I’ve been an RD for 20 years. Here’s what I’ve learned about food and eating.

I’ve been a dietitian for 20 years! In 1999, I was in Redwood City, California, writing my board exams and starting my career. I was living the dream when some of you were still in diapers. OMG!

Being in this line of work for this long means I’ve learned a heck of a lot. It’s funny how so much of what I was taught in nutrition school (I went to Loyola in Chicago) and at the beginning of my career is now obsolete. I shudder to think that I once recommended margarine instead of butter, and fat-free pretzels instead of any fat-containing snack foods. Eh, I guess we all did stuff in the 90’s that we’re not proud of, am I right?

 

Nutrition science changes. One day in 2001 I’m telling people not to eat eggs, the next, it’s 2007, and I’m advising them to eat as many eggs as they want. But anyone can look that stuff up, and it’s the other learnings – the emotional and psychological sides of food and how our attitudes towards food, eating, and our bodies affect our food choices – that I believe are most valuable and impactful. You can’t help people make changes if you can’t relate to them or understand the why of how they’re eating. 

Here are some of the biggest lessons I’ve learned in my career so far: 

People just want to be listened to.

I recently gave an interview about myself to examine.com, and one of the questions they asked me was how I’ve changed my practice over the years. My response? I’ve learned how to listen.

Not just hearing, but actually listening, is key to understanding where a person has been and where they want to be. My thoughts used to be two steps ahead of a client’s when they were speaking to me, and as a result, I wasn’t getting the full story or asking the right questions. Blame it on my inexperience, insecurity, or my headstrong nature that made me want to turn everyone towards what I thought was best for them, rather than what they wanted. It was ineffective and insulting of me, and a total rookie mistake. 

When I see interns do the same thing now, I immediately correct them. 

Since then, I’ve learned the value of saying nothing. Of asking tons and tons of questions (if any of you have ever had a consultation with me, you’ll remember how many questions I asked, even about things that are seemingly unrelated to food). Of putting myself in the client’s place, and of meeting them where they want to be met, instead of pushing them where I think they should go. 

If you are with any healthcare practitioner – a doctor, dietitian, nurse practitioner, whoever – who doesn’t make you feel valued, who talks over you, or who only addresses their agenda instead of your issues, find someone else to care for you. Someone who knows how to listen.

The human body is a lot more forgiving than we think, and we need to remember that.

A day, week, or month of making less-than-desirable food choices isn’t a reason to throw in the towel on healthy eating. Just going back to your regular eating habits without dieting or restricting food will likely put you right back where you began before your eating went off the rails. 

Driven in part by bullshit media like this Instagram of Jamie Lynn Spears talking about how she’s going to eat pizza and then drink diet shakes to make up for it, so many people think they need a cleanse, or detox, or diet to help right the wrong. But overeating isn’t wrong, it’s normal: We all overeat sometimes. What’s wrong is feeling guilty about it and overcorrecting, which can precipitate further overeating. What’s also wrong is listening to celebrities selling crap like appetite suppressants, cleanses, Teatoxes, and whatever else.  

From what I’ve seen in my practice, the people who understand that a bump in the road is nothing to freak out about are the most successful in maintaining a diet that’s physically, emotionally, and socially sustainable. 

The most successful diets/eating habit/nutrition changes are ones that people instigate themselves.

People who have been ordered or shamed into changing are rarely the ones who I’ve seen successfully change their eating habits. I’ve gotten plenty of calls from husbands and parents in particular, trying to make their wives or (older) kids appointments to see me. ‘Do they want to see me? If they do, why are you making the call instead of them?’ is always my first question. It sounds a bit bitchy, but the reason for my question is this: if a person truly wants to see me, they should be the one to take the step to make the appointment (unless there’s a good reason why they can’t). If someone can’t take the initiative to pick up the phone and make an appointment, how ready are they to make changes to their diet and lifestyle?

Changing the way you eat and shifting your attitude towards eating, food, and your body all take hard work, and you need to be ready for it. You can’t do it for anyone else, and in fact, research shows that being shamed or forced into changing your eating habits actually has the opposite effect. 

Do it for you.

The first step to a healthy diet is learning how to self manage. 

We as dietitians used to shove fistfuls of ‘education materials’ at patients, sending them home with all the instructions they needed to ‘eat healthy’. Until fairly recently, the concept of ‘self-management’ didn’t really come into play.

The issue? Anyone can read instructions, but self-management is the way people actually live those instructions, manage their barriers, and move forward on their own terms. 

It’s the whole, buy a person a fish, they eat for a night, teach them how to fish, they eat for their whole life or however that saying goes. 

Self-management in nutrition is basically taking initiative and having strategies to ensure that you’re prepared for whatever life throws at you, long after those ‘education materials’ end up in the garbage (which is probably five minutes after the person leaves an RD’s office)

Some people want everything done for them, which is why diet plans with pre-packaged food like Optavia are popular. But it’s not realistic to be on that sort of plan long-term, and it does nothing for self-management.

If you’re looking for more information about how to self-manage your weight or health, a dietitian can help you chart your course. 

It’s about figuring out the emotions behind why you eat. 

When I was in school for nutrition, we learned a heck of a lot about energy balance and its role in weight gain and loss. Give someone a calorie level to stick to, and their weight should adjust accordingly. Except, no, not exactly.

Deviations from ‘normal eating’ – that is, consistent over-or-undereating – are usually not about food, they’re about emotion. Often, these are emotions we have stuffed down with food since early in our lives, but they constitute much of the ‘why’ in our food choices and behaviours. Many of my clients don’t even know how much and how long their emotions have mediated their food choices until I bring that awareness to them.  To make meaningful, lasting change to their eating habits, a person needs to understand their WHY and deal with those emotions head on.

As a dietitian, I can help people figure out their ‘why’, even if that means referring them out to a qualified therapist (which I am not). 

The best diet is the one you can stick to. 

And by ‘diet’, I mean ‘what you eat’, not necessarily a restrictive eating plan.

There has always been controversy about which diet is the ‘best’, but research suggests that there is no definitive answer that applies to everyone. Lots of plants and mostly whole or minimally-processed foods are always a good thing. So is a healthy attitude towards food and eating.

In my early RD days, we were so prescriptive in our diet orders: Eat this way, and X will happen. It was more about the physical changes and not about how a diet would affect a person in other ways. There was really no, ‘they might lose weight, but can they actually sustain this way of eating financially, socially, and psychologically?’ Nope. None of that. Now, I consider those things to be as important as the actual eating plan.

What also matters is consistency and satisfaction – both physical and emotional – with the way you eat. Are you happy with the way you’re eating? Are you cutting out entire food groups for no apparent reason? Can you spend time with family and friends and not stress out about what you’re going to eat or not eat? Do you feel guilty about eating? Is your diet costing you an arm and a leg? Do you really feel all that great physically, or are you tired and cranky? IS THIS DIET WORTH IT?

All things to consider.

 

Here’s to another twenty!

Abby XO