Good Dietitian, Bad Dietitian

Back in 2003, I was in the middle of my dietetic internship, which consisted of a year-long series of rotations at various clinical settings to learn how to be a hands-on dietitian.

One of those rotations was at an upscale bariatric surgery clinic in Atlanta. People who came to the clinic all wanted to lose a large amount of weight via gastric bypass surgery or a lap band procedure that shrunk the size of your stomach, limiting the amount of food you could eat.

I was assigned to a dietitian who was in charge of determining whether these people were good candidates for the surgery. The sole factor was their ability to stick to a diet that she had prescribed.

This dietitian was very efficient but not super warm or friendly. Her style was very different from mine, and I could feel it the moment I met her.

She told me right off the bat that nearly all the people she met with were “noncompliant” – the unfortunate medical term for people who won’t follow instructions. If they didn’t show willingness to change their diets or the ability to do so, they were rejected.

The dietitian’s office was very small. There was a desk for her, a chair across the desk for the patient, and my chair wedged right in between. I wasn’t allowed to say anything during the sessions. I was just there to observe.

I will never forget one of the first potential patients who came in. She was in her late 30s, had small children, and was a stay-at-home mom. This was her second visit to the clinic after having been there the week before to receive her diet plan.

After my introduction and everyone was seated, the dietitian asked her how everything had gone. The woman was apologetic almost immediately, a sure sign that things had not gone well.

She explained that she’d had a hard time sticking to the diet because she was so tired by the end of a day with her kids that she didn’t feel like cooking. She also said that her husband didn’t want to eat what she was supposed to eat, so making a dinner that both her kids and her husband liked was exhausting. And after a long, stressful day being a mom, the last thing she wanted to do was cook.

I will never forget how the dietitian responded.

She looked across the desk at this poor woman – who was clearly ashamed that she had “failed” and in desperate need of a little empathy – and said, “Am I just wasting my time here?”

Oh my God, it was horrible. It was all I could do not to get up and wrap my arms around that poor woman and tell her I understood how she felt. Instead, I was forced to sit there and watch.

She berated the woman for not having adhered to the rigid diet plan she had given her and told her that if she didn’t do better next week, she wasn’t going to recommend her for the surgery.

The woman was demoralized and felt like a total failure. And after that session with that horrible dietitian, I was pretty sure she wasn’t approved to have the surgery.

It should be obvious from this story that shame doesn’t motivate anyone. In fact, it wrecks your self-esteem, making it almost impossible to make changes.

Unfortunately, we all have a Bad Dietitian in us who’s ready to shame us nonstop. And if you’ve been listening to her, is it any wonder you feel like nothing will ever change?

Shame must be eliminated from the equation if you ever want to change your body and lose weight.

Shame doesn’t work in any change-making scenario, but it’s particularly insidious when women have been brainwashed to believe that everything about our bodies is shameful – regardless if we need to lose weight or not.

But how do you stop listening to your inner Bad Dietitian and start tuning into the good one?

It’s not easy. Dieting keeps the Bad Dietitian on full blast, because diets focus on food. If you eat the wrong foods and don’t stick to the diet, you failed. When you fail at a diet, you’re a double failure: you’re a failure because you have no willpower and you’re a failure because you’re still “fat.”

Your Good Dietitian, however, knows that it’s not about the food. She knows that it’s about making small shifts to your behaviors – especially the way you eat – that build on one another to get exponential results.

She knows that shame has no place in achieving a goal and improving yourself. She knows that it will prevent you from even getting started.

The easiest way to stop shaming yourself is to make one small behavioral modification. Focusing on improving one habit is a lot easier than overhauling your entire diet in one week.

If you pick a habit and start making small changes to it, you get small wins that build your confidence – and confidence is the antidote to shame.

When I was listening to the woman in the clinic tell her story, I could easily see that it wasn’t that she didn’t have willpower. Her life circumstances didn’t allow for radical diet changes.

I knew that all she had to do was make one small shift to her daily routine that would be the domino to set off a chain reaction of wins.

I would have instructed her to get up 30 minutes early and set herself up for success: organize her kitchen, do some food prep for a day’s meals, and search online for recipes that incorporated foods from her diet into meals her family would enjoy. I would have explained how the simple act of taking control like this would carry her through a day of making the right choices.

Most of all, I would have shown her empathy. Because who’s life doesn’t get in the way of eating healthy?

I want you to do two things this week. First, I want you to praise yourself for the things you do right, and stop criticizing yourself for the things you “failed” at. Second, I want you to pick a habit that you want to change and start making two or three simple shifts to that habit to start changing it.

Whenever you hear your inner evil dietitian, I want you to think of that horrible experience I witnessed and have compassion for yourself. And I want you to turn the volume up on the kind, compassionate dietitian inside of you, who’s there to cheer you on.

And in case you were wondering, the Good Dietitian in that room was me. 😊