please help me !! I'm a frustrated dietitian

first of all Hi ! I took a look around here and loved it !
my first langauge is not english so plase excuse me if i make mistakes

I need help and adivse regarding my clients I''m so frustrated with
I'm confident in my knowladge but I dont have enough experience and im young (23 year old) so my clients dont trust me ... also im not very strict and mean when I talk to them im very relaxed and I dont get upset with them when they dont listen (they dont take me seriously)

anyhow I go to the gym 3-4 times per week, and my personal traininer begged me to agree to join the gym and be their dietitian for an intestive 6 weeks program for obese people .... I agreed to work part time (as I already work full time in a hospital)

and now my gym clients are ALL complaining about me to the trainers ... they all say that I give them too much food and that my diet is making them NOT lose weight because they are excerising too much (3 hours daily) and only lose 1-2 kg per week

why is it my fault ? the manger wants me to meet with them and explain it to them

since week one I noticed that they ALL believe in fad diets ... they were SHOCKED that in my diet there were fruits and carbs (whole grain of course) ... their BMI ranges from 30 to 40
and when I did all the calculations for them they should be eating 2000+ calories per day

but I was scared to give them that much so I gave them between 1400 - 1600 (bigger people got more caloreis)

their diets looks something like this

breakfast : 2 slices whole wheat bread + I boiled egg _ I cup skimmed milk + a fruit of their choice (with a list of fruits and calories content so they wont overeat)

snack: rice cake + 1 table spoon peanut butter

lunch : 90g grilled chicken breast with no skin + 1 cup quinoa + salad _ 1 cup skimmed yogurt

snack= fruit or milk preworkout

dinner= same as lucnh or tuna salad

is this TOO MUCH ? I'm so frustrated with them I want to cry .... they have so many wrong information and are so scared to eat they even eat less than I give them ...

please tell me if I did something wrong and how can I convience them that it is not my fault they didnt lose alot of weight in the 6 weeks peroid like they wanted to (they expected to lose all the excess weight or something )

Replies

Mr_Knight

...and only lose 1-2 kg per week

Good grief.

The clients have some seriously misguided expectations, unless those can be changed I think you might be in a no-win situation.

heybales

The only fault was joining a place that requires and/or desires fast results to satisfy client's perception no matter the failure rate later, which can easily be blamed on the customers themselves not adhering well at that point.

And if the trainers are setting unrealistic expectations too as to what should be possible, shifting the blame from the workout to the diet (which it is the diet, correct for the amount of workout just as you are doing).

Why do you think MFP has a confusing profile setup, gives little to no explanation as to the initial settings and what they mean, and explaining what eating back exercise calories means.

They have great opportunity to cause great weight loss, be that fat and/or muscle mass, and hook subscribers, which when things stall or problems arise, already hooked by fast results so they stick around. Advertisers love the big numbers for MFP to make money.

Sounds like you were trying to do it right.

Curious, did you get any kind of chance to get decent estimate of bodyfat %, to start your math with Katch BMR rather than others that might be inflated?

frustrateddietitian

I know ! I regret agreeing to the job with all my heart
they show up very late ... or they dont show up without telling me (wasting my time) and im being paid next to nothing for all the effort I do to them

I'm so doubting myself that I dont trust my judgment anymore ... I dont kow what to do ... should I give them no carbs diet to shut them up ... what are the points that I should cover in the "meeting" they have with me to discuss why they are "not losing weight"

they were happy with the dietitian that had in the program last year because they lost more in the 6 weeks (she was giving them 1 week fruit diet, 1 week vegetables diet,1 week protein diet ...etc) but they all gained the weight back after the 6 weeks eneded but they dont care LOL

padams2359

They want to blame someone for their problem. Tag, your it. Now they are complaining about eating too much? Ashame they didn't feel that way about the 2nd or 3rd Eclair.

OMGeeeHorses

Have them get an HRM or a Body Media armband. In doing this they will see the true calories they are burning and then see why they need to eat more!! Have them research calculators with there weights and heights to show them what they need to really eat to lose weight healthy and happily.

I use to be one of those fad dieters and would FAIL AND FAIL!! but as you can tell with MFP I have had success in burning fat and keeping it off!! I am sorry they are blaming you for the issues happening with them, but I can say I get a little frustrated sometimes when I see people losing 140lbs in 7 months and so forth, because they were my start weight and lost it very quickly!! I feel this is the issue your people are having, they are getting it in there head they need to lose more than the regular 1-2lbs a week and that you are to blame for them not doing that. Keep your head up and know you are doing it right!!

fruttibiscotti

Ok, so basically I am reading that they are demanding that you give them a specific diet....so, why then do they come to you. If they have the plan figured out already, why aren't they doing it on their own? Did you ask them that?

heybales

Can you start out with getting real - questions on how many times have they dieted in the past just to fail - make them squirm?
Ask if they'd like to keep yo-yo dieting their life away, having a bad relationship with food the entire time?
Would they like a diet that makes them want to cheat?
Would they like a diet that could seriously impact their metabolism for years to come, and fail like last year?
Would they like a diet that causes them to not benefit from all the exercise they are doing and really get great body improvements?
Ask if they'd like to lose weight but still appear fat, or lose fat and look great even if weight hasn't dropped that much that fast.

Then time to educate, use even the sad hand-held bodyfat analyzer to log things, unless trainer already has done that. Get measurements if trainer hasn't.
Educate on what the trainer probably hasn't correctly.

TarynAngeline

Ok, so basically I am reading that they are demanding that you give them a specific diet....so, why then do they come to you. If they have the plan figured out already, why aren't they doing it on their own? Did you ask them that?

Great point.

cafeaulait7

Maybe explain the need to keep muscle as you lose weight. That takes protein and (some) carbs and not too huge a deficit. They will be much happier later when that muscle burns more calories for them than the fat would have.

For the fruit and whole grains, maybe pull out the Glycemic Index, too. If what they are eating is low on that scale, it's fine even for people with blood sugar issues (depending on the person, naturally). It's the 'fast' carbs that can suck.

You need to call yours something faddish like the Low Glycemic, Muscle-Retaining, Weight Loss Miracle Diet

claire671

My husband is a personal trainer and recently took a nurition course. It's his biggest problem that when he asks about their nutrition clients immediately get defensive and expect to be put on some silly diet. My husband uses me as an example all the time as how you can EAT and still lose weight. Half his clients still don't believe him!!! I think because we have been so conditioned into thinking it takes drastic measures to drop weight when someone comes along and says eat a bit less, move a bit more it's like "What is this nonsense??!!"

Best of luck with it all, keep calm and carry on as they say.

geekyjock76

Make the conversation about unrealistic fat loss expectations and the high rate of obesity relapse in fad diets. Explain to them that the amount of fat mass they can oxidize in a 24 hour period depends on how much total fat they have. Losing 1 to 2 kg per week is pretty much ideal for anyone with 36 + kg to lose. If these people have a history of yo-yo dieting, they should realize following the same approach will just get them back to their heaviest weight again. The more times they lose weight by this method, and regain the weight, it becomes more and more difficult since they're consistently reducing lean mass and RMR with each yo-yo diet. Thus, maintaining goal weight is more challenging since they have to eat less and less.

ereck44

You could be my dietitian anytime!

Those clients believe in the lies that are in magazines that weight loss is fast and effortless. It's unfortunate because the advice you are giving is the correct one. I have got to believe that you have one or two clients that are listening to you.

Good luck!

frustrateddietitian

thank you all so much !!! you all make EXCELLENT POINTS and made me feel alittle better
I have one lady who is the "leader of the gang" she always make rude comments toward me regarding how she is so full from my diet that she will suffocate LOL I swear that I gave her the diet mentioned in my first post ...
they demand alot of things they want me to "change the diet" every week ... in my knowladge it is not needed to change the meal plan (reduce it more) every week ,,, I already explained about the exchange list and how they can have whatever they want (healthy of course) withn the calories limit ... i gave them smoothies recipes .... amd how they can have meat/chicken/fish/beans but to stick with the amount (I did a list with the caloreis from almost all the food that are common) and the serving size

i have a group of ladies who follow my diet "without the carbs"

nutmegoreo

In my opinion, if you are not making much, and you don't need the income... quit the job. You sound way to stressed for what you are getting out of it, plus you said you are starting to doubt your own knowledge. Of course, I am old, jaded, and don't put up with crap as much as I used to. Just my thoughts here.

geekyjock76

Your clients are like 99% of the MFP population here, unfortunately.

heybales

Just thought of an additional point to get the trainers on your side, concerning their money.

How many of these clients that fail, or don't see great results from the exercise, stick with the trainer the whole year?

If they gained the weight back, I'm guessing they didn't keep working out either.

Would the trainer rather keep these people on a consistent basis, or have them drop off for months at a time before coming back for another year.
Constant income, or out of balance?

And how well would the people stick with the trainer if they were getting real results from the workouts, while eating with reasonable deficit, compared to a massive deficit.

I doubt greatly they get as much out of the exercise, at the level you describe, by undereating like they'd like to.

padams2359

I have known a few people that have been placed on the Diabetes Diet. Almost all of them had a hard time with the diet at first. Not because of what they were eating, but how much. They were eating much more on the diet than they were eating before they started. It was just different things in different amounts. Once the pounds started coming off, they got the point.

The people you are dealing with are planning to fail. They are looking for the reason when it happens. You can control their reactions about as much as you can control what they are eating when you are not around. Stop falling into their trap. You were sent an invite to their "Pity Party". Don't RSVP! Tell them you gave them the tools to lose weight, they are choosing not to follow them. Tell them to enjoy their obesity. I have total sympathy for people that are trying, and struggling. I have no sympathy for people like you describe. They need to get to the root of their problem, and it isn't food!

adorable_aly

I don't get why you are still at this job?

pinktac0

just tell them they have a homework assignment....send them over here to MFP and let them read all the success stories with A LOT of people who dont blame anyone, dont make excuses, and follow a healthy long term plan with pretty jaw dropping results. Bet you they show up a lot quieter next time they see you. So many people on here are amazing but VERY straightforward which I love and why i stayed

judychicken

Bump

WalkingAlong

I'm not going to touch the calorie debate but that menu looks seriously repetitive and dull. I don't know how anyone could eat that for 6 weeks and work out 3 hours a day without burning out an about day 4 and deciding weight loss isn't worth it.

QuietBloom

There is SO much misinformation out there, that you are swimming upstream when you try to talk sense. People want the ONE magic thing that will MAKE them lose weight. Eating sensibly and working out? BORING! Instant gratification is a huge problem in this day and age IMO.

I liked the idea of explaining to them the importance of sparing LBM. Good luck. :flowerforyou:

Stage14

Am I the only one who thinks a dietician who calculates that someone should be eating 2000 calories to lose weight, then tells them to eat 1400 because she's "scared" to challenge the client's ideas is a bad dietician?

_Zardoz_

Am I the only one who thinks a dietician who calculates that someone should be eating 2000 calories to lose weight, then tells them to eat 1400 because she's "scared" to challenge the client's ideas is a bad dietician?

No just a dietitian lacking in confidence in their abilities. Though I do agree that the menu looks dull and most people would dump it after a few days

Topsking2010

Am I the only one who thinks a dietician who calculates that someone should be eating 2000 calories to lose weight, then tells them to eat 1400 because she's "scared" to challenge the client's ideas is a bad dietician?

No just a dietitian lacking in confidence in their abilities. Though I do agree that the menu looks dull and most people would dump it after a few days

No way I would eat that menu for 6 weeks!!! Asking someone to change their habits overnight probably won't work. Take one step at a time to build someone confidence.

CyberEd312

Am I the only one who thinks a dietician who calculates that someone should be eating 2000 calories to lose weight, then tells them to eat 1400 because she's "scared" to challenge the client's ideas is a bad dietician?

No just a dietitian lacking in confidence in their abilities. Though I do agree that the menu looks dull and most people would dump it after a few days

Agreed I would dump that meal plan on day 2...... OP this is tough love, but you went to school and should know the how too... and I think you need to implement your plan and stand your ground, if they are seeing results at the pace you deem fit than tell the gym they can either let you do your job or find someone else....... A little tough love and accountability on your clients behalf also needs to be set up... Realistic expectations and a solid plan is what they need and someone to implement it and stand by it... Is that you??? Best of Luck

BrainyBurro

give them 3 numbers and insist that they meet those numbers every day.

1) calorie goal
2) protein goal
3) fats goal

then tell them you don't care what foods they eat to meet those numbers. it's up to them.

they'll learn quickly that their fad diets are bull*bleep* because they will have trouble hitting those numbers with restrictive diets.

then tell them if they are having problems meeting those numbers, you'll happily help tailor a meal plan for them - BUT ONLY IF THE WILL TRUST YOU AND FOLLOW IT for a predetermined amount of time.

if they choose to ignore your advice, don't feel bad. they are not yet ready to embrace the truth. let them struggle for a couple more years because of their pride and stubbornness. use this as a learning experience to figure out what works and what doesn't when dealing with difficult clients.

you could also find and print out materials on IIFYM (if it fits your macros) in your native language and pass them out for them to read. perhaps you can make each of them a binder and continue to print out real scientific articles and summaries explaining the falsehoods in various fad diets and the necessity of of getting proper amounts of macro- and micro-nutrients.

just remember, you can lead a horse to water but you can't make him drink. (an English language idiom).

drshona

Lots of good points so far - they're expecting results too quickly, but also if they're expected to eat the same things every day it's pretty boring (although you did say they could 'exchange' things)

One further thought, is that 6 weeks just isn't enough time. If they're obese, they've at least 3 stone to lose at a rough guess. Possibly much more. So, in 6 weeks, they just aren't going to lose enough weight to really feel like they're getting anywhere.

What about fortnightly meetings, so it covers 12 weeks? Or weekly for 4 weeks, then fortnightly for 4 weeks, then monthly for 2 months, so in 8 sessions you're covering 4 months?

Mr_Excitement

They've got unrealistic expectations if they think 2-4 lbs./week is too slow. Probably been watching too much of The Biggest Loser.

If I were you, I'd tell them to eat the 2000 calories I prescribed or piss off.

TheRealParisLove

I know ! I regret agreeing to the job with all my heart
they show up very late ... or they dont show up without telling me (wasting my time) and im being paid next to nothing for all the effort I do to them

Are you an employee or are you self employed?

It sounds like you are self employed from you description above. If this is the case, you need to make some changes in your daily work habits. For instance, confirm all appointments 24 hours in advance via phone, text or email (whichever the client is most likely to respond to). You should also take a deposit or have the client pay for their consultation in advance. You have reserved time for that person, meaning your time is not available to see anyone else at that time. If he/she stands you up, they still need to pay you for your time.

If you are an employee and earn a salary, being stood up wouldn't effect your income. I hope things get better and you find clients who are interested in the advice you have to offer.