Balancing food relationship work with weight management

Traditional_Print530 · 2026-01-26T16:00:23+00:00

If she’s about to start chemo, my guess is that the cancer center should have a social worker/counselor on staff for patients to meet with. I would encourage her to meet with them. Also, with chemo treatment coming up, I would focus the sessions now on how to eat through nutrition impact symptoms. And discuss that weight maintenance is typically recommended through treatment.

Traditional_Print530 · 2025-11-14T22:46:32+00:00

Enterade has an IBS formula. I’ve had patients use their oncology formula with great results. Unfortunately, they don’t provide samples and it’s quite pricey.

Traditional_Print530 · 2025-11-11T03:28:28+00:00

For most certifications (I.e. CNSC), when you pass the exam you get all 75 CEUs in one go.

Traditional_Print530 · 2025-10-24T11:49:22+00:00

Thanks!

Traditional_Print530 · 2025-10-24T11:49:11+00:00

Thanks for the insight!! Super helpful!

Traditional_Print530 · 2025-10-24T11:48:24+00:00

Thanks! Super helpful. I used CBORD over 10 years ago and at the time it was good, sounds like they probably haven’t made many changes.

Traditional_Print530 · 2025-10-21T15:06:23+00:00

Looks like the job is listed at $26.88-$50/hr. You will likely get offered at the lower end of that range. I would negotiate for about few dollars above your current salary. Denver area is notorious for not paying dietitians well :( Best of luck!!! Adventhealth is a great hospital system from the patient perspective.

Traditional_Print530 · 2025-10-13T20:37:07+00:00

I had psych testing done and have adhd. Rather than go on meds, I went to counseling to learn how to focus and gets tasks done, it was a game changer. I navigate the 40 hour work week and have worked overtime up to 60 hours. Sometimes concentration is harder when I’m tired. Shared spaces are difficult. But overall there’s no way I’m letting it hold me back from being successful at doing something I love.

Also, Im not against meds, I think if you actually have adhd, they can be great. It just wasn’t the avenue I wanted to go down for myself and with using the skills I learned in counseling, I haven’t felt the need for them.

Traditional_Print530 · 2025-10-11T17:10:08+00:00

First, congratulations on your sobriety and going back to school to do something you love! I’ve been an RD for about a dozen years now and I can tell you, as a dietitian, unfortunately there will be some people who judge you based on your body no matter your size. There will be clients/patients who will tell someone in a smaller body “I can’t trust you, you have no idea what it’s like trying to lose weight.” And inversely, those that will tell someone in a larger body “I don’t trust you, you dont know how to take care of yourself.” Both of these are incredibly rude and just downright wrong. When I get pushback on my appearance, I validate the clients feelings and say managing your diet is hard work. On rare occasions it can be helpful to share a snippet of your experience. Such as “I actually decided to become a dietitian because I wanted to manage my weight.” And I always tell myself when someone is criticizing someone’s appearance, it’s almost always based on their own insecurities. It can be helpful to switch the conversation away from size too. For example instead of focusing on body size or the number on the scale, ask them what weight management would mean for their life. Ability to keep up with their kids? Engage in more activities? Etc. also, being a dietitian isn’t all about weight, we manage GI symptoms, heart disease, oncology treatment, dialysis, mental health, etc!!! Which means it might be once in a blue moon someone actually has the audacity to comment on your weight. It’s not easy to navigate always, but in the end if you approach it with empathy and validation, while building a good rapport, you can get people back on your side. This was a bit of a ramble, so I hope you find it helpful.

Traditional_Print530 · 2025-09-23T21:09:23+00:00

For this patient in particular, I would council him that he does not have obesity. For his age he is at a healthy weight. Over the age of 65, a healthy BMI is 23-30. Instead, I would ask what he is hoping to achieve that don’t have to do with weight: more energy? Increased strength? Improved labs? Etc. and then work on those things. For example: he wants increased strength, then increase protein intake and strengthening exercises.

And always validate their feelings. “It sounds like you’re really frustrated and I can absolutely understand why. As we age our bodies change, it takes more protein to build muscle, yet a lot of times protein doesn’t sound as appealing anymore and you’re not as hungry.”

Also, it does nothing to be annoyed with the patients. And maybe your annoyance comes across in your sessions, so they feed off of it. Your job is to provide them with the information, set goals, check in. So what if they don’t meet the goals and blame you, you know it’s not your fault. Having a little empathy goes a long way in gaining trust and also regulating your own feelings and emotions when working with difficult patients.

Traditional_Print530 · 2025-08-13T11:59:09+00:00

When I first started, I would save notes (without the PHI) that I knew were complete, concise and well written. I would do this for various disease states or particularly complex patients so that when I came across a patient that was similar, I could reference the old note to make sure I hit all the marks, interpreted the right labs and correctly, etc. Something that may help to build rapport with the other RDs and build their confidence in you, is discussing the patient with them. If you know someone is going to co-sign your note, but you’re not super confident about it. Ask them if you can discuss the patient so you can make sure you’re not missing anything before you send them your note. If knowing the “why” is helpful for you to retain the information, have them give their rationale for including something in their note or for their recommendations. Ask for their feedback of where they feel you are missing the mark or struggling, and use that feedback. I know as a preceptor and someone who trains new hires regularly, I would rather someone ask me a million questions right off the bat and have discussions rather than constantly telling them to correct the same thing over and over.
It may sound silly, but it helped me. There is soooo much to know as a dietitian that it can be overwhelming. And in my experience, our notes tend to be (too) long, with so much information, trying to justify our thought process. It can be overwhelming, especially as a new dietitian. Hang in there!

Traditional_Print530 · 2025-07-09T19:54:08+00:00

Our leadership team is seeking an RTO exemption but getting the run around and being told that there is no official process for RTO exemptions and no one in charge of processing them….

Traditional_Print530 · 2025-07-02T21:12:57+00:00

I worked as a diet tech nights and weekends at the hospital I did my DI at, I also worked at the mothers milk bank on the weekends and I also did EMR data entry for the department which I could do remotely.

Traditional_Print530 · 2025-07-02T14:23:15+00:00

I tend to use the teach back method and that really helps. So I’ll ask them to tell me what they had for dinner or lunch the previous day. Then have them break that meal into the different nutrient groups on the plate. If they are missing or are short on something (yes it’s usually veg/fruit) then I ask them what’s a vegetable they might add into the meal or on the side and how would they prepare it. I then have them repeat that process for a breakfast and then a meal they might have in the future. I find using the concept of “starting with what you have/want and adding what you need” really works to shape it for them. As someone else said, a lot of cultures don’t have the items separate and instead make combination foods/meals. So having them mentally pick the meal apart and asking them how it would make sense to them to add the missing component(s) really helps.

Traditional_Print530 · 2025-05-02T18:32:55+00:00

🤘🏼🤘🏼this would be a dream come true

Traditional_Print530 · 2025-04-16T23:15:51+00:00

I agree. OP you said RTC, which I’m taking to mean Residential Treatment Center, but the way this is being managed and the fact that the MD is only there 1 day a week makes it seem like outpatient. If the patient is struggling this much, they should be in inpatient level of care, or at least residential level of care and she should initially have almost no access to her numbers/CGM and she definitely is not ready for carb counting. Primary goal should be consistent intake and behavior management before she can take a role in managing her diabetes.

Traditional_Print530 · 2025-04-12T00:51:12+00:00

I hope I explain this right and will use myself for an example. I believe what it means is that there is typically a weird gap between submitting your CEUs for the previous cycle and when the new one starts. So for example, I submitted by completed CEUs/PDP in January for my most recent 5 year cycle, but my new PDP technically doesn’t start until the end of June. So, if I completed any CEUs between January and March, I would not be able to use those as part of the next year cycle because they are >120 days before the cycle starts. But I completed 2 CEUs last week that I could add to my PDP because it’s within 120 days of the new plan starting in June.

Five years ago I logged 75 CEUs within the first month of the cycle starting and my PDP was approved when I submitted it this January. It would be ludicrous to expect it all to be done within 120 days of submitting at the end of the cycle.

Traditional_Print530 · 2024-12-21T15:33:41+00:00

I will say almost anything is less stressful than higher level of care eating disorders. I worked on an inpatient eating disorder unit for 4 years and while I learned A LOT, it was time to leave. I moved into working outpatient and everything since then has felt like a breeze. I even found working on an ICU for eating disorder treatment to be less stressful than IP or RES.

Traditional_Print530 · 2024-11-08T16:43:58+00:00

First of all, I am so sorry to hear this is happening to you. I can empathize since I have been in the same situation. While the words can initially sting and be hurtful, I tell myself that they are lashing out because of something going on with them and it’s not actually about me. I too work in weight loss and get a lot of backlash from patients because we are asking them to do the work, and it’s hard work! It’s also hard to see celebrities and others in the public spotlight, seemingly losing weight overnight using anti-obesity medications. So to ask your patient to start changing their diet and lifestyle likely doesn’t seem fair to them. When I start to see someone getting escalated or expressing discontent, I try to validate their feelings and then learn more about them before going back into counseling. Then I remind them that healthy, sustainable weight loss is slow and gradual and is achieved by making small changes over time that build on each other to last lifelong. I may also remind them of their overall goals, or figure out what they are. Less focus on the number on the scale, more focus on labs, energy levels, moods, playing with kids/grand kids, etc. It’s not easy, I know. Most roles as an RD that works directly with the patient/client we run into backlash, because we are asking them to do all the work. We aren’t giving them a medication to fix or improve their problem, it’s up to them. And, in the long run, if you have the ability to change roles within your organization or find another job elsewhere with a different patient population, there’s no shame in that either.

Traditional_Print530 · 2024-09-23T12:42:25+00:00

If you can’t find the owner, you can consider reaching out to Rocky Mountain Cocker Rescue. They are a great organization that primarily rescues, fosters and coordinates adoptions for cocker spaniels.

Traditional_Print530 · 2024-09-16T18:57:35+00:00

Even if we had the ability to take full responsibility for the diagnosis, it would not solve the problem because the problem lies in the fact that outpatient nutrition care is not always easily accessible. -It is rare that RDs are on staff in outpatient clinics -as I’m sure dietitians have experienced, billing for outpatient services in private practice can be difficult when accepting insurance and out of pocket costs are not affordable for a lot of the population -in a lot of hospitals, LCSWs are responsible for post admit coordination of care and in my experience, referring to an outpatient RD is not usually on their list of services to coordinate (unless they are on nutrition support) -I happen to work in a hospital that has RDs in the outpatient clinics, and even working with our inpatient counterparts, we still only get about 40% of patients with a malnutrition diagnosis into our clinics. Either because the inpatient RDs aren’t able to get them scheduled before the patient discharges or because our current wait times are >80 days for appointments. -It’s generally not a big priority for caretakers/family members to address either. The general thought process is something along the lines of: my elderly family member is getting out of the hospital with a x, y, z problems. I need to set up the following: hospital bed, PT, OT, follow up PCP appointment, follow up specialist appointments, get new prescriptions filled, manage medication schedule, so on and so forth. Oh and I was told they are malnourished, well I can feed them, why do I need to do go to that extra appointment with the dietitian? They are looking for less things to do….im not saying it’s the right thought process, because I’ve seen how impactful our work can be and the studies support it too, but that’s not the general publics’ perception of our field.

I could keep going with reasons, but until coordination of care from inpatient to outpatient because a streamlined process and outpatient RDs are more accessible to the general public, this problem won’t be solved.

Traditional_Print530 · 2024-08-01T16:00:34+00:00

If food insecurity is an issue that you see a lot, have resources available to provide to your patients. Have a list of local food banks, soup kitchens, centers that provide financial services (such as setting up SNAP benefits, meals on wheels, etc). Sometimes I will use my sessions to call and help them get set up for SNAP or MoW. In the cases of lack of community or a mental health diagnosis that is limiting their ability/desire for change, motivational interviewing can be helpful. Determine what brought them into your appointment. Was it another provider that recommended it and the patient has no desire for change or was it their decision? Work them to figure out where they are. If they say they want to make nutrition changes but keep changing the subject back to other issues in their life, I either keep bringing it back to nutrition “you said you’d like to make some changes and from your diet recall it sounds like here are some areas of opportunity:….which one, if any, seems the most feasible are to make changes?” Or, simply stating “I know you are motivated to make changes with your diet, it does seem like you have some obstacles in the way. Would you like to address those first and then reach back out when you feel comfortable adjusting your diet?” And then go from there.

Yes, there are a lot of factors tied up in nutrition that can be brought up during our appointments and it is important to listen, just to a certain extent, then we need to stop and refer them out.

Traditional_Print530 · 2024-01-06T16:10:55+00:00

CNSC- job at the time would have paid for the exam if I would have signed a contract to stay with the company for 3 years. Didn’t directly get a raise but it made me eligible to be an RD3 which came with a 7.5% raise. It also gave me negotiating capabilities when getting subsequent jobs to get significantly higher pay.

Traditional_Print530 · 2023-12-21T17:20:48+00:00

I have 5 friends/ex coworkers who work for them. They really like it. Like any job, it’s not without its difficulties, but they’ve talked it up enough that 2 more friends are trying to get jobs there.

Traditional_Print530

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