What they don’t tell you about working in weight management

the word 'healthcare' written with scrabble cubes

I remember on my first dietetic placement, one of the ICU dietitians described weight management as ‘touchy feely’ dietetics. And now having worked as a weight management dietitian for 8 months, I can kind of understand what she meant.

Weight management just isn’t as simple as ‘eat less and move more’.

This blog post is a reflection of the lessons I’ve learnt to far in my career as a weight management dietitian in digital lifestyle change programme. I can only speak on what I’ve seen so my experiences may be different to others.

It’s not always nutrition that people struggle with: 

The first thing I learnt is that people generally already know the basics of nutrition and that this isn't what stops them from losing weight. People already know that vegetables are full of nutrients while foods like ice cream aren’t. There are other factors that lead to their eating behaviours. Just having a good nutrition knowledge doesn't lead to change.

A plate of salad with leaves, tomatoes, chickpeas, sweet potato, cabbage and avocado.

Emotional eating:

We may not realise, but emotions play a huge role in how we eat. That chocolate bar to cheer you up after a hard day, that glass of wine to destress after work, those biscuits you nibble on when bored.

The majority of people I come across at work recognise that emotional eating is something they struggle with. A lot of us are used to using food as the only coping mechanism for our emotions, which can contribute to weight gain. Supporting people to come up with other coping mechanisms for their emotions is a big part of my role.

Habitual eating:

Another thing I’ve seen is that people’s eating habits are formed in childhood, and it’s incredibly difficult to break them as an adult. One common experience is being told to finish all the food on your plate as a child. So now as an adult, you always finish your plate, regardless of how full you feel.

We aim to get people to listen to their hunger and fullness cues instead of using an empty plate as a sign of satisfaction. But undoing a lifetime of unconscious habits isn’t easy and takes ongoing effort.

In order to successfully lose weight and maintain that weight loss, people need to change their eating habits which isn’t easy to do.

An empty plate with a frown drawn on it in black marker pen. A fork and knife lie next to the plate.

This leads onto my next point. Changing your eating habits is hard work and some people aren’t prepared to make a change.

People may not be willing to change: 

Some people aren’t prepared to work on changing their lifestyle at this time. And that’s okay. People have to be ready and willing to make a change. They have to be motivated from within themselves and this is something you can’t force.

If people aren't able to make changes, it’s not the right time for them to be embarking on a weight loss journey. I continue to offer support, but also have to accept that they may not take on what I say.  

This is a reality of working in weight management. 

You need to take people’s mindsets away from dieting: 

An image of a brain.

Another large part of weight management is people’s mindsets. My job offers a 12 week programme to help people build healthy habits that they’ll be able to maintain. However, some people join the programme with the mindset of it being a quick diet to lose weight and then continue as they were before.

People don’t realise at first that a quick diet won’t lead to sustainable results. The idea of being ‘on’ or ‘off’ the programme has come up before. With people saying things like they’re going ‘off plan’ at the weekend. Helping people shift from the dieting mentality can be challenging.

We don’t want people to be ‘dieting’ forever, we want them to create healthy habits that will support them to be a healthy weight. As I’ve written before here, diets don’t work but people don’t know this. And it’s not their fault.

This leads me onto my next point. People have to deal with lots of conflicting nutrition information from the media, influencers, other weight loss programmes. This can all lead to confusion and a dieting mindset.

There’s a lot of conflicting nutrition information to deal with: 

There are so many sources of nutrition information out there. Most of them aren’t quite right. Some people join the programme and are on meal replacement shakes or are calorie counting. I’ve also had people relay nutrition advice they got from a family member to me and although the intent was kind, the advice was not.

A lot of people join the programme with pre-existing nutrition beliefs, and it can take them a while to adjust to not demonising food groups or restricting certain foods.

A common one is people trying to avoid fat at any costs. The idea that fat is bad has been drilled into us by the media and other weight loss programmes. Trying to get people to switch to full fat products can take some convincing. The reason we advise people to have full fat products is because fat is satiating and keeps you full for longer. But it can be difficult getting people to trust what we say when they’ve heard conflicting information.

An avocado with a measuring tape wrapped around it

This is all contributes to the dieting mindset that we have to try and help them shift out of. It is nice to empower people to make food choices that they enjoy and let them know that they don’t have to restrict things.

You might get treated like a friend: 

My final point is that some people may treat you as a friend. I don’t mean this in a bad way, it’s great to be friendly with the people you support and build a relationship with them. But sometimes people can tell me things that I’m not qualified to help them with. People can send very emotional messages sharing a lot of information about themselves.

This can then put you in a situation where you feel that it’s outside of your scope to support them properly. It’s important to set clear boundaries and tell people if there’s something you can’t help them with. Doing this can help you to not feel emotional or in a situation where you're out of your depth. We can also signpost them to the appropriate healthcare professional for their needs.

All in all, I really enjoy my role. Although there are some challenges, the ability to support people to make healthier lifestyle choices and have a better relationship with food makes it all worth it!

I hope you enjoyed this blog post! I’d love to hear your thoughts in the comments below.

Bye for now! 👋


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