Why see a dietitian?

You may have ended up here because you searched “heathy eating” or “trail mix cookies” and be curious about who I am and the services I offer. I’m a registered dietitian, a credential earned by completing a series of both undergraduate and graduate level nutrition courses and a clinical internship.

How does a dietitian differ from a nutritionist?

Anyone can call themselves a nutritionist; it’s not a protected credential. This is not to say that nutritionists cannot provide quality nutrition advice. There are other avenues to obtain the training necessary to coach someone how to incorporate more healthy foods into their diet, eat in a more balanced way, and reach athletic goals, however, the big difference is that nutritionists cannot practice medical nutritional therapy.

What does “medical nutritional therapy” encompass?

Below are under the scope of practice for a dietitian, but not a nutritionist:

• Assess specific energy and nutrient needs (calories, protein, fat, carbohydrates, and micronutrients). Even if these are not communicated to the patient directly, a dietitian is able to assess a patient’s nutrition needs so they can convey how a patient can reach these needs during their counseling.

• Interpret medical labs.

• Give nutrition advice on how to improve nutrition-related labs (for example, high cholesterol, high blood sugar, low iron).

• Nutrition recommendations that pertain to high cholesterol, pre-diabetes and diabetes, kidney disease, irritable bowel syndrome, inflammatory bowel disease, pre- and post- natal nutrition care, cancer, eating disorders, and other diseases.

How do dietitians and physicians work together?

Dietitians work in and out of the hospital (both inpatient and outpatient) alongside doctors to provide nutrition-related medical care. Dietitians are a specialized position in the hospital whom doctors refer patients to when they need nutrition care. For example, if you broke your ankle, your primary care physician may refer you to a physical therapist for physical therapy after your injury. Similarly, a primary care physician refers patients with unmet nutrition needs, nutrition questions, and for prolonged counseling to dietitians. Your primary care physician likely only received about 2 weeks of nutrition training. This is not to say they haven’t studied up more on their own and be capable of giving quality nutrition advice, but, this is not their specialty. They refer patients to dietitians to complete nutrition assessments, provide quality nutrition education, and nutrition counseling. However, you don’t need a referral to see a dietitian. Patients can also pursue working with a dietitian based on their own concern for their health, interest in learning more about nutrition, fitness goals, or other health goals.

Dietitians often work closely with primary care physicians to gather a complete picture about their patient. Are there medications they should be aware of? Pertinent past medical history the patient forgot to mention? Labs the patient should have taken? Dietitians also advocate for their patient to the primary care physician to help patients receive the best quality care from their care team. A dietitian may sense a patient’s diagnosis (or lack of diagnosis) may be affected by a doctor’s weight bias (even if unintentionally) and can advocate for a patient to receive more complete care aside from suggesting weight loss. A dietitian may believe a patient would benefit from a medication, and can suggest the doctor consider prescribing it. Physicians and dietitians work together as a team to provide the best care for the patient, and how much the physician and dietitian are involved varies patient to patient.

Is seeing a dietitian covered by health insurance?

Yes! Many health insurance plans cover unlimited preventative nutrition appointments with a registered dietitian. Therefore, out of pocket costs for seeing a dietitian can be zero or minimal, depending on your exact insurance plan.

What does working with a dietitian look like?

In my private practice, clients begin by booking an initial consultation appointment. Before booking, I am available to answer questions via email; please reach out via the contact me buttons on my website. Before this appointment, I send you an intake form to fill out so I can gather a more complete picture of your current nutrition intake, assess recent nutrition-related labs, prioritize nutrition needs, and generate a plan of action to bring to the appointment. During the initial consultation, I ask you to elaborate on areas of your form that deserve clarification and more time, and help you identify your main goals for our session(s) together, as well as suggest my own based on my assessment.

A dietitian assessment takes into account the whole picture of the patient - lifestyle, food preferences, past medical history, height and weight (used to calculate nutrition needs), nutritionally-relevant labs, patient goals and readiness, and more - to counsel a patient. Each patient’s needs are unique, and a good dietitian takes the time to assess how to help each patient best based on their unique circumstances and goals.

At the end of the initial consultation, we decide how often you’d like to book follow-up appointments (or maybe this was just a one-time nutrition education session, which is okay too!). I usually recommend starting with every two weeks to provide space for nutrition education, adjustments to goals, and settling into a routine. Once you get into a good groove, we can switch to monthly for check-ins. My goal is not for you to be my patient forever, either. My goal is to empower you to be confident in your nutrition decisions, without me. However, my door (or really, website since I see patients via tele-health) is always open for a check-in after we end our regular sessions if you feel like you need more support from time to time.

You decide when you want to end our regular sessions based on 1) do you feel like you learned what you set out to learn from me and can incorporate these changes into your life without my support? 2) have your labs improved (for example, high cholesterol or high blood sugar) and you feel confident you can continue to keep them down on your own? 3) do you feel like we’ve hit a plateau and you want to try things solo for a while, maybe scheduling a check-in here or there as needed? 4) many other reasons! Each patient is unique and their timeframe will be unique. We work together to make sure you are happy with your cadence of appointments and our plan towards your goals.

Who can benefit from seeing a dietitian?

Honestly, most people! And it’s not something to be ashamed of. I also think most people would benefit from working with a therapist; it helps to have support. Aside from support, working with a dietitian teaches you how to incorporate healthy habits into your life that are evidence-based, not something you saw on the internet and felt skeptical about to begin with. Most people do not have extensive training in the field of nutrition, however, most people do need to feed themselves everyday, so therein lies the population of people who would likely learn a ton from working with a dietitian.

Even through educating yourself on nutrition, it’s hard to know:

1) What information is real.

Should you avoid carbs? Should you go vegan? The simple answer is the best style of eating for everyone is different, because we are all different.

2) How to eat to optimally support your needs.

Are you training for a marathon? Are you a student with little time for cooking? Are you a new mom currently breastfeeding? Do you have familial history of high cholesterol? Do you have pre-diabetes? Do you like eating breakfast? Are you a three square meals a day kind of person, or a snacker? You see where I’m going here. Everyone’s needs are different based on their unique circumstances, and it’s hard to internet search what will best meet your unique nutrition needs.

3) How to incorporate changes into your current lifestyle.

Maybe you read that omega-3 fatty acids are good for you, and the internet list suggests salmon as a good source. But you hate salmon. Are you out of luck? No. There are many other sources, and a quick internet search will give you some options. However, doing this for every nutrient gets to be complicated, especially in the context of all the other nutrients. That’s where a dietitian really comes in handy. In a nutrition assessment, a dietitian identifies areas for improvement and works with you to assess ways these improvements can be seamlessly, or as seamlessly as possible, incorporated into your lifestyle.

So…should I book an appointment?

That’s up to you. Most people would greatly benefit from seeing a dietitian for many of the reasons discussed above. This can look like a one-time healthy eating session, an initial consultation nutrition assessment to see if there are any nutrient holes in your diet, a series of appointments to improve a few nutrition labs, a series of appointments during marathon training, a few appointments to implement some new healthy habits, and so on. It all depends on where you are at and what support and nutrition education serve you best.