this process. In addition, it’s important that teens don’t transition to college before working directly with a dietitian who can support them with essential life skills of grocery shopping, cooking, feeding, etc…, ways of resisting and challenging food and body image triggers, etc… In order for treatment to be effective, I typically recommend that I work directly with your child and also have parent support sessions as part of your outpatient nutrition treatment. However, since each family is unique, the plans for treating teenagers will vary.
Are you familiar with Dialectical Behavioral Therapy (DBT)?
Yes! Our team has training in DBT and have worked on teams that use DBT in higher levels of care. We can use methods that compliment DBT skills and coping tools that you are using in therapy.
Will you give me a meal plan?
Yes, if you’re working on eating disorder recovery, you will likely have some sort of a meal plan as part of your treatment. In our process, meal plans are highly individualized and very carefully constructed with your full participation. Some clients need very clear, structured plans and others need more loose guidelines. We may spend several sessions collecting information before constructing the right plan for you or we might start a plan at your first appointment. We always encourage you to share what you think you need and what feels the most supportive.
I need someone to tell me what to do? Can you do that?
We expect you to be an active participant in the recovery process. We are a team. We are not authoritarian (controling, demanding) figures in the working relationship. Rather, we see ourselves as supporters, advocates, educators, and cheerleaders. We’re 100% invested in your treatment and we expect you to also be 100% invested. That looks different for everyone depending on your stage in recovery. Being ambivalent (unsure) about your recovery from time to time is part of the recovery process and we’re here for you on your recovery-minded days as well as your entrenched-ED days. On a rough day or week, just showing up for a session tells us you are invested. Some clients need more direct recommendations than others and this will be assessed on an ongoing basis. If you are looking for a dietitian who does take on a more authoritarian position and spends the majority of the session instructing (rather than listening and encouraging you to be an active participant), we are not the team for you.
Will I be working with just one dietitian on your team or will this change throughout my treatment?
You will be assigned to a dietitian on the team and that is who you will carry out your treatment with.
How would you describe your style when working with people with eating disorders?