Am I expecting too much from dietitian?

Huh does she actually give you meal plans or meal ideas? Does she talk about food ideas at all?

I saw a dietitian 17 years ago (once a week)... In those 30 minutes, he weighed me, then gave me a meal plan. He didn't care about what I was eating, he told me what I should eat (probably why it didn't stick because it was WAY too restrictive for me, although he did add extra stuff I could eat regularly, but still). My mom's boyfriend is seeing one too and it's the same thing... telling him what he can eat and when.

Let's just say that I lost 30 pounds at the time with that dietitian, and gained it all back within 6 months once I started working and couldn't follow that plan anymore.. and I've been on MFP for 3 years, reached pretty much the same weight (ok, I'm 6 pounds heavier, but I have more muscle and I'm quite older, so whatever), and been maintaining that for 2 years.

IMO... save your money. You don't need a nutritionist. Focus on protein, good fats, get your servings of fruit and veggies, have whole grains if you like them, and use up whatever's left on whatever you like. Done.

Forgive me for the long rant, but here are some of my experiences regarding seeing a professional about weight loss.

When I was 18 and just starting to gain weight,I saw a nutritionist at my doctor's office. She basically went on a fifteen minute lecture about herself and the choices she's made about food and how I should adopt them.

The crux of her advice? - never, ever eat butter. Ever. Even on special occasions. Replace it with olive oil (which I now know has more calories). Also don't put cheese on your sandwiches. I remember telling her that I don't eat sandwiches too often anyway and that even then I don't add cheese because I didn't like the cheese offerings at the college dining hall, and she just shrugged and said "good." And that's it. That's the only advice she had.

Three years ago, I was really struggling with my weight and just couldn't figure out how to make it happen consistently over a long period of time. I had been logging my food, but not consistently. And I wasn't calorie counting - just making sure to be aware and have a record of the food I ate. I set up an appointment with a doctor at the Northwestern Comprehensive Center on Obesity. I was so convinced there was something medically wrong with me. I felt like I should be overweight given my lifestyle and diet, but I didn't think I should be *this* overweight. I felt like I lived the lifestyle of someone who should be 30 or 40 pounds overweight - not 70 pounds overweight. The doctor I saw was in high demand, and I was put on a wait list to see him.

The center has won all sorts of awards, and has all sorts of people who work in the field of obesity prevention and treatment. And my appointment was literally the biggest waste of time ever. In fact, someone at the center was in training and sat in on the appointment just to learn from my doctor and listen to our consultation. She only spoke up twice during the meeting, but I think she would have been ten times better than the doctor who specialized in obesity. I remember him asking me what I had eaten in the past 24 hours, and I froze - I could not remember. I could remember breakfast, but I couldn't remember the day before. And I remember him making a big deal out of the fact that I couldn't relate that info on command - saying he hopes that now I see the pattern in eating with awareness. He was very dismissive of everything I said and asked, and agreed to run some tests, since that was what I came there for. The office was supposed to call me with the results of the tests, but they never did. When I called in and asked, they said they didn't have records of any tests, despite the fact that they drew blood and collected a urine sample. Yeesh.

I'm sure that center had the resources to help me in some way or another, but I wasn't able to access them. The doctor I saw didn't really give me the sort of information I needed to make a big change, and the fact that they just blew off the tests I took and didn't even bother with follow up or any sort of program or advice really made me feel like they didn't give a *kitten*. I'm sure now that I didn't have anything medically wrong with me. But they should have confirmed that.

That said, my regular doctor had a conversation with me that made me realize how important calorie counting was. A few years ago I didn't have medical insurance, so I saw a doctor occasionally who charged on a sliding scale and mostly catered toward more impoverished immigrant communities. Later on, I got really great health insurance, but didn't find any doctor at the nice offices or hospitals that I liked as much as that first doctor. So I went back to her, and she was the type who actually made time for patients and was willing to have detailed conversations with them about their lifestyle. Sometimes if she didn't have another patient after me we'd just chitchat. I talked about my struggles, and she talked me through my weight gain, when I had gained weight, when it got better, how long it took, what was going on in my life at the time, etc.

Finally, she said "ok, so for the past 12 years you've managed, on average, to eat 56 more calories per day than your body needs for maintenance.

I looked at her like she was crazy. And then she did the math for me. 70 pounds over 12 years. 245,000 calories. 20, 416 calories per year. 56 calories per day. Yes, there were times I ate way more than an excess of 56 calories per day. 200 or 300. But it was averaged out by the days I ate healthy or ate less or exercised a lot.

And that's when it really was clear to me why despite the fact that I ate healthier food and exercised more than most people who were healthier than me, I had somehow gotten into this mess. It was the first time I realized that I was aggressively attacking a problem that could be approached with more gentleness and moderation, and that attacking the problem with tons of exercise and severe food restriction was setting me up for failure. I also saw how the weight just eased up on me despite my healthy food choices.

Anyway, my point being that there are a lot of really good professionals. And a lot of *kitten* ones. And really you won't find the good ones in the places you expect them to be. I think the medical field in general, historically, is about diagnosing and treating disease. In recent years the development of preventative medicine is catching on but I still think it's sort of a side note - overall doctors really aren't trained in obesity treatment or prevention or even nutrition. They can be knowledgeable about it - but they are not specially trained in like they are trained for the treatment of disease.

I guess I am a special snowflake but I learnt a lot from my Rd but I was seeing her for Crohn's not weight loss

She sounds like a very un-professional health professional.
Is there anyone else in your organisation you could see, or can you get a referral to someone else?