A nutritionist – a doctor or someone like a trainer?

In Europe, two-thirds of adults and one-third of children are overweight or obese, according to the WHO. Year after year, these figures are growing [1]. Obesity is more than numbers on the scale. It can cause cardiovascular disease, some types of cancer, and diabetes. According to the market economy’s laws, nutritionists enter the market in response to society’s request to reduce weight. What are they doing? And how to distinguish a professional from a charlatan? The answer is in this article.

Who are nutritionists?

People with higher medical education. That is six years at a medical university, then a specialized residency or a retraining program in the direction of “dietology.” No short-term courses, list of books read, work as a fitness trainer, or a corresponding mark in the social media profile cap confirms the status of a nutritionist. 

Why are charlatans dangerous? They can harm a person and cannot guarantee the observance of the ethical principles of medicine – whether it be a blog or a face-to-face conversation [2]. Existing international documents in this area oblige specialists [3] to:

• adhere to the principles of evidence-based medicine;
• evaluate applied scientific evidence without personal bias;
• act with care and respect, mindful of individual differences and cultural and ethnic diversity;
• cooperate with other specialists, if necessary;
• disclose any conflicts of interest;
• refrain from accepting gifts or favors that may influence professional judgment;
• respect patient autonomy;
• do not guarantee weight loss or weight gain, etc.

Also, pseudo-dietologists cannot refer you for examination to a doctor of a different profile or make an accurate diagnosis. At best, working with such a “specialist” will result in the absence of results, at worst, new health problems. This is especially dangerous if the person has, for example, an eating disorder or a serious undiagnosed illness. 

What do nutritionists do?

Nutritionists are not doctors. This is a specialty at the intersection of natural and human sciences, which can be mastered in courses, in person or online, including those without a medical education. After receiving crusts, a person can conduct professional activities in nutrition. What does this mean? 

The short explanation goes like this: nutritionists at the popular level convey nutrition information to the audience. At the same time, they do not prescribe treatment (developing a diet is also a treatment) because they are not doctors [4]. Therefore, to say that a nutritionist and nutritionists are the same is incorrect. 

When should you consider visiting a nutritionist?

Another doctor may refer you to a dietitian. For example, a person goes to a therapist complaining of sudden weight gain/loss. He will be sent for an examination and then narrow specialists – for example, a nutritionist to correct his eating behavior. It is important to remember that a nutritionist often works in a team with other doctors. For example, with a psychotherapist, endocrinologist, or gastroenterologist.

Sometimes nutritionists are contacted directly. Dissatisfaction with body quality and measurements, excessive preoccupation with the amount of food eaten, chronic overeating, and anxiety about certain foods are just a few examples that may be a reason to visit.

There is nothing wrong with immediately contacting a specialist, but be prepared that the doctor will refer you to colleagues and prescribe a series of examinations.

Don’t expect a magic pill from a nutritionist. Suppose the difficult relationship with food or weight is unrelated to specific diseases and conditions. In that case, the doctor will talk about the principles of a balanced diet and ask you to follow them. There will be no healing diets or stress methods for losing weight and gaining mass – an evidence-based approach excludes them.

What should moments in communication with a nutritionist alert?

We said above that non-compliance with ethical principles is the first thing patients should pay attention to. You can read more about them, for example, on the Academy of Nutrition and Dietetics website. Here are a few more things to consider as red flags:

• a nutritionist offers to purchase an author’s weight loss program;
• the specialist practices body shaming – humiliates, ridicules, or insults people for non-standard body parameters;
• the doctor points out hormonal imbalances, talks about the need to “cleanse the intestines and the body of toxins” and other non-existent diagnoses;
• promises that you will achieve your goals by a certain date;
• criticizes you for relapses and condemns your relationship with food.

How to find and choose a good specialist?

There is no universal instruction that would guarantee success. In addition to the aspects described above, you can try to follow the general principles of finding good doctors.

First, choose a clinic with a clean reputation and an evidence-based approach to treatment. In a good hospital, the chance of meeting a smart nutritionist is higher, and if there is no specialist, you can ask for a recommendation from another doctor you trust.

Secondly, do not focus on social networks and friends. A beautiful picture and other people’s reviews do not guarantee the result and do not always speak in favor of the doctor’s reputation. Education and publications, including scientific ones, will tell much more. 

Third, rely on your instincts. If you have chosen a nutritionist, but at the first or subsequent appointments, you feel that communication with a specialist causes discomfort. The doctor’s approach to business raises questions, seeks a second opinion, or changes a specialist. 

Finding a competent nutrition and nutrition professional, if you need it, is no less important than realizing that the path to harmony with your own body is long and thorny. It is better to go on this journey with good company, which will support you during times of difficulty, give direction and be there when needed.

Sources:

1. Obesity causes cancer and is an important determinant of disability and death, according to a new WHO report / World Health Organization.
2. Professionalism in the Use of Social Media / American Medical Association (AMA).
3. What is the Code of Ethics / Academy of nutrition and dietetics.
4. What nutritionists do / Association for nutrition.