What do you think about dietitians VS doctors?

[drmerbear]

I've been seeing a dietitian for a while now as part of some personal health tx. Some of the dietary recommendations that I am given just seem questionable/lack validity and do not feel scientifically convincing. I don't think she articulates herself in a very savvy way, and I get the feel that she talks down on me in a negative tone... maybe because she knows that I'm going into medicine.

Anyway, I was wondering what general views people have on dietitians... like what do people think of them? I couldn't seem to find anything on sdn. Would you take nutrition advice from a dietitian or a medical doctor? I am simply curious what people think. My experience with a dietitian just makes me cringe...

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[WedgeDawg]

You are on a premed forum - what kind of answers do you expect you'll hear?

 

[drmerbear]

Haha, I'm probably hoping to have my own views reinforced so I feel better about myself...

Fine, maybe what I was asking is do doctors or dietitians know more nutrition? Hoping for objective view points on this?

 

[WedgeDawg]

Haha, I'm probably hoping to have my own views reinforced so I feel better about myself...

Fine, maybe what I was asking is do doctors or dietitians know more nutrition? Hoping for objective view points on this?

In all seriousness, I would honestly say most likely the dietitian, considering that's the main selling point of their profession. I wasn't under the impression that physicians received extensive training in nutrition, but I could very well be wrong.

 

[genericpremedstudent]

i would take nutritional advice from a nutritionist over a doctor. you are comparing apples to oranges.

 

[allantois]

Being a physician does not make one an expert on all aspects of well-being and healthy living. Just like you wouldn't go to an ophtalomologist to get your glasses fitted, or a psychiatrist would probably not be a psychotherapist of first choice similarly someone who does nutrition for a living and has qualifications in it should be able to assist you better over someone who just doesn't do it full-time.

If you are not happy with your provider (be it a physician/nutritionist/whatever else), you should seek services from a different person.

 

[drmerbear]

In all seriousness, I would honestly say most likely the dietitian, considering that's the main selling point of their profession. I wasn't under the impression that physicians received extensive training in nutrition, but I could very well be wrong.

Yeah, that's what I was wondering. Our curriculum includes a semester of nutrition, but I'm not sure how extensive that compares to the training that dietitians go through. It's pretty clear that diet can have significant health implications. But I imagine that a doctor's additional extensive training in other areas can offer a greater degree of dietary recommendations that a dietitian does not have the capacity to formulate.

 

[drmerbear]

i would take nutritional advice from a nutritionist over a doctor. you are comparing apples to oranges.

That's a good way to think of it. I suppose it's like a specialty in its own sense.

Being a physician does not make one an expert on all aspects of well-being and healthy living. Just like you wouldn't go to an ophtalomologist to get your glasses fitted, or a psychiatrist would probably not be a psychotherapist of choice similarly someone who does nutrition for a living and has qualifications in it should be able to help you with your dietary needs.

If you are not happy with your provider (be it a physician/nutritionist/whatever else), you should seek services from someone else.

This makes sense. I appreciate your insight. I think I just had a bad experience. Just like doctors, there are good dietitians and bad ones. I should be a little less salty about my experience.


EDIT: Then why not a new speciality in nutrition where doctors go through MD training but then specialize in dietary recommendations/nutrition? This seems like it could do more than just a dietitian without medical training? Then it would be like the differences between a psychologist and a psychiatrist.

 

[iluvbeingpremed]

Just out of personal experience, I saw a dietician while I was recovering from an eating disorder and I really think she was an integral part of my recovery. She worked in the same office as the adolescent medicine MD I saw, so I would see the dietician after every appointment. I mean n=1, but I thought she was very knowledgeable and helpful, and had the time to sit down and talk with me which I wouldn't have gotten with the doctor.

 

[genericpremedstudent]

Yeah, now if it was an ND offering nutritional advice to cure metastatic cancer, I would be much more weary. But in terms of dietary advice, the nutritionist will be the more qualified person on the subject. There definitely are nutritionist who are inept just as there are people in any field who are inept. I've also known RD's who are morbidly obese lol.

 

[allantois]

I should add that if you have some complicated medical condition (a food allergy or whatnot), then absolutely you should seek a piece of mind from a medical specialist. In my view, physicians take care of extreme cases whereas a nutritionist could be a go-to person for something common like weight loss or brining your sugar/cholesterol down.

 

[genericpremedstudent]

EDIT: Then why not a new speciality in nutrition where doctors go through MD training but then specialize in dietary recommendations/nutrition? This seems like it could do more than just a dietitian without medical training? Then it would be like the differences between a psychologist and a psychiatrist.

i think they call those naturopaths lol.

 

[DubVille]

Most dietitians have legit knowledge and require formal licensure. "Nutritionists" on the other hand can get their "title" after doing online classes. I'd say the great majority of dietitians know more than almost all docs. They complement the team. I do agree nutritional science is still pending in many regards, but I don't have time, or want to extensively talk to patients about reading nutrition labels, protein/carb/fat ratios, good vs bad fats, and daily total calorie needs.......and then for them to ignore me and disagree that drinking sweet tea and Gatorade instead of water isn't affecting their waistline.

 

[drmerbear]

Just out of personal experience, I saw a dietician while I was recovering from an eating disorder and I really think she was an integral part of my recovery. She worked in the same office as the adolescent medicine MD I saw, so I would see the dietician after every appointment. I mean n=1, but I thought she was very knowledgeable and helpful, and had the time to sit down and talk with me which I wouldn't have gotten with the doctor.

I'm actually seeing the dietitian for that reason. I'm glad she was helpful in your recovery! I think I just don't have a good match with my dietitian lol. I literally walk out of her office feeling like all my symptoms are my fault. Needless to say, she is not very compassionate haha.

I should add that if you have some complicated medical condition (a food allergy or whatnot), then absolutely you should seek a piece of mind from a medical specialist. In my view, physicians take care of extreme cases whereas a nutritionist could be a go-to person for something common like weight loss or brining your sugar/cholesterol down.

This is a very good point!

i think they call those naturopaths lol.

Haha good one

 

[drmerbear]

Most dietitians have legit knowledge and require formal licensure. "Nutritionists" on the other hand can get their "title" after doing online classes. I'd say the great majority of dietitians know more than almost all docs. They complement the team. I do agree nutritional science is still pending in many regards, but I don't have time, or want to extensively talk to patients about reading nutrition labels, protein/carb/fat ratios, good vs bad fats, and daily total calorie needs.......and then for them to ignore me and disagree that drinking sweet tea and Gatorade instead of water isn't affecting their waistline.

I lump dietitians/nutritionists together by mistake, so maybe that's why I had a doubtful mindset when I met with one. And yes, that's true. I guess you can have someone else take care of the rest just like nurses and bed side care.

 

[nRomaleos]

From my experience, my physicians have not been well-versed in diet/nutrition

Many dietitians have gone through some rigorous clinical rotations. Personally met one who was an integral part of helping cancer patients with diet. Gotta lud that teamwork.

 

[Banco]

Nutrition advice often seems like it is shady because honestly we don't really know enough about nutritional science to make definitive claims; there is still a lot left to study. I would probably trust a dietician on those matters more than a doctor, unless the doctor has some kind of specific training in it.

 

[CaliforniaDreamer]

i think they call those naturopaths lol.

Actually called integrative medicine. I am sure their are various degrees and flavors of it, but the doc that I have worked with seems very effective with his patients. A huge focus is placed on nutrition.

 

[NickNaylor]

You learn very, very little actual nutrition in medical school apart from the metabolic pathways macronutrients, vitamins, etc. participate in. So if for whatever reason I have a condition that requires extensive modification of my eating regimen, I would see a doctor for my medical care but a dietician for diet suggestions.

They are two fields with different foci.

 

[genericpremedstudent]

Actually called integrative medicine. I am sure their are various degrees and flavors of it, but the doc that I have worked with seems very effective with his patients. A huge focus is placed on nutrition.

That was a joke. Hence the "lol"

 

[ChrisMack390]

Its a bit specialized, but the nutrition consult can be one of the most important parts of an oncology service!

 

[jesssal17]

Yeah, that's what I was wondering. Our curriculum includes a semester of nutrition, but I'm not sure how extensive that compares to the training that dietitians go through. It's pretty clear that diet can have significant health implications. But I imagine that a doctor's additional extensive training in other areas can offer a greater degree of dietary recommendations that a dietitian does not have the capacity to formulate.

I apologize for this being years late....i was a nutrition major in a dietetics program and we not only get 2 semester of nutrition but 2 semesters of advanced nutrition(advanced nutrition and human metabolism-Gropper & smith txtbook-biochemstry of nutritions and effects of body, esp learn the gi system), 2 semesters of medical nutritino therapy(krause nutrition care process txtbook, where we earn different diets for diferent conditions, learn charting, lab values, physical nutritional findings, TPN and EN calculations, nutritent- medication interaction), apart from the standard a&P courses, we also go through the sociology and psychology part of nutrition(2 semesters of community nutrition, and 1 semester of nutrition counseling and education) such as why people buy certain foods, eg, money, culture, religion, knowledge, availability, income, tradition, past events, emotional cues on community nutritinon, we also learn about nutrition policies and how to write grants for research /community projects. 8-10 semesters of food courses such as food management, production and processing(USDA stuff) experimental foods , where we get to experiment with foods to try to make healthier versions of it and uses of common ingredients.in some schools, 1 semester of sports nutrition is also taught.. by the time we are done with a bachelors, we have a pretty good idea of the GI system.hope this helps

 

[857770]

Hands down a dietician has much more knowledge in this area. They also have a medical/science background, but it is not as strong as a physician's background. Their science courses are taken with the science majors.

 

[Eagleye2]

I would definetly say dietician. However, as someone attending medical school next year who is passionate about nutrition I definetly see it as my responsibility to emphasize to patients the importance of nutrition and exercise. I hope the next generation of doctor will get more education regarding nutrition

 

[500miles]

Honestly, many physicians in my experience sorely lack knowledge in areas such as diet. But this comes back to many people contacting the medical field when they have a problem, not before. That being said, dieticuans can also be highly trained in areas such as palliative/hospice when patients have complicated nutritional needs. It's all apart of the increasingly interdisciplinary nature of healthcare, I wouldn't call it a bad thing.

 

[ciestar]

On my IM rotation, we consulted Dietary a LOT. We had one course in nutrition first year and that was it.

 

[The Knife & Gun Club]

I've been seeing a dietitian for a while now as part of some personal health tx. Some of the dietary recommendations that I am given just seem questionable/lack validity and do not feel scientifically convincing. I don't think she articulates herself in a very savvy way, and I get the feel that she talks down on me in a negative tone... maybe because she knows that I'm going into medicine.

Anyway, I was wondering what general views people have on dietitians... like what do people think of them? I couldn't seem to find anything on sdn. Would you take nutrition advice from a dietitian or a medical doctor? I am simply curious what people think. My experience with a dietitian just makes me cringe...

Personally, I LOVE the dieticians. In the hospital they’re invaluable both for critical nurition (feeding tubes, surgical recovery & optimization, etc) and general education (“please please please eat more plants”). You’d be amazed how many lay people have 0 understanding of how diet affects health.

I remember trying to explain the ketogenic diet to a low SES mom who’s kid had epilepsy. It was like pulling teeth. Trying to explain to someone what a carb is and what they needed to avoid eating was near impossible. Our dietician spent hours helping them understand what goes into food and what is/is not healthy. That dietician was a saint and changed that family’s life.

That said yes there are some that are downright useless as well. I had a dietician tell me I could cure my Ulcerative colitis by eating less spicy food because that was a cause of liver inflation....which is just profoundly wrong on every possible level. As with many things in medicine there are good providers and bad ones. Sounds like you had one of the bad ones, as I did. Just keep an open mind as you go forward in your studies

 

[curbsideconsult]

I had a dietician tell me I could cure my Ulcerative colitis by eating less spicy food because that was a cause of liver inflation

Clearly they were wrong. The real cure is apple cider vinegar. For everything. Everyone knows that.

 

[NicMouse64]

The know more about nutrition than doctors but less than doctors in everything else.

/end thread.

 

[RNtoMD87]

I haven't been impressed with most dieticians that I've dealt with. I feel that dietary science is very wishy washy and very surface level. "Fat is bad, eat sugar. Sugar doesn't make you fat" "Eat tons of fat, avoid sugar. Sugar is evil". I have a better idea- eat natural food, free of preservatives, dyes, and other crap, and barring some health condition or extreme circumstance, the body will tell you what it needs. I am a power lifter and never understood why people stress over "Is it 1.5g protein/pound of bodyweight or LEAN bodyweight?! Exactly how much protein do I need?!" Your body will tell you what it needs. When I need more protein, I crave meat. I eat what I feel like eating. It works.

People need to put in the effort to understand their bodies instead of depending on others to do it for them.

As a celiac sufferer, no matter how hard I trained in the gym, watched what I ate, etc I only lost weight temporarily, and gained even more. I was ALWAYS starving. When I tried to eat less, I just got hungrier. As soon as I corrected this problem by avoiding gluten, and avoided artificial food, I lost weight, and it stayed off. Why? I didn't feel like I was starving myself. My body wanted less food. Self control is great, but it will never win against hormones.


I had a dietician actually teach a patient that its about "Calories in calories out" as if the human body is that simple, and weight is not regulated by many hormonal checks and balances.

In contrast, Jason Fung MD has some very insightful youtube videos on managing diabetes, fasting, etc. I am a religious viewer to his videos. Agree 100%.

/endrant