To be an effective dietitian you need to get into your clients' heads,
says Daniel Tisi. And he doesn't just say this because he works in a psychiatric
hospital. All dietitians need to connect with and motivate their clients.
"Motivation is a big part of it, psychology is a big part of it," says
Tisi. "They do offer some of that (in university), but in my opinion... they
don't give you enough of that stuff. They're focused on the hard science,
which is good, you need to have that, but you have to kind of fill in the
void yourself and find some way to motivate people."
There are more than 200 patients at the psychiatric facility where Tisi
works. He's the only dietitian on site. He doesn't see every patient. Instead,
he consults with just those who need assistance. For example, if a patient
is put on a medication that could cause weight gain, he meets with them and
tries to preventatively stop them from gaining the weight.
Tisi is a registered dietitian with a master's degree in clinical nutrition
and he is currently pursuing his doctorate in human nutrition. The hospital
where he works has patients with a wide range of psychiatric problems.
"It's basically the psychiatric facility for the area, so we have a lot
of different disordered patients -- some schizophrenia, some mood disorders,
bipolar, depression, etc.," says Tisi. "Usually the delusional disorder [patients]
are really the hard-hit people and usually the medications associated with
that have significant impacts on weight."
Diana Steele estimates that 70 percent of her clients are focusing on weight
loss. They often need to be educated about health myths and fad diets.
"There are a lot of myths in sports nutrition and also with weight loss,"
says Steele. "There are all kinds of diet books out there and celebrities
who've come up with new eating plans that are not backed by science.
"Just being able to talk through things with the client and
helping them realize that regardless of what plan they follow, if they're
eliminating all the junky foods in their diet, they're probably going to do
a fairly good job," says Steele. "It's just about what they can continue to
do for life and not making it a diet -- trying to make some lifelong health
changes."
Having the right information and acting on it are two different things.
It's not easy to break old eating habits and adopt healthy new ones. Helping
people do that is a big part of a dietitian's job.
"Food is a very difficult thing for people to change in their lives," says
Steele. "You have to think about food every day and you have to think about
it often... helping people change something that is so integral in their lives
can be a very slow, challenging process. And it's about trying to figure out
what's going to help that one person make a change, because it's different
for everyone."
Mindy Black, a registered dietitian in Florida, says it's often challenging
to get people to try healthy foods.
"We live in the generation of McDonald's and KFC, so getting them to open
up and try healthier foods is usually hard, but once they try it they're usually
on board." Black says her plan wasn't to become a dietitian when she started
college.
"I fell into it," says Black. "I thought I was going to be a doctor, and
once I got to college and I was two years through college, I realized that
I didn't want to go to school for another eight years. I really liked my nutrition
classes so that's where I headed from there."
Black works a lot with athletes. "The biggest challenge with athletes
is that they have a million different people telling them different things."
Black educates athletes about different supplements and at what times they
should eat, and what they should eat at those times for their particular sport.
She also has to dispel myths that athletes (and others) read about nutrition
online.
Kristine Van Workum also considered medical school before deciding to become
a dietitian. She also considered doing physical therapy.
"As I got into my college-level classes and took an introductory nutrition
class, that was really where I was exposed to learning more about the science
behind the nutrition and how it affects the human body," says Van Workum.
"And, honestly, I didn't want to take the time to go through all of medical
school, so I chose to be a dietitian instead so I could still stay in the
loop and work with physicians closely."
Van Workum works with athletes as well as people dealing with eating disorders
such as anorexia and bulimia. Her youngest client was 10 years old. Some are
in their 60s and 70s.
"A lot of times [patients with an eating disorder] require more comprehensive
treatment where I'm involved in monitoring their nutritional status and helping
them form a healthier relationship with food, helping them a lot of times
to reestablish a healthy weight," says Van Workum. "And then I work... very
closely with their therapist and medical doctors, to monitor their overall
status from a team approach."
Steele is another example of someone who didn't know at first that she'd
become a dietitian.
"I've always been interested in food and I've always been interested in
health," says Steele. "I hadn't thought of combining the two. I actually went
to university to be a physiotherapist, but changed focus when I was there."
Steele says being a dietitian has allowed her to be a health professional
while also raising a family. She managed to continue her private practice
by hiring other dietitians. This allowed her to spend less time at work when
her children were small.
What kind of person is well suited to being a dietitian? "If they want
to help others, if they have a passion for food and eating and cooking, and
are interested in health and healthy living," says Steele.