Dietitian vs Nutritionist: The Battle for Your Health
September 1, 2016With the copious opinions floating around on the Internet, it comes as no surprise that you might not know the difference between a dietitian vs nutritionist. There is an alarming amount of confusion regarding what, exactly, dietitians are and what they do, and how they differ from nutritionists and/or health coaches. Many times, the titles are even used interchangeably; however, this could come at a serious health risk to the client: you.
Dietitian vs Nutritionist and a Health Coach: The Right Fit for You
Calling yourself a nutritionist or health coach is not the same as being awarded the title of a "Registered Dietitian." There is no regulation on the title "Nutritionist." While some will say they are a certified nutritionist, it is usually because they have a printed certificate of completion from a 6 to 12-week online certification course.
Dietitian vs Nutritionist vs Health Coach
In contrast, there are four major steps to become a registered dietitian (RD). One must complete a bachelor’s degree, and beginning in 2024, all incoming RDs must have their master’s degree. In addition to the bachelor’s degree, one must complete all of the required dietetics courses in an approved didactic program, which include basic nutrition, nutrition through the lifecycle, food science, food safety, food service, biochemistry, organic chemistry, nutrient metabolism, and medical nutrition therapy classes, averaging over 100 units total.
Once the didactic program is completed, one must be accepted into and complete a dietetic internship, which has an acceptance rate of about 50%. A dietetic internship is typically 1,200 supervised hours over a 10-12 month period under a nationally certified program at a hospital, which includes rotations in clinical such as the burn unit, neonatal intensive care and more, rotations out in the community, and rotations in food service. After satisfactorily completing the internship, one must take the national exam.
Now, I do not mean to say that all nutritionists are scammers, or that they don’t know anything about nutrition. However, their advice is often opinion-based, filtered down from celebrity “professionals,” or based on poorly conducted, non-peer reviewed research.
Dietitians are held to a higher standard. The Academy of Nutrition and Dietetics (AND) is the regulating agency for all RDs, and hosts a large, evidence-based library of nutrition-related topics AND often publish position papers, stating the evidence that supported the Academy’s opinion on a specific nutrition topic, such as vegetarianism or even weight loss surgery.
In addition, RDs are required to maintain their registered status through professional continuing education units (CEUs) every five years. They must specify a plan of education over the five year period to meet a variety of credit hours, such as a certain number of credits related to specific topics, which can vary based on each dietitian’s personal education goals. Dietitians’ hours are frequently audited for authenticity, too. There is no such requirement for a nutritionist.
Just because someone has lost weight does not make them a weight loss expert; it makes them an expert on what worked for them to lose weight and nothing else. I do not mean to say that successful post-ops should not be able to offer their services to others in order to help them in their weight loss journeys. However, they should clarify their scope of practice and stay away from activities that someone medically trained should do.
For example, supplements are commonly used after weight loss surgery. However, a dietitian has been trained to review blood lab values and assess whether or not a doctor referral is necessary, before recommending any kind of supplementation. In addition, dietitians are evidence-based, in that they follow peer-reviewed research that supports which forms of which vitamins to take, how much to recommend and more.
Unfortunately, I have witnessed in some online support groups that there are post-ops advising others on which vitamins to take and what deficiencies they must have. Instead, they should be telling the post-ops to check with their surgeon’s office and/or a dietitian; after that, and if they are in fact diagnosed with a deficiency or encouraged to start/change supplementation, the other post-ops are more than welcome to share what products have worked for them. It is important to establish these boundaries between post-ops (and even pre-ops).
Finally, a health coach is often someone who works for a specific company that, in all honesty, wants to sell you a product. This does not mean that health coaches do not help many people. It means that they have been trained (maybe extensively, maybe not) to meet certain requirements of the company in order to be given the title “health coach.”
For some companies, it means they’re sales representatives. For others, they conduct classes and may even coach one-on-one, selling the services of the company. However, you must be careful with this because they simply do not have the education and experience needed to address all issues after WLS.
If you need a boost to get “back on track,” maybe joining a class with your WLS friends might help you. If you notice yourself binge eating and rapidly gaining weight, talking to a dietitian who specializes in eating disorders might be even more beneficial.
What to Look for When Seeking Help
1. What does your insurance cover? Many times, a dietitian can directly bill your insurance. However, if they do not accept insurance or are not covered under your insurance plan, a dietitian can be more expensive than a nutritionist/health coach.
2. What are your needs? If you’re looking for an individualized meal plan, a dietitian might just be what you need. As mentioned above, if you catch yourself bingeing and want to address it, a dietitian who specializes in eating disorders can often help; they might also be able to refer you to psychiatric help. If you want the support of fellow post-ops going through the WLS journey, you might be able to find that in a support group or class of some kind. If you just need some accountability but you know what rules you have been provided by your surgeon and/or dietitian, you might be able to schedule visits with a nutritionist or health coach.
3. What does your surgeon say? Your surgeon knows what is best for you when it comes to your WLS, your lifelong tool for weight loss and weight maintenance.
In summary, when you match your support for your needs, you are best able to optimize your health care. Dietitians vs. nutritionists vs. health coaches can be of help, but only when they match your personal needs and resources as a WLS patient.
 | ABOUT THE AUTHOR Bec McDorman, MS, RDN discovered her passion for health and wellness after undergoing Roux-en-Y Gastric Bypass surgery in 2010 to lose more than 100lbs. Bec has received her masters from Cal Poly Pomona and completed her dietetic internship at Johns Hopkins Bayview Medical Center. She has reached her goal of being a registered dietitian so she can help pre- and post-op bariatric patients with their journey.Read more articles by Bec! |
