What to Expect in Your First Nutrition Follow-Up
Written by: Gaby Olguin-Flores, RDN, LD
Beginning a new professional relationship of any kind can be nerve-wracking to say the least. When the professional relationship is also medical in nature, there’s a new layer of vulnerability to consider protecting. There is an inherent power imbalance that can form in a patient-provider relationship. When providers do not take steps to foster trust and establish this new relationship as mutually beneficial, seeds of self-doubt, fear, or mistrust can be planted in the patient. An environment that can facilitate curiosity, courage, and compassion is what we hope to create in follow up sessions with clients (we use the term client most often instead of patient) who are starting to discuss some of the most uncomfortable topics, sometimes discussing them for the first time. I created this blog to provide some insight on what it can be like to have a first follow up with a dietitian at RoundTable Wellness using my own experience and input from other providers. We hope this can calm some of those nerves and provide clarity.
I like to acknowledge in assessment or in follow ups with a new client that I personally dread the question “what do you do?” in everyday life. I understand “dietitian” can equate to “food police” or that I went to school so I could teach people “the best way” to eat or that I am constantly judging people’s plates. That is the opposite of how I want to make anyone around me feel and are not accurate portrayals of what I do. Instead, I’ve found clients refer to me as their food therapist because we spend sessions discussing their thoughts, beliefs, and feelings around food, their body, and, at times, their relationship to exercise.
What is a dietitian and what do they do?
Using the Academy of Nutrition and Dietetics’ definition: a dietitian is “the food and nutrition expert(s) with a minimum of a graduate degree from an accredited dietetics program and who completed a supervised practice requirement, passed a national exam and continue professional development throughout their careers.” Class requirements of the dietetics program include biology, biochemistry, anatomy and physiology, food science, medical nutrition therapy, food service management, and more. All that to say, we are NOT food encyclopedias as much as we may try and are required to submit 75 hours of continuing education every 5 years to keep up with current research. I have been working with populations that are finding sustainable recovery with food and their bodies after periods of fear, anxiety, shame, or guilt around food so of course I am out of practice with the assessment and interventions for chronic kidney disease, however I was required to study them in case I wanted to work in a clinical setting after graduation.
Dietitians can work in multiple areas due to different specialities that exist. Especially in the age of social media, I find that dietitians are having to combat misinformation by providing reliable sources for food and nutrition recommendations based on whatever need is presenting. A dietitian can be in charge of creating cycle menus and procurement for school corporations that have to meet certain standards for the USDA Lunch Program. A dietitian can meet one on one with patients navigating a new diabetes diagnosis and go on to become certified diabetes educators. A dietitian can help lessen meal anxiety and stress in the pediatric population by meeting with parents and children. A dietitian can provide insights with marketing and product development in the food industry. A dietitian can become a board certified specialist in multiple areas including: sports nutrition, pediatric critical care, renal, gerontological, and more. Of course, it would be remiss not to include dietitians that work in research and development. Hopefully that gives some idea on the different ways a dietitian can utilize their knowledge for different needs.
What to Expect from Dietitians at RoundTable
Here are some topics that we may review in that first follow up session:
● What brought you to RoundTable Wellness: reviewing assessment data together
● Getting to know all about you which can include discussing your current environment, support system, stressors, stress relievers, medical updates or concerns, and day to day schedule
● Your values
● Short or long term goals and dreams (related to treatment and in life)
● The latest, most concerning aspect when it comes to food, body, and/or exercise
● Clarifying the role of the dietitian in the treatment team
● Reviewing how collaboration with therapists is a key element to treatment
● Myth busting nutrition (mis)information that is contributing to self-doubt around food
● Reviewing previous experiences with dietitians: what helped and what did not
● Reviewing privacy and confidentiality protocol
This list is an idea of possibilities a first session can cover. If there is something missing, we encourage you to bring it up during that session! Because nerves can be running higher, I encourage folks to write down a few bullet points or script out questions or beliefs that are important to share.
What if I’m Still Unsure if I Would Benefit from Nutrition Therapy?
Transparency and accountability are important values we keep in mind throughout sessions. As a provider, I can have the best of intentions and I can still unintentionally harm clients when I do not check my own biases outside of sessions. It is important to strive for impact over intent when creating an environment that encourages and normalizes accountability, trust, and open communication. In an effort to increase equitable treatment, our team is encouraged to use annually allotted professional development time to learn from others on new and different practices to support clients.
Like all relationships, the dietitian and client relationship is built over time. We hope that you’ll give us a couple months to determine if sessions are helpful. This can be difficult when we are working on beliefs with food that may have had years, if not decades, to develop. We understand that not every provider and client may be a great match. We encourage clients to directly share any uncertainty with their provider to see if anything can be done differently in sessions to ease that uncertainty. After making changes and clients are still feeling uncertain or disappointed with the provider, it could come down to personalities or therapeutic styles not aligning with the client's needs. In that case, we can initiate a transfer to another dietitian. Unpacking one’s relationship with food and body narrative is incredibly vulnerable work and we want clients to feel comfortable with their dietitian during that uncomfortable process.
Take a look at our dietitian profiles to see if anyone seems like a better fit for your wants and needs!