Excellent First Meeting with Dietitian

Monday, December 03, 2012

So a mere 21 months after embarking on a healthier lifestyle, I finally decided to see a dietitian about improving the overall quality of my diet. I did this with some trepidation because my very limited experience with dietitians has been all about restrictions, what you SHOULD eat and what you MUST avoid. I am not much (as in not at all) for following a restrictive food plan. The main thing I’ve done since March 2011 is to limit calories and sodium. In the past few months, I have also increased protein and fat grams to assist with losing increasingly hard to shed pounds. But then I started to worry I was getting too much protein.

Fortunately, I found a dietitian, Susan, who sounded very positive and encouraging on her web page and I did a brief interview with her by phone before setting an appointment. I knew we would be a good fit when she said the minute people say they are never going to eat certain foods, she feels they are setting themselves up to feeling deprived and going back to harmful ways of eating. Another good sign was when I said every time I read how carbs were evil and sugar was death, it made me want to go eat a big piece of cake, she laughed and said she’d be right there with me. At any rate, her approach is to individualize the plan based on what each person is currently doing, incorporating the foods that they enjoy and want to eat.

Our first appointment was over an hour and a half during which Susan asked a bunch of questions about what I typically eat and how my approach works for me. Protein bars have been a very big staple in my diet and lately I’ve added to yummy protein shakes to the rotation. I have no desire to give either up, but would like to add in some more “whole” foods. In addition, I want to have a better handle on the number of carbs, protein and fat I should eat each day. SP Guidelines give me really huge ranges for each category. I am usually in those ranges, but what does it mean? There are so many opinions on what to eat, so much conflicting research out there, that I wanted an expert to offer some guidance. Lastly, I am in the process of figuring out what my maintenance range of calories will and could use some assistance there as well.

Susan looked a little alarmed when I told her I wanted to nudge my maintenance weight range down a bit more. I’m sure her concern is not that I am wasting away (despite what my mother and some others insist) but because the lower my weight, the fewer calories I will be able to eat to maintain it, given my height (short), age (older by the minute), gender and sedentary job (slumped in front of a computer). So she asked why I wanted to be a lower weight and I told her partly it was I just liked the numbers better. But more importantly, with my knees being severely arthritic, I honestly feel the lighter I can be, the longer I can delay knee replacement with my goal of scheduling the surgery as Never.

We didn’t spend much time quibbling about what my weight should be, but she did state her calculations were based on me being 130. Currently, I am hovering a pound or two under that. Susan compared how much a person can eat to a checking account. The vast majority of people do not have unlimited funds so the amount of money they can take out is dependent on what they have in their account. Likewise, the vast majority of us have only a certain amount of food we can eat without running into trouble. Instead of bounced checks, overdrawing on our calories results in weight gain. The trick, Susan said, is to find the balance between over-spending so that you have problems and being too frugal so you aren’t really enjoying what you have available.

I liked that analogy a lot. Susan calculated that my maintenance range, or calorie account is 1500-1700 which is a bit below what SP suggests of 1600 -1950. Since I’ve been losing weight at 1600, I imagine my calories will be more around 1700 or above, unless I manage to get down to 125 (my latest secret goal), which may reduce my daily intake a bit. The ranges she gave narrowed protein to a target that makes much more sense to me rather than the huge range SP offers. The range for fat is a bit higher and carbs a bit lower and much narrower than SP’s. I am comfortable with these ranges and feel they can be achieved with only a little extra effort on my part. As I always aim for very achievable goals, that made me happy.

Susan noted, and I agree, that I am very much about numbers. I like to record grams and calories rather than food exchanges. After all this time, that is how I think as far as planning and tracking my food. She included a few days worth of suggested meals and snacks as a starting point. It really seems pretty easy to incorporate. Today is the first day I am trying the full plan (weekends I am active, happy and relaxed so tend to eat less and like it that way).

The biggest challenge for me will be planning snacks into my day. Susan felt I went too long between meals (4-8 hours), and this contributed to my urges to mindlessly eat. I can usually beat back those urges, but they aren’t much fun. She suggested a snack of fruit and nuts at around 3 or 4 would help me feel less like Godzilla rampaging through my kitchen in search of tiny Tokyo residents when I arrived home at 6 (my words, not hers). Best of all, she made sure that I can continue to incorporate my much loved protein and fiber bars and the protein shakes I now adore into my daily eating plans.

I will meet with her in a few weeks to go over how this plan is working. My biggest curiosity is about how the snacks and a slightly larger breakfast will fit into my days. I decided I do not need to wolf down a huge lunch and then wait 7 or 8 hours for dinner. I can spread the food out a bit and see if that ends up being something I’m comfortable with. Right now I am watching the clock (1 hour, two minutes until an apple and cashews, LOL) but I am guessing snacks will feel more natural with some practice. A smaller dinner and snack a bit later also will be quite a change for me.

I am happy I finally got around to seeing a dietitian and that I chose one who is such a good fit for me. I feel more confident about what ranges I need to stay in and hope to run into fewer urges to mindlessly eat. Plus, it is great to have someone both knowledgeable and flexible to work with me as I fine-tune my diet. I really appreciate Susan’s positive attitude and encouragement and am relieved that she was not appalled by my diet.

I do believe this is a significant new step in my healthy lifestyle and one that will increase my comfort and ease in maintenance.

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Member Comments About This Blog Post
  • PINKIE78
    Thanks for sharing all of this. Sounds amazing and gives me some helpful things to think about. Best wishes!!
    1986 days ago
    Hi my name is Rossie Istarted sparks but stopped I have trouble with computers. I want to start again in the New Year. You are the first person I have spoken with on a computer. Are you real? I would like to congradulate you. I am impessed about your story. Thank you for giving me something to say when food is given? And all the candy I get at Christmas?
    1988 days ago
    emoticon Thanks for sharing. I would love to work with a dietician. Smart move on your part.
    1988 days ago
    Wow. I think the advice you got was spot on. It sounds like you have a great plan in place. I hope it works out for you and your lifestyle.

    1988 days ago
  • KANOE10
    She sounds like an excellent advisor. Good luck with your new plan. I eat a large breakfast also...and have nuts for a snack in the afternoon. It helps.

    Thanks for sharing all of her tips.

    1993 days ago
    Thank you for sharing. It's interesting to me because I also recently started seeing a dietician, be it for different reasons. It's nice indeed to be able to talk to someone about topics like this.
    1994 days ago
    I've been thinking about seeing an RD and I'm very appreciative of your blog telling about your experience. Best wishes for increasing health!!
    1996 days ago
    Good job! Sounds like a successful meeting and you'll get a good plan together!
    1996 days ago
    Susan sounds like a very caring dietitian with an approach that is professional and friendly at the same time. I like the checking account analogy. I've used a similar one while losing weight. I always thought of meal planning like going shopping with a wallet that has a certain amount of money - mind you, no credit cards allowed!
    I hope her guidance helps you work everything out. Good luck!
    1998 days ago
    So glad to hear she turned out to be a good fit. Sounds like the visit was a real confidence booster. Snacks are very important to me - I eat smaller meals but I have a snack inbetween. The timing on the snacking varies - especially the one between lunch and dinner. I have it when I start getting hungry - if I go too long after I am hungry before I snack, then I tend to eat much more at dinner. Good for you for going to someone.
    1998 days ago
    How awesome for you! I'm so happy this is working out for you. You really found a good fit.
    1998 days ago
    That sounds like a fantastic plan! Good for you for working to develop a manageable maintenance plan with a professional--and one with a sense of humor to boot. I absolutely love her Godzilla reference and will definitely have to steal that.

    Good luck implementing your plan and keep us posted on how everything's going.

    1998 days ago
    Wow Liz, sounds awesome! I'd love to have such a meeting with a dietician to tell me just what to do!!

    I hope it goes really well for you. You are so positive and have such a can-do spirit, and you've been doing so well with your weight loss, I'm sure it will be great!
    1998 days ago
    RDs are a wonderful resource to consult whether you need to make big changes or little ones! I'm glad you spoke to one who works well with you!

    You'll get used to snacking, I promise! Then you'll discover the joys that one teenie little snack can give you!
    1998 days ago
    So glad that you took the step to get the guidance that you felt that you needed!
    Thanks so much for sharing!
    1998 days ago
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