What to Expect Working With a Non-Diet Dietitian — Registered Dietitian Columbia…

As someone who has been a dietitian in a variety of settings over the past 15+ years (!!!), I’m used to there being a lot of confusion about what we do. As an inpatient dietitian, I dealt with complaints about hospital food on the daily – I promise I wasn’t the one oversalting your mashed potatoes! As an outpatient dietitian, I realized people often expect us to be a living, breathing My Fitness Pal, with encyclopedic knowledge of the nutrition facts of every single food, and someone who could easily whip out an individualized meal plan in the course of minutes. Even today, as a dietitian who works primarily with eating disorders, and as someone who is fairly vocal about weight inclusivity and non-diet approaches, acquaintances still ask for weight loss tips!

I joke about it, but I get it! It’s almost impossible to summarize the nuanced and individualized work that happens with non-diet nutrition counseling, and the weight-centric paradigm is so normalized in our culture that it’s assumed it’s how a dietitian practices. It’s one of the first reasons that in onboarding a new client, I provide an FAQ sheet and summary of what nutrition counseling looks like, and a brief overview in their first appointment. It’s important to me as a provider that my clients feel comfortable and have a sense of what to expect in our work together.

It takes a lot of courage and vulnerability to trust someone with something as personal as your relationship with food and your body. This is especially true if you’ve had a bad experience working with a dietitian or other healthcare provider in the past.

I know that I feel a lot less nervous about something if I have an idea of what will happen. If you’re curious about working with a non-diet dietitian but not sure what to expect, read this post to get a sense of what it is like!

What to Expect Working With a Non-Diet Dietitian:

Focus on your relationship with, and behaviors/habits around food – NOT the scale.

Non-diet dietitians know the BMI scale is BS. While changes in weight can provide us with some information that might make weighing a client helpful in specific circumstances (for example, during nutrition rehabilitation and weight restoration in eating disorder recovery), we know that it tells us practically nothing about about your health, your eating habits, and absolutely nothing about your value as a person. The scale is a distraction from helping you take practical steps to improve your health and wellbeing – which is not the same thing as weight loss. Instead of focusing on the scale, a non-diet dietitian will aim to provide a safe environment for people of all body sizes to work towards their individual, non-weight related goals.

That said, just because as non-diet dietitians we don’t focus on weight loss, that doesn’t mean we can’t support you if you want to lose weight. Sometimes people worry that they’re not allowed to bring up their desire for weight loss when they’re working with a non-diet dietitian*. But as I remind my clients, if you didn’t want to lose weight, you’d probably already be a pretty intuitive eater! Pretty much everyone we work with wants to lose weight on some level, and it’s OK to talk about that with your dietitian. They should be able to help you unpack your desire for weight loss, have a nuanced and individualized conversation about potential risks/benefits of pursuing weight loss, and help you figure out how you want to move forward.

*Unfortunately, I’ve seen a few dietitians who are new to this work dismiss clients weight concerns, and I know when I was new to this work, I did the same. It’s a learning curve for us moving to a totally new paradigm! If this has happened to you and you have a good relationship with your dietitian, it’s OK to share this with your provider – they should be open to listening and learning from you.

Lots of listening.

You are the expert of your body, and your experience. While we have plenty of insight and advice, we want to understand each individual client and their unique needs before dispensing it. No one-size-fits-all approaches here! Non-diet dietitians are typically trained in therapeutic modalities like motivational interviewing, acceptance and commitment therapy, cognitive behavioral therapy, and mindfulness, along with intuitive eating, medical nutrition therapy and health at every size. We have an extensive toolbox of nutrition, behavioral, and therapeutic interventions that we can pick and choose from to support you and your unique needs. Different dietitians will have different personalities and approaches, but generally speaking, meeting with a non-diet dietitian you’ll get a lot more listening and a lot less lecturing – hopefully close to none!

Minimally to nonrestrictive nutrition support.

Non-diet dietitians work with many different concerns, not just eating disorder recovery. We see lots of clients with food related health conditions, including some people who may benefit from temporarily or permanently eliminating or reducing certain foods. A non-diet dietitian will understand that food is just one part of health, and will aim to provide nutrition care that is as minimally restrictive as possible. Sometimes dietary restriction is part of truly evidence-based care (think gluten for celiac disease), but we will work with you to make that as painless as possible and not add on any unnecessary restriction. Furthermore, we often support clients with food related health concerns by helping them add more foods in! I love working with clients with IBS who have been told to eliminate a litany of different foods, because it’s so much fun to help them eat more and feel better!

An environment that fosters a growth mindset.

Part of challenging diet mentality is challenging binary thinking and the idea that with food, there is a right and wrong. We don’t expect you to be a “perfect” intuitive eater after a session or two – or really ever! Human beings make mistakes with food and eat in ways that don’t feel good. That’s part of life! We see these instances as learning opportunities, not to mention a general side effect of being a living, breathing human.

It’s normal to worry about being judged for food choices, especially if you have been judged for food choices by family members or other providers. You should feel safe to share these challenges with your dietitian, who should be able to get curious rather than judgmental, help you understand what happened, and learn from it.

Nutrition!

We may be non-diet dietitians, but we’re still dietitians! Depending on your individual needs, nutrition may be more or less emphasized, and will likely look different than the kind of nutrition you usually see promoted online – probably a lot less sexy and exciting lol. However, nutrition therapy will still be part of your care, whether it’s a simple as supporting you in eating enough throughout the day (the most important aspect of good nutrition), or more targeted nutrition support.

If you’re currently working with a “non-diet” dietitian and not getting these things out of your work together, it might be time to consider what value you’re getting out of your working relationship. Although I love that body positivity and intuitive eating have become more mainstream, it also means that unfortunately there are more people using the non-diet label who aren’t necessarily experienced or trained, not to mention people who use non-diet as a marketing pitch rather than a treatment paradigm.

Whether you’re working towards healing your relationship with food or trying to understand how to best take care of your body with a health condition – or both! – our goal at Rachael Hartley Nutrition is to help you define health on your terms, and provide the support you need. Read more about the practice philosophy here, and reach out if you’d like to see if we’re a good fit to work together. We work with clients out of our Columbia, SC office, and virtually in many states throughout the US. We’re also in network with BCBS so you may be able to receive nutrition support as part of your benefits.