Trauma-informed care: A dietitian’s guide 

The intersection between trauma and nutrition is gaining long-overdue attention in various healthcare settings. Dietitians are well-trained in assessing nutritional intake, supporting behavior change, and managing chronic disease. Yet, recognizing the emotional and psychological factors that shape those behaviors requires another layer of training. Reinforcing this awareness among nutrition professionals is essential for providing truly comprehensive and compassionate care.  

How does trauma-informed care apply to nutrition counseling? 

In Substance Abuse and Mental Health Services Administration (SAMHSA) Concept of Trauma and Guidance for a Trauma-Informed Approach, trauma is defined as “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual well-being.” Trauma-informed care (TIC) is a framework that requires one to have a basic realization about trauma, recognize the signs of trauma, respond with the principles of care, and resist re-traumatization.  

Different past experiences, such as weight stigma, disordered eating, food insecurity, or medical trauma, can shape a patient’s relationship with their health. It may affect how they think, feel, and make decisions about food, as well as how they perceive themselves and their bodies. By becoming more aware of how trauma influences behaviors, nutrition professionals can help create a safe space where trust and empathy foster long-term healing and more meaningful change.  

According to SAMHSA, trauma-informed care rests on six key principles. Each one of these can be applied to nutrition counseling:

1. Safety. Create a calm, predictable environment where patients feel secure.  

Example: Asking for permission before discussing weight, avoiding unexpected measurements, or ensuring that food recommendations don’t feel overly restrictive, which could be triggering. 

2. Trustworthinessand transparency. Be open about what patients can expect from sessions. 

Example: Clearly explain the purpose behind each recommendation and be honest about what you don’t know. Transparency builds trust.   

3. Cultural, historical, and gender issues. Recognize how identity, lived experience, and cultural backgrounds shape a patient’s beliefs about food, health, and body language. 

Example: Honor traditional foods, explore how culture influences eating patterns, and remain mindful of how discrimination or stigma may affect a patient’s relationship with nutrition. 

4. Collaboration and mutuality. Treat the patient as a partner in the process, rather than a passive participant.  

Example: Co-create goals, welcome feedback, and use language that speaks to teamwork. Collaboration strengthens trust and helps clients feel seen and respected. 

5. Peer support. Leverage community and shared experience to reduce feelings of loneliness.  

Example: Recommend support groups or help connect them to community programs where recovery stories normalize the healing process.  

6. Empowerment, voice, and choice. Help patients gain a sense of control and agency around food and their bodies. 

Example: Offer choices when goal setting and creating meal plans. Remind the patient that they know their body best and that growth comes from self-compassion, not doing everything perfectly.  

The role of a dietitian in trauma-informed care

Trauma can show up in various and possibly subtle ways during nutrition counseling. It may look like emotional eating, which may stem from the use of food as a coping mechanism. It can also present in a disconnection from hunger and satiety cues, negative body image, or gastrointestinal issues, such as irritable bowel syndrome, indigestion, or pain. All of which can affect intake.   

The role of a registered dietitian goes far beyond educating a patient on a healthy, balanced diet. The dietitian is a resource that helps a patient feel safe enough to explore their relationship with food. A trauma-informed approach to nutrition means the provider looks for the root cause of eating patterns to understand how past experiences, nervous system responses, and emotions all influence a patient’s behaviors around food. At its core, trauma-informed nutrition care removes shame and blame from the table.  

How can dietitians integrate trauma-informed care into practice? 

For dietitians, it’s imperative to understand how to integrate trauma-informed care effectively and ethically within the scope of practice. At the heart of trauma-informed care in nutrition practice is creating safety and predictability. An example of this might look like starting a nutrition counseling session by reviewing what will be discussed, asking their permission to discuss certain topics, such as weight or food tracking, and being mindful throughout the encounter of any topics that may be sensitive or triggering. Another example is being considerate of the physical safety of the area in which the dietitian practices and creating a welcoming, non-judgmental space. 

The language used matters more than one might think. Trauma-informed communication means using words that are respectful, compassionate, and inquisitive. For instance, instead of saying “You need to stop skipping meals,” try “Would it feel manageable to add one small snack during your workday if you don’t feel like you can eat a full meal?” This type of interaction invites collaboration instead of sounding like a demand.  

Integrating trauma-informed care into nutrition practice also means knowing when to call on support. Dietitians have limits, and it’s important to recognize that by partnering with therapists, physicians, or social workers, the patient can receive more of a whole-person care approach. This allows dietitians to focus their expertise and rely on others to address theirs. 

Finally, it’s important to consider one’s own reactions. Working with patients who have been affected by trauma can stir up emotions, biases, or even trigger memories within providers. It may be necessary to seek peer counseling or take time for self-reflection to help stay clear about the role played by dietitians.  

Bringing it all together  

Trauma-informed care changes how dietitians show up for their patients. When leading with empathy, curiosity, and respect for others’ lived experiences, nutrition care becomes more than diet education and counseling. It can promote healing and person-centered care.  

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References:  

SAMHSA’s Trauma and Justice Strategic Initiative. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Published July 2014. Accessed October 6, 2025. https://www.nctsn.org/sites/default/files/resources/resource-guide/samhsa_trauma.pdf.   

Trauma-Informed Nutrition: Healing Through Food. Nutrition in Recovery website. Accessed October 6, 2025. https://www.nutritioninrecovery.com/nutrition-news/trauma-informed-nutrition/.  

Dennett C. Trauma-Informed Nutrition Care. Today’s Dietitian website. Published June 1, 2021. Accessed October 6, 2025. https://www.todaysdietitian.com/trauma-informed-nutrition-care/.   

Goldstein E, Chokshi B, Melendez-Torres GJ, et al. Effectiveness of Trauma-Informed Care Implementation in Health Care Settings: Systematic Review of Reviews and Realist Synthesis. Perm J. 2024;28(1):135-150. https://doi.org/10.7812/TPP/23.127