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What is a dietician and why are they relative to mental health?


By Paige Penick, RDN, CLT, CPT

What is a dietitian?

Registered dietitian (RD) or registered dietitian nutritionist (RDN) are the same credential. Anyone who has earned this credential has received a bachelor’s degree in dietetics or a similar field, completed a supervised practice and passed a national exam. Beginning in 2024 a master’s degree will also be a requirement. 

Their studies include nutrition (for all decades of life), food service management, diseases and disorders nutrition can play a role in, behavior change and practicing counseling skills.

What do dietitians do?

It is often thought that dietitians work in kitchens in hospitals. There is some truth to this, however dietitians today work in many, many places. This includes 1:1 private practice, online programs, corporate wellness, consulting and contracting with brands and businesses, and writing for various media outlets. 

Many people also think that dietitians don’t approach nutrition from a whole person approach, and just tell people to go “eat better”. This is simply not the case. Many dietitians emphasize that it is extremely important to look at every aspect of a person’s life. Eating matters, but areas such as lifestyle, stress, and relationships are necessary to address in order to best help a person with nutrition related choices and their overall health.

What’s the difference between dietitians and nutritionists? 

It can vary among states, but in general there is no requirement to be a “nutritionist”. This title is not protected and doesn’t have regulations around it. The use of registered dietitian or registered dietitian nutritionist is protected in the sense that anyone using these titles needs to have earned the RD/RDN credential.

Since there is no regulation around “nutritionist” there are concerns that those using the term may not have the proper training, knowledge or skills to treat certain people and certain diseases and disorders. The potential for serious harm does exist, and that is problematic.

Why are dietitians an important resource for therapists and other professionals to know about?

Dietitians are in important part of the care team in hospitals. They are also an important part of client care outside of hospitals. They bring to the table knowledge of medical nutrition therapy, nutrition education and behavior change around food and food choices.

Therapists and dietitians have some work that overlaps, however at the end of the day each of them have skills and training that the other does not. Many clients benefit from having a therapist and dietitian. This team can also include a psychiatrist, general practitioner, gastrointestinal doctor and others. 

It’s great when a client’s various providers can communicate and keep each other abreast of what the client is working on, in order to get the client the best care possible. At the end of the day, getting a client feeling better is what really matters. 

What are the consequences of not receiving care from a dietitian and how could it impact mental health negatively? 

The dietitian is there to support the client when aspects of mental health and nutrition are tied together. In this type of scenario it is very important to get care from a nutrition expert. There are so many things related to nutrition that impact mental health and vice versa. Without support from a dietitian the client may remain stuck where they are, or even become worse off. 

This can apply to clients with a number of diseases, disorders or struggles. Eating disorders specifically have a lot of statistics and research on the relationship between mental health and eating disorders. When a client has an eating disorder it is very important that the client sees both a therapist and a dietitian in order to get the best care possible. 

When a client is struggling with disordered eating or an eating disorder the longer they don’t address the nutrition and food part of their struggles the worse off they will likely become. It’s ideal to be catching this before they’re in a scenario where they need more intensive care, such as an in-patient facility.

How do you know a child, adolescent, adult or older adult needs to be referred to a dietitian? 

Depending on the situation it may or may not be so obvious that a client can benefit from meeting with a dietitian. Diagnoses such as diabetes, kidney disease, or heart disease are definitely instances that a dietitian can assist a client. 

Other times a client may express confusion around what they “should” and “shouldn’t” eat, have a desire for weight loss, or be a serial dieter. These are also scenarios where a dietitian can definitely help a client.

When a client has a diagnosed eating disorder it’s very important to recommend they begin meeting with a dietitian. There are also clients that may have an eating disorder but aren’t yet diagnosed. Signs a client may be struggling with disordered eating or an eating disorder may include having a lot of rules or rigidity in regard to eating, talking about logging or tracking foods consumed, having preoccupation with food or food choices, or expressing discomfort with their body.

How does a dietitian help a client?

Dietitians help people in a number of ways. This often includes a mix of nutrition education, specifics based on any diseases or disorders, talking about lifestyle, behavior change and coping strategies. Nutrition choices don’t exist in a vacuum. Stress, anxiety, and relationships all impact our food choices. Helping people understand this and assisting them in finding healthful coping strategies is really important.

How to know what dietitian is best for a client

Not every dietitian is for every client. With websites and social media today it is a great idea if a client can look into a dietitian before they decide to work with them. See what topics they talk about, what expertise they have, how they work with clients, and if their approaches and personality feel like a good fit.

Paige Penick, RDN, CLT, CPT. 
Paige is the founder of Start Fueling Better. She uses online programs with 1:1 and coaching to help women change how they approach food and nutrition. With an emphasis on shifting away from diets, rules and restriction, so they can start fueling and feeling better for good.