A Typical Meeting with a Non-Diet Dietitian

New experiences are intimidating. Whether it’s attending your first yoga class or a new employer’s Zoom meeting, you’re not aware of the culture. The unwritten social norms. 

In the case of yoga, you may be thinking -

  • “Wait, I can’t bring my phone into the yoga studio with me?

  • Should I flip the token to “yes” for hands-on assistance?

  • What are these cold towels for…the mat? My sweaty face? My hands?"

At the Zoom meeting -

  • ”Do we chit-chat before the meeting?

  • How much of my participation is expected?

  • Video on? Video off?”

What about a visit with a dietitian? What questions do you have?If you’ve considered seeing a non-diet dietitian, are you wondering:

  • What’s the structure of a nutrition appointment? 

  • Is the dietitian going to ask me what I’ve eaten every day for the past week?

  • What topics will we discuss? 

  • What questions will the dietitian ask me?

 

If you’re here for a follow-up, I’ve already met with you for the first appointment - the nutrition assessment. You’ve shared your story, current eating habits, lifestyle, concerns, and overall goals.

Beginning of Nutrition Session

Optional Mindfulness

When we begin, we may start with a brief mindfulness break, like this one (but even shorter). It’s totally optional. Read more about why I offer mindfulness as a dietitian here.

Updates from the Week

Then, we’ll look back on the past 1-2 weeks.  I’ll ask you how you’ve been feeling physically, mentally, and emotionally this week.

You’ll share updates on what’s happened situationally in your life. Sometimes circumstances impact food, sometimes they are simply part of being human. For example, a new medication, a change in your weekly routine, or a stressful interruption to your life.

Oftentimes, you’ll process a food or body story that occurred this week:

  • Times you felt triggered, like a dinner with extended family or a vacation when you were in a bathing suit.

  • What you noticed about your hunger, or how a recent change, like increasing breakfast, impacted the rest of your day.

  • A realization that you had, like how WW points keeps you from eating nutritious foods like nuts

Ways You’re Making Progress

You’ll tell me all about your glimmers, which you can read more about in this post. These are moments when you notice your mindset shifting or when you’ve done something differently.  Like

  • leaving Poptarts in the pantry all week,

  • ordering a satisfying entree at a restaurant and passing on the appetizer,

  • discovering a particular food you LOVE,

  • or going on a walk because it felt good instead of like a “should.”

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    Barriers

    You might mention what’s been challenging, or just annoying lately. Like not knowing what to make for dinner, or feeling disappointed in your body when you shopped for new clothes.

    We Don’t Always Talk About Food Recalls

    This may surprise you, but I don’t ask many detailed questions about what you’ve eaten.  It doesn’t matter how much butter you put on your toast. I’m not the food police! I won’t interrogate you!

    Sometimes I get a rundown of what dinners looked like this week, or what you’ve been snacking on. Other times, we may not get to it.

    I’ve spent entire sessions that were focused on sleep schedules and self-care since that was the priority at the time. Dietitians talk about stuff other than food!

    Middle of the Nutrition Session

    Our conversation might naturally lend itself to a certain discussion topic. 

    Or I’ll ask what questions you have.

    Or I might suggest some options for what to dig deeper into.

    Here are some examples…

     

    Foundational Topics in Nutrition Counseling

    • The importance of eating enough

    • Flexible eating schedule or structure

    • Snacks

    • Meal ideas

    • Understanding binge triggers

    • How dieting has interfered with your life

    • How to meal plan without dieting

     

    Intuitive Eating Topics in Nutrition Counseling

    • Hunger - when do you feel it? extreme vs subtle?

    • Fullness - how do you know when to stop?

    • Food rules

    • Unconditional permission to eat

    • Satisfaction - how to choose what to eat?

    • How to eat trigger foods without bingeing

    • When eating is coping with emotions/stress

    • Mindful self-care

    • Movement

    • Body respect - how to shift your attitude toward your body

     

    Other Topics in Nutrition Counseling

    • Nutrition guidance for diabetes, vegetarianism, fertility, aging, etc

    • How to aim for good nutrition without going back to disordered eating

    • Weight stigma

    • How and why to focus on wellness instead of weight

    • Acceptance and Commitment therapy techniques

    • Strategies to raise your kid(s) as an intuitive eater

     

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      End of a Nutrition Session

      We’ll create goals together related to the discussion topic.

      • Some goals are concrete and action-based, like “follow the flexible eating schedule” or “add more to breakfast.” 

      • Some goals you’ll be completing homework, like a worksheet, journal prompt, or listening to a podcast. 

      • Some goals are about increasing your awareness

        • “Notice subtle moments when you start to have urges to escape. Can you pause and take care of yourself?”

        • “Pay attention to how present you are during meals, if that changes based on people you’re with or where you eat. What effect do distractions have on your eating? Come from a place of curiosity, not judgment.”

      Action and homework goals typically occur during the first 2-6 sessions. Awareness goals happen throughout our time together as your mindset shifts toward intuitive eating and kindness toward your body.

      We’ll look ahead to the next week or two.

      Is anything out of the ordinary coming up in your schedule? We talk through these situations that could potentially be challenging or triggering.

      Being mentally prepared - aware of what’s coming - can alleviate distress. For example, you have an in-person work conference next week. We’ll talk through the logistics of eating plans outside your routine. We’ll prepare for negative body image because you’ll wear more formal clothes around people who don’t normally see your body.

      Finishing Up

      After we’ve talked about the past, touched on a food or body-related topic, and planned for the future, our 45 minutes is typically up. We’ll reschedule for 1 or 2 weeks out.

      Later, you’ll receive a part of my note within the patient portal. It contains

      • your main goals for nutrition counseling,

      • a visual roadmap that intuitive eating is a space and not a race,

      • an overview of what we’ve covered so far in our time together,

      • key points to remember based on today’s discussion,

      • and goals for the week.

      The note will look something like this:

      Feeling Prepared?

      I hope this gives you the confidence to know what to expect. If you have more questions or hesitancies about nutrition appointments, give me a ring

      If you’re ready to start this new thing with me, let’s begin!

       
       
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