Dear Food Speak: What can I expect from a visit to a dietician?



When I meet people who find out I'm a registered dietician, they often blurt out, "Oh, I could use you!"

But I get the feeling they don't really understand what I do.

To set the record straight, registered dieticians are not drill sergeants or the food police. We provide medical nutrition therapy, an essential component of comprehensive health care that prevents and treats a wide variety of health conditions.

Behind the scenes, the therapy incorporates behavioral counseling to bring about long-term positive eating habits and optimal health.

If you are considering medical nutrition therapy, do some homework. Contact your insurance company to see if your plan covers this service. If it does, find out how many visits it allows and whether the benefit is limited to certain medical diagnoses, such as diabetes. For those without insurance coverage, there's no better investment than your health.

To find the right registered dietician, start with a referral from your doctor. Be sure to inquire about a prospective dietician's practice focus.

While all registered dieticians complete academic and professional requirements to earn their credential, some specialize in one or more areas of nutrition.

So if you're battling binge eating, enlist a registered dietician who's experienced in both weight control and eating disorders. For help with diabetes meal planning, call on a dietician who's a certified diabetes educator.

During a first medical nutrition therapy visit, which lasts about an hour, a nutrition assessment is completed. From an interview -- which, if done right, should be a friendly conversation -- your dietician will gather information such as current and past eating habits, exercise patterns, medical history, family history, lab tests, allergies or aversions to foods, and any medications that may affect nutritional status.

If possible, bring to this appointment a three-day, truth-be-told food diary; a list of all current meds and supplements; a copy of recent lab tests; and a list of questions and/or personal goals.

Usually by the close of the first visit, you'll be introduced to a personalized nutrition intervention. This is where your dietician translates complicated nutrition science into a practical meal plan for you.

Once your dietician estimates your nutrient needs, some sample meals may be designed on the spot with your input to account for your preferences.

Keeping a diary of your progress will help make this plan stick. You and your dietician also can use the diary to explore food-related barriers, like mindless eating habits, diet-driven behaviors, or being out of tune with hunger and fullness.

Subsequent visits with your dietician usually last about 30 minutes and can offer the support necessary to sustain meaningful lifestyle change.

In the case of someone struggling with obesity, weight loss may require a shorter term nutrition intervention, but research strongly supports ongoing visits with a dietician to avert weight regain.

In general, most people visit with a registered dietician approximately two weeks after their initial visit, then again once every month or two until they're meeting their health goals independently.

After that, consider scheduling an annual nutrition check-up to optimize your nutritional health.

Courtney Sansonetti is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates Inc. Her Food Speak column appears monthly. Email your questions to