We were lucky to catch up with Cara D’Anello recently and have shared our conversation below.

Cara, thanks for joining us, excited to have you contributing your stories and insights. Looking back at internships and apprenticeships can be interesting, because there is so much variety in people’s experiences – and often those experiences inform our own leadership style. Do you have an interesting story from that stage of your career that you can share with us?

In my training to be a registered dietitian, I went through various practicums within my dietetic internship. My favorite was shadowing at an eating disorder treatment center. Many of my peers chose practicums in food service, the hospital, or in the community. I knew from the beginning of my studies in nutrition, I wanted to be in a counseling setting and work with those navigating their relationship with food and their body.

I have always been driven in my academics, learning as much nutrition and medical knowledge as I could; however, I had not yet learned the importance of active listening and not having all the answers. Throughout my undergraduate and graduate degrees, I had been actively engaging in my own healing of an eating disorder while bettering my understanding of eating disorder prevention, awareness and treatment. It wasn’t until my practicum at the treatment center, that I realized I could have all the information in the world to encourage someone struggling to eat; yet, that was not always the answer. It really came down to connection, holding hope, building trust, and validation that made all the difference.

I was shadowing one of the dietitians at the treatment center at the time and felt inspired by the way she interacted with clients. Instead of being prescriptive around nutrition advice, she had taken the time to ask about what felt challenging around eating and how she could be of support. I found this provider to patient connection integral to the development of my own style of counseling. In my internship, showing gentleness and understanding while strongly advocating for a patient’s self described needs had been new to me. Seeing this type of compassionate care again and again made all the difference in how I’ve decided to practice as a dietitian.

Awesome – so before we get into the rest of our questions, can you briefly introduce yourself to our readers.

My name is Cara (she/they), and I am a registered dietitian in private practice. The majority of my work surrounds the realm of eating disorders, disordered eating, chronic dieting. All of my identities show up in my work as a provider-being queer, genderqueer, neurodivergent, and having lived experience with an eating disorder supports me in providing cross cultural support in my client/provider relationships.

I originally came into the nutrition profession with the hopes of supporting people’s health from a traditional dietetic lens-the weight centric approach. This came from my own internalized anti-fatness and my struggles with an eating disorder during the time I was heading to college. My own healing and knowledge of eating disorders developed during college and the beginning of grad school, a time in which I was deciding how I wanted to work in the nutrition profession. At one point, I was ready to move away from my nutrition training and major in psychology. Instead, I decided to focus my chosen practicums in counseling roles and in environments where mental health intersected nutrition.

Since graduating from my Master’s in Nutrition Science, all my jobs have been in the eating disorder field-clinics and outpatient group practices. Starting in August 2023, I went into my own private practice and work specifically with folks navigating disordered eating, diagnosed or self diagnosed eating disorders, and health conditions (such as PCOS, High Cholesterol, High Triglycerides, Insulin Resistance, IBS) that can be supported by a non restrictive approach to medical nutrition therapy.

My role as a dietitian is supporting clients to align their eating patterns, beliefs and thoughts surrounding food choices with their core values. Because our relationship with food is impacted by other lifestyle behaviors, I bring in conversation around sleep, stress, movement, social connection, and social identities.

I practice from a Health At Every Size ®aligned framework, which challenges the weight centric focus of traditional dietetics. Instead of prescribing weight loss to address health conditions, I work with individuals around non restrictive food based behaviors that can support one’s health more sustainably. My work is also based in a neurodiverse affirming approach to eating. Because I work with many folks who are ADHDers, Autistics, OCDers and have other intersecting neurodivergent identities, I make sure that nutrition guidance challenges neuronormative ideals around eating and is based on accommodations versus fixing how one may go about executive functioning differences, food textures, sensory experiences around food.

Learning and unlearning are both critical parts of growth – can you share a story of a time when you had to unlearn a lesson?

That it’s okay to not have the answers. You may be asking…”You’re a dietitian, right? Aren’t you supposed to have the answers around nutrition??”I may have degrees worth of knowledge in nutrition science though my experience has shown that behavioral changes don’t occur just because knowledge is present and given.

My second job was in a group practice of dietitians specializing in eating disorders. I had come from working in a day program eating disorder clinic and was in charge of creating meal plans, monitoring vitals, and assessing clients’ nutritional status. My role was to give nutrition guidance and expect clients to make changes on their own. Only until I went into the outpatient setting where sessions went from 15 minutes to 50 minutes, did I realize that a conversation around food did not have to be about creating a goal by the end of the session. A lot of what I’ve learned over the years is to become more of an archeologist alongside my clients, giving them the tools to dislayer their beliefs and experiences surrounding food and their relationship to eating, body image and self worth. A whole lot different than giving a meal ideas handout and calling it a day.

I’m very proud of where I’ve come and continue to grow as a provider. Counseling is a huge aspect of my job-I would say 75% of what I do. I remember learning in a motivational interviewing training that telling people to change their behavior does not work in the long term. When we reflect to our clients their own interests, barriers, and motivators, they are more likely to make change based on what they hear theirself say versus what someone else suggests.

How about pivoting – can you share the story of a time you’ve had to pivot?

Since the start of my career in Dietetics, I had always worked in a hierarchical work setting-whether that be a treatment facility or group practice. I always enjoyed being in community and collaborating with similar minded providers. As much as I’ve enjoyed being part of a bigger team, I’ve always found myself working differently than other providers. As a provider with ADHD, I’ve needed to mask ways of working that make most sense for me. The demand of getting notes and collaboration with other team members done, while staying present in emotion ridden sessions, and seeing an increasing number of clients on my caseload can be a hard load to handle.

Creating my own practice and working for myself felt like the next step in continuing my work in the field of eating disorders. In dietitian land, perfectionism, hustle culture and people pleasing is very commonplace-something that I’ve always struggled with at times and resented the further I’ve learned about my values and style as a provider. Creating my own practice has allowed me to have more agency over my professional demands, have more time and energy for the projects I enjoy doing in and out of work, and work in a way that is most authentic to how my brain functions.

Contact Info:

• Website: www.homewardboundnutrition.com
• Instagram: homeward_bound_nutrition
• Linkedin: https://www.linkedin.com/in/cdanello/

Image Credits
Oliver Scott, Brooke Lark, Priscilla Du Preez, Ella Olsson