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Rethinking Nutrition Therapy

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A few days ago, I had a friend surprised confused as to why she was already seeing her dietitian 1 week after her initial assessment appointment. The conversation started off with her telling me she had just gotten to the dietitian’s office (it was 2:52 pm, her appointment was at 3pm) and in the waiting room, asking me if she should knock on her office door or wait in the waiting room. I laughed saying “Wait, she’ll come get you when it’s time for you appointment” (I laugh because I too work in private practice and would find it funny if my client had knocked on my door 8 minutes before their appointment).

I followed up by asking my friend

Me: “Did you bring in your labs?” (she had just gotten some this week).

Friend: “No.. was I supposed to? I’m not really sure what we are doing today.”

I was honestly surprised by her response.

Me: “She’s checking in with how things are going!!”

Friend: “It’s been 1 week!!”

Me: “You’re supposed to have regular appointments. I see my clients weekly and see how things went that week and what did/didn’t work, make goals for the week… etc.”

Friend: “Oh really??”

Again, I was surprised by her response. I finished the conversation by explaining the importance of regular appointments with her dietitian (weekly if possible) for accountability and appropriate progress, some roles of the dietitian, and how follow-ups usually go. “It’s like therapy with a therapist but for nutrition….”

Her answer….


This is where I realized my friend did not really understand what a dietitian does. She was surprised that she already had to come in a week later. I often find this in my practice when I suggest weekly appointments. Some clients are surprised when I don’t support them waiting for 2-3 weeks until their next appointment. She had no idea she would need see the dietitian so frequently. She thought the initial appointment was like seeing another doctor where they have an appointment and don’t see you for another month or two, but that’s not how it works and it doesn’t set the client up for the most success.

Making nutrition changes take time. It’s not a “one and done” type of thing.

It is important to have regular and frequent appointments with your dietitian, ESPECIALLY if you’re struggling with an eating disorder. Continuing to see your registered dietitian will help keep you accountable and help support the new eating behaviors as time passes. Following up with your dietitian regularly allows for small, subtle changes weekly vs. changing everything at once (which usually doesn’t work). Regular appointments allow to make adequate, timely progress vs. waiting until too much time passes problems can potentially grow. Regular appointments allow to review how the goals set in the previous appointments with and revise to better support the client if needed or come up with new goals to continue to move forward. It’s an opportunity for continued improvement and support. You also can’t learn everything about nutrition in one session, although I know many clients who would love to so they would not have to come so frequently. That doesn’t truly help you, but rather overwhelms you and does not set you up to be the most successful. You need continued education which needs to be consistently presented to the client as repetition is key to adopting new behaviors. Regular nutrition counseling can offer you a change to voice your concerns and have consistent feedback.

If a client has an eating disorder, regular appointments are extremely important when a client’s eating behaviors are not stable. If a client is transitioning out of a higher level of care, outpatient follow-up afterwards is imperative for a full recovery. It is important to see a dietitian after treatment to support new eating behaviors in a less structured environment as this transition is harder than most except and old eating disorder behaviors may easily resurface in an old environment. After treatment, clients need continued nutrition education and repetition of education is key to truly replacing old food behaviors. Having a dietitian helps you stay recovery focused in a world so focused on diet and weight loss.

I know that we all have busy lives and regular appointments can at times be overwhelming. Trust me, I know, I can relate. But I promise, it’s important and the best way ensure you achieve the nutrition outcomes you seek.