Nutrition and dietetics is a second career for me. Today, I’m the Clinical Nutrition and Wellness Manager at the Dubin Breast Center at Mount Sinai Hospital in New York City, but before that I worked in healthcare public relations.
To persevere through the trials and tribulations of completely starting over, I knew I had to really love it. And to really thrive, I knew I needed a passion for the field that would never falter. While it was really hard financially (I’ll probably be in student loan debt forever.) and I feel a bit behind career-wise, I’m still just as pumped to talk, teach and research all things nutrition.
It’s funny though, because the topics I’m currently talking about, teaching and researching have done a 180 since I started practicing as a registered dietician (Think: Carbs are no longer the enemy), and it’s something I never would have predicted. I could probably give you endless pages about the surprising things I’ve learned on the job thus far, but for the sake of brevity, I’ve pared it down to the three most important (and useful) takeaways:
NUTRITION COUNSELING CAN BE HEAVY ON THE “COUNSELING.”
Food is often an emotional topic, and can bring on feelings ranging from great joy and happiness to immense amounts of stress and shame. It’s our job as dietitians to get to the bottom of these feelings surrounding food to help our clients nourish their bodies and their minds in the healthiest way possible. Oftentimes this means getting a little touchy feely, which is an area that gets less emphasis in school compared to scientific data, basic interview questions and anthropometric calculations.
As a new dietitian, it can be daunting to address things beyond checking the boxes of: “How is your appetite? Any nausea/vomiting? etc.” that we’re taught to ask at our hospital internships and to understand it’s OK to have conversations with people and get to know them on a more personal level during the interview process. That alone can greatly improve your nutrition care plan, relationship with clients and overall impact on their health. The best way to get better at nutrition counseling is on-the-job practice and supervision from more experienced dietitians — and it’s a skill that’s in constant development.
Nowadays, it’s not uncommon for me to talk with clients a lot more about their feelings around food than it is about how great kale is, and that’s how it should be. Which brings me to …
MOST PEOPLE HAVE A COMPLICATED RELATIONSHIP WITH FOOD (INCLUDING DIETITIANS!)
This can get filed under: Things I definitely wasn’t taught in nutrition school/the dietetic internship. In fact, a recent observational study found dietetic students and professionals had a higher incidence of disordered eating compared to the general population. Personally, I think it’s essential to address your relationship with food before you can effectively do so with clients. One big reason my nutrition philosophy and the way I practice has changed so much is because I did some important work on my own relationship with food and am proud to say, it’s a much more positive one than when I was in school and a brand new dietitian.
Now, when I address this with clients, it provides essential insight not only into their food choices, but the types of health-promoting behaviors that would be most meaningful for them to work on. Oftentimes that starts with healing their relationship with food and their bodies, and never with putting them on “X diet” to achieve “X results.” That’s because …
DIETS DON’T WORK. AND RESEARCH DOESN’T ALWAYS TRANSLATE TO REAL LIFE.
It’s a lot more complicated than “calories in, calories out.” Diets, or any eating plan with strict rules and restrictions about what to eat, when and why, fail about 95% of the time. Meaning, 95% of those who go on diets regain any lost weight within five years. In fact, diets are the single biggest predictor of weight gain in individuals, and it’s no one’s fault but the actual diet. The vast majority of diets are unsustainable in the long-term and therefore offer only temporary results because eventually our bodies resist restriction and deprivation (which is why you see yo-yo dieting so often).
It’s important to know, too, a lot of research into the weight-loss success of various diets has been done over very short time periods in controlled environments that are hard to replicate in real life. Or, they’re performed on animals. That’s why it’s crucially important to think of real people in real life when interpreting research results and deciding whether or not it could be useful for clients.
THE BOTTOM LINE
As a dietitian, I have learned to embrace the fact I will never know everything. There is always new research, distinct experiences and varied connections that can change the shape of how I think and practice nutrition and dietetics. That’s why this job is just so darn fun. Ultimately, despite the profession literally having the word “diet” in it, dietitians do a whole lot more than put people on diets — they can help reframe an otherwise unhealthy relationship with food into a positive one.