Common Questions

• Therapists and licensed mental health practitioners have specialized training to help you examine the Why's of how you developed your eating disorder and to work through and treat underlying issues behind your eating disorder. They are also able to diagnose and treat other psychological issues which might be present such as depression, anxiety, a trauma history or substance use disorders.

• As a Carolyn Costin Institute-trained coach I do not diagnose or treat conditions or have the training to delve into more underlying issues. Instead, I am trained to support the work and treatment goals you have with your therapist or treatment team should you be working with one, to focus on the “here and now” and the How's of recovery, and to help you in accomplishing day-to-day behaviour changes. However, if underlying issues do come up in a coaching session they will be empathized with and considered for how they are affecting you now, as well as how you might be able to bring them up with your therapist or most appropriate treatment team member.

• Therapists generally work from an office and sessions are generally an hour long. As a coach I can be an addition to the work you are doing with your therapist and work with you in areas where you might need support in your daily life and for variable lengths of time. For example support with eating at restaurants or grocery shopping.

• Having recovered from my own eating disorder, I can also act as a tangible role model for recovered living and I hope to provide you with a source of hope and inspiration that full recovery is possible. From my own experiences, I truly know the pain of an eating disorder and the challenges of recovery. Through my training I am conscious of how to use my personal experience in the best interest of each client.

• A registered nutritionist or dietitian has specialized training that allows them to assess a person's nutritional status, create meal plans, and make professional recommendations regarding specific foods, supplements and eating changes.

• As a coach, I am trained to help you implement the work you are doing with your dietitian. I am also trained to help you challenge your food fears and eating rules and rituals in the moment to help you move towards where you would like your relationship with food to be. However, I cannot prescribe a specific meal plan or give guidance around what or how much to eat in a treatment-like way. Coaching support can look like:
  • Supporting you by guiding you through a challenging meal or snack and eating the same food with you, as well as supporting you by text or e-mail throughout the rest of the day.
  • Eating a specific fear food with you.
  • Supporting you to purchase the food necessary to follow your meal plan.
  • Supporting you to purchase new foods to expand the variety of your diet and challenge food fears.
  • Supporting you to grocery shop without looking at nutrition labels.
  • Supporting you to break entrenched eating patterns by preparing and then eating a new dish together at your home, whether in person or via videoconference, or
  • Any type of practical support that will help you to implement the work you are doing with your dietitian and that will help you with your answers to the questions, "What would you like to do with food that you currently can’t do?" and "What behaviors would you like to stop doing with food, but currently can’t stop?" (questions from 8 Keys To Recovery From An Eating Disorder Workbook by Carolyn Costin and Gwen Schubert Grabb).

• For a more detailed description of how I can support you with food and eating challenges, please visit my Services page.

• As a Carolyn Costin Institute Certified Eating Disorder Coach I am trained to be an adjunct to an overall treatment team and to work with clients to help them implement the goals that they are working on with their treatment team into their daily lives.

• I am trained to deal with real-life situations that other team members might not want to or have the ability to perform due to time constraints or legal reasons. For example, navigating shopping at the grocery store, eating at a restaurant, cooking meals at the client’s home, buying clothes after weight restoration, or even going to a social event to support the client in their day-to-day life where their eating disorder has been in control. These are all things that can be difficult or impossible for therapists, doctors or other licensed professionals to do, but are things that sober coaches have been doing with substance abuse clients for a long time and which can be powerful for those with eating disorders.

• My doing this exposure and response prevention work with your client will allow yourself and other team members to have more time to spend with the client on their underlying issues, larger psychological problems, or specific nutrition-related issues that are not in my scope of practice or training to address.

• I will work with the client in the here and now, dealing only with their current thoughts, feelings and behaviours and with helping the client to build a skill base for daily living that will help their recovery become internalized and lasting in a complementary way to what they are working on with their therapist and other team members.

• I am also able to provide on-call support for the client through texting and e-mail to help take some of this time commitment off of other team members, or to provide this for the client if other team members do not provide it.

• As a recovered coach I am also trained in how to use my personal experience in the best interest of each client and can provide the client with a tangible role model for recovered living and provide a source of hope and inspiration that full recovery is possible.

• From my eating disorder coach training, as well as my previous work as a registered dietitian working with eating disorders, I have a true appreciation for the importance of clear communication with you and the client's treatment team in whichever way each team member prefers. My goal is to help the client implement the work that they are doing with you and other team members more fully into their daily lives.

• If you have any further questions or would like to discuss in more depth how I can support your clients I would love to connect with you. You can contact me by phone at +1 (778) 535-5766 or e-mail at sarah@sarahrzemieniak.com.

• I work with individuals 15 years and older primarily diagnosed with anorexia nervosa, bulimia nervosa, orthorexia (an unhealthy obsession with healthful or right eating), and/or compulsive exercise, and any disordered eating or body image issues that are causing distress for which an individual would like help and support in overcoming, whether diagnosed as an eating disorder or not.

• In most cases, especially with a diagnosed eating disorder, I will require that you are also working with a therapist and/or a dietitian prior to beginning our work together.

• The fee for coaching is $140 USD per 60-minute video session and this includes text support between sessions and collaboration with team members. However, fees may be adjusted lower for currencies outside of the USA or Europe.

• I typically meet with clients on a weekly basis at a minimum as I’ve found this to be the most effective for clients in achieving coaching goals and experiencing positive changes from the coaching work. If more support is needed or desired I am able to see clients more often, and towards the end of the coaching work sessions may become less frequent as the client becomes more advanced in their recovery. However, all of this is flexible and tailored to what is most beneficial for each client or financially feasible.

• The overall length of the coaching work varies greatly based on a variety of factors specific to each client, as well as ongoing evaluation on both of our parts in terms of recovery progress and goals.

• Eating disorders, disordered eating and body image issues can affect people of any age, ethnicity, gender or background. They also affect people of any body shape or weight.

• I agree with the belief of The Carolyn Costin Institute and many others in the eating disorders field that full recovery from an eating disorder is possible, where full recovery means more than being in remission or knowing how to manage your illness but rather that the eating disorder is truly gone and out of your life forever. I believe that individuals of all lengths and severities of illness have recovered and can recover.

• However, while I believe that full recovery is possible, I also believe that it is up to each individual to define what their version of recovery looks like and what quality of life aspects are meaningful to them, and to let this guide our work. There are many individual factors and privileges that come into play that cannot be measured or compared as each of us is a study of one. However, I also know that ambivalence and the waxing and waning of motivation and hope is so normal, and that part of my work is to help you find your Why's for recovery and to explore your motivation, patience and hope along the way.

For more information on this topic, you can explore:

• Carolyn Costin on 'Recovered' vs. 'Recovering'
• The Eating Disorder Harm Reduction Manifesto by Gloria Lucas
• Almost Anorexic book excerpt: Recovered. (Period.) by Jenni Schaefer and Jennifer J. Thomas, PhD