What If Meeting With A Dietitian Felt Safe?

People hear “dietitian” and picture rules, judgment, and a perfect plate. We want to replace that stereotype with something more honest: nutrition counseling that feels human, collaborative, and actually useful. We’re joined by Mia Bailey, RD, who works with eating disorders and body image using a HAES aligned, weight-inclusive, evidence-based approach. Together, we unpack why some clients have real “horror story” experiences with nutrition care and what it looks like to try again without forcing instant trust. Mia shares how she starts by asking what didn’t work before, explains her philosophy clearly, and lets the relationship build through actions rather than pressure. If you’ve ever felt nervous to be honest about what you eat, this conversation names that vulnerability and makes space for it. We also get practical about what dietitians really do. Yes, we talk meal timing, planning, groceries, and real life situations like holidays or big transitions. But we also talk about the deeper work: food neutrality, body image, triggers, societal pressure, and why recommendations are not the same thing as judgment. We dig into a common turning point in eating disorder recovery, when someone says, “I don’t think I need a dietitian anymore,” and how to tell the difference between true readiness and eating disorder avoidance. If you’re considering nutrition counseling, we break down what a first session typically includes and the question we love asking: where do you want your relationship with food to be in six months? Listen, then subscribe, share with someone who needs a steadier relationship with food, and leave a rating or review so more people can find the support they deserve.

Show notes:

Trigger warning: this show is not medical, nutrition, or mental health treatment and is not a replacement for meeting with a Registered Dietitian, Licensed Mental Health Provider, or any other medical provider. You can find resources for how to find a provider, as well as crisis resources, in the show notes. Listener discretion is advised.

Resource links:

Hilltop Behavioral Health: https://hilltopbehavioralhealth.com/ 

Alliance for Eating Disorders: https://www.allianceforeatingdisorders.com/ 

ANAD: https://anad.org/

NEDA: https://www.nationaleatingdisorders.org/

NAMI: https://nami.org/home

Action Alliance: https://theactionalliance.org/

NIH: https://www.nimh.nih.gov/

How to find a provider: 

https://map.nationaleatingdisorders.org/

https://www.psychologytoday.com/us

https://www.healthprofs.com/us/nutritionists-dietitians?tr=Hdr_Brand

Suicide & crisis awareness hotline: call 988 (available 24/7)

Eating Disorder hotline: call or text 800-931-2237 (Phone line is available Monday-Thursday 11 am-9 pm ET and Friday 11 am-5 pm ET; text line is available Monday-Thursday 3-6 pm ET and Friday 1-5 pm ET)

If you are experiencing a psychiatric or medical emergency, please call 911 or go to your nearest emergency room.

Transcript

Welcome, Sponsor, And Trigger Warning

SPEAKER_01 0:00

Join us as we redefine, reclaim, and restore the true meaning of health.

SPEAKER_03 0:04

Let's dive into the tough conversations about mental health, nutrition, eating disorders, diet culture, and body image. This is Nourish and Empower. This episode is brought to you by Hilltop Behavioral Health, specializing in eating disorder treatment. Hilltop offers integrated therapy and nutrition care in one compassionate setting.

SPEAKER_01 0:38

Visit www.hilltopbehavioralhealth.com because healing happens here.

SPEAKER_03 0:45

Hello, everyone, and welcome to this week's episode of the Neuros Nourish and Empower Podcast. Hello. Today we have Mia Bailey, a dear friend and colleague. She is a registered dietitian with extensive experience supporting individuals navigating eating disorders and body image concerns across both clinical and outpatient settings. Her approach is relaxed, collaborative, and direct with a strong emphasis on building a trusting, authentic relationship with each client. Mia works alongside individuals to explore their relationship with food and their bodies in a way that feels supportive, practical, and sustainable. Mia holds a bachelor's degree in dietetics and food science from the University of Vermont and a master's degree in nutrition and health promotion with a concentration in sports nutrition from Simons University. Her work is grounded in a Hayes approach, emphasizing weight-inclusive, compassionate, and evidence-based care. She believes that nutrition and health are deeply influenced by social, cultural, and environmental factors, and she integrates this perspective into all aspects of her practice. Trigger warning for today. We are identifying the following triggers that will be discussed, but are not limited to eating disorders, body image, and mental health. Listener discretion is advised. This show is not medical nutrition or mental health treatment and is not a replacement for meeting with a registered dietitian, licensed mental health provider, or any other medical provider. You can find resources for how to find a provider as well as crisis resources in the show

Why Dietitians Get A Bad Rap

SPEAKER_03 2:23

notes. Wow, today is just a day for chatting. Let me tell you. Oh, thank you so much. Thank you. Thank you. Thank you. Mamia, thanks for coming.

SPEAKER_00 2:55

Thank you. I'm excited. I'm nervous, like I said, but I'm excited. Stoked to have you.

SPEAKER_01 3:02

Yes. I feel like too, number one, your bio is great. There's so many good descriptor words in there. And I feel like that is going to come into this conversation so much because even like words like relaxed and collaborative or practical, sustainable, I feel like people don't always know what dietitians do or what meeting with a dietitian looks like. And so I feel like even kind of looking at some of those words in your bio, like that makes a lot of sense to us. But I feel like for other people, they might be like, what does that even mean? So I'm glad we're gonna go through all of it today.

SPEAKER_00 3:42

Yes. Yeah. I try to be as descriptive as possible. It's not easy to explain, but I hope that clients read it and get at least somewhat of a sense of what it could feel like, which hopefully is like inviting and all of the things I described.

SPEAKER_03 4:00

And I can concur that you are all the things that you say that you are, because I know we work together and we've done sessions together, so I know that they are true. Thank you. Always no, thank you, because right, the whole point of today's conversation is discussing what it's like to work with a dietitian because a lot of dietitians can get a very bad rap, and it's not fair to you guys, it makes me so sad because you guys agree. But it is uh there's uh reason for some things that I've heard from clients as to why certain dietitians get the rap that they do. But not all dietitians deserve to be like encompassed in one negative experience that some that you know people have. So I love that you get to debunk some of the things that people might perceive or assume about dietitians today.

SPEAKER_00 4:53

I know I'm excited. I do feel like we sometimes get a bad rep. And sometimes it's justified. I hear some things from clients and I'm shocked and disappointed for them. And so it's nice to be hopefully the person that kind of turns it around for them a little bit.

SPEAKER_03 5:11

Yeah.

SPEAKER_00 5:12

Yeah. I've heard horror stories.

SPEAKER_01 5:15

Can I ask you more about that? Yeah. Okay. So,

Rebuilding Trust After Past Harm

SPEAKER_01 5:19

because I think this is a really good topic that if somebody has had a not so great experience with a dietitian in the past, whether it was far in the past or recent in the past, like what advice would you give to them about kind of giving nutrition counseling another try? And like, how do you kind of approach that with clients? Would you say?

SPEAKER_00 5:41

Yeah, good question. I usually start by asking them like what they didn't like about the sessions. I think sometimes clients are a little apprehensive to share the details of the work that was done. And while I respect that, I think it's better to name it so that I know what they don't like and like what didn't drive with them. So I usually ask clients to explain, just give me more detail, and then I will explain my philosophy, which is usually very different than their experience with the previous dietitian. And usually that like eases some concerns. I also try to tell clients, you know, you don't have to believe or trust me right away on any therapeutic relationship that takes time to grow. And I don't expect clients right off the cuff to just trust me. And so I usually try to tell them that and I just share like hopefully that trust will grow and develop. And if it doesn't, that's okay too. But I try to encourage them to keep an open mind and see where it takes us. And then they can always be open if they feel like it's not progressing or the trust isn't building. But I am, I try to be more of a like, let me just show you, let my actions speak for me, rather than me just sitting here trying to convince you that you should trust me. Does that answer the question?

SPEAKER_01 7:07

Yeah, yeah. And I love that you said something, use the words the work didn't align. And I think that's so important, like focusing on the work and not just the person. Because I think sometimes I've also asked that question of like, you know, have you ever met with a dietitian before? Like, what's been your experience? What's been helpful, not so helpful? And I think people hesitate because they think then like we're asking for a critique of that person or like a review of that person. And that's not what I'm going for. It's more of like, hey, what were the approaches or the style that I aligned with? What did I feel like wasn't as supportive for like me and my health? And that's really like the information that we're trying to get because that then, you know, can give us a lot of kind of guiding factors leading into our work together. Cause just like the client isn't going to trust you from just one session or one time of meeting, like they're also a stranger to us at this point still. Right. We may have spent only one hour with that person or less than an hour with that person. So they don't trust us yet. And like we don't know them super well yet, too. So any of that information just helps build the relationship so much more quickly.

SPEAKER_03 8:15

Yeah. Yeah. When clients hear you say, you don't have to trust me. What's typically their reaction? Because I know, like as a therapist, and I'm like, you don't have to trust me right now. Like, we'll build that relationship. They look at me like I'm crazy. So I'm curious from like a dietitian's point of view, like what does that conversation look like?

SPEAKER_00 8:34

Yeah, I think the clients in that scenario where they've had like negative experiences before, I don't want to speak for them, I suppose, but I usually sense relief more than a look of what are you talking about. So I think that is just something that maybe that population needs to hear when you're starting, starting over, like with a new practitioner or a new dietitian. If I were to say that to someone who was coming in, didn't have experience with a dietitian, didn't have an opinion one way or another. And I said that, I feel like I might get a face of like, okay, I wasn't thinking about that at all, but sure. So it's usually reserved for those that have an opinion already. And I work to change that opinion, but I can understand and respect that that doesn't happen overnight. Mm-hmm. Mm-hmm.

SPEAKER_03 9:26

And I can't imagine for a client to because I like that you said relieved, because I think I've I've seen it, and I think it's something it's like very empowering for clients to hear, right? Like one of the things we always work with and we always say to clients is that like you are in control. And like Maggie's famous line that I always love is that like you're the driver and I'm the passenger. And like you guys, we are there to just support. And I think a lot of clients don't recognize how much control that they have. So being able to even say, like, okay, you're not making me trust you, you're allowing me to figure out if you're the person or not. Like I've said to clients, I might not be your therapist. I'm a very acquired taste, and I understand that. So, like, if I know, I will say to clients, like, if you don't think I'm your clinician, that's fine. I will help you find one. Like, that's the thing where I feel like I see a lot of relief from clients. So I can imagine with like dietitians and that trust because it is so vulnerable, that I love that you see that because I think it is very powerful that you give them that space to like make that decision and not feel pressured to have to like you or to have to work with you.

SPEAKER_00 10:40

Yeah, I usually tell clients like, I want you to want this as much as I want it. And so if that isn't there or the relationship isn't there, I would rather go meet with a different dietitian that you feel like the relationship or the connection or the philosophy is there and you get more out of it than us trying to make this fit or make this work. And I like giving clients kind of an out, I guess, right? Like that's an uncomfortable conversation to have to begin with. And so just being off the cuff with it of like if it works, it works. If it doesn't, it doesn't, hopefully it provides, yeah, some sort of relief.

SPEAKER_03 11:18

Can I

When A Client Wants To Stop

SPEAKER_03 11:19

ask a question on topic but off topic all at the same time? Because you just said having that conversation is uncomfortable. And it reminded me of other types of conversations that are hard to have with the dietitian. One specifically being if a client is telling their therapist, I don't think I need a dietitian anymore. And the therapist is like, well, maybe we do, right? Like, because it's it's easier to say I can figure out what to do with food, it's fine. How do you approach that conversation with a client? Of them being like, no, like I'm I'm fine, I'm fine, I got it, when in reality we know that their eating disorder is the one driving that boat.

SPEAKER_00 12:03

It's so nuanced. Maggie, I'm curious your thoughts on that before I answer.

SPEAKER_01 12:07

If you have a spot, okay, let me think. Um, no, but I feel like I mean, just as you were saying it, I was kind of like, I feel like almost every client coming in either has had that hesitancy of even wanting to see a dietitian or has had that thought of like, I think I'm at a spot where I'm good and like I don't need it anymore. And so I feel like throughout all of my years of doing this, like I think just having the transparency is such an important piece because honestly, I can tell. Like I can tell when a client is like one foot in, one foot out. And I have just, as I've gotten like more and more confident as a clinician, like I just like name it. I name what I'm sensing in the room. And so I'll just be like, it feels to me, or it appears to me, like we're feeling maybe a little hesitant, or maybe you're feeling like you don't have as much to talk about right now. And I would love to just explore that with you and see what's coming up for you. And I think that's been met with a whole host of different responses of like sometimes like relief, like, oh thank gosh, I didn't know how to bring this up, but I was feeling the same way. Or sometimes maybe met with like, no, that's not at all what's going on. And I'm like, that's fair. My perception is only my perception, right? That can be totally different than you know what somebody's experiencing. And I think too, not always viewing that as a negative thing. I think sometimes as clinicians, whether it's the individual clinician or it's the team member, we might view that as a negative. But I also think too, like there could be a lot of growth in taking a pause, or there could be a lot of growth that has led to that pause. And so a pause is not always a bad thing. Obviously, like, guess I feel like the example you're talking about is more when somebody is really entrenched in their eating disorder and like they do really need a dietitian, and maybe there hasn't been, it's not the example I'm thinking of where like there's been a lot of progress. And I'm like, this is kind of great that there isn't as much for us to talk about. Like, I also want you to progress.

SPEAKER_02 14:18

Yeah.

SPEAKER_01 14:18

But I think when it's more the situation of somebody is pushing back and it's probably entrenched in their eating disorder, I think just naming it, exploring it, and also kind of coming up with, okay, what about our work maybe isn't feeling so supportive to you right now, or is feeling like it's kind of making your eating disorder angry. And is that something we can tolerate and push through, or is that something like we can pivot and I can adjust? I used to have this article hanging up when I used to work in person, which feels like a thousand years ago at this point. But I used to have this article hanging up in my office that said, like, why it's okay to hate your dietitian and eating disorder treatment. And it was awesome and I loved it. I have to read it again soon. But like I always say to clients, I'm like, if your eating disorder likes me, then I haven't done my job for the day. And I'm like doing you a disservice. So I would rather your eating disorder dislike me and me feel like we're actually accomplishing what we're setting out to accomplish. And maybe your reaction to wanting to step away is an avoidance. And like, I'm gonna throw that back to the therapist and you guys can work on that. Sorry, that was long-winded.

SPEAKER_00 15:31

No, I I love that, and I agree. I think there's nuance in that conversation of how well a client is doing, frankly. Like, if yeah, if they're in a position where I'm also kind of grasping at straws to figure out what we're talking about each week or what we're working on, and they're well into recovery, then we could probably stand to like decrease frequency or meet for less amount of time, you know, figure out what the continuity of that care looks like. But for people that are so deep in it, and we're kind of on the receiving end of discomfort, I usually ask them like, okay, so if we were to stop meeting, what would you be doing? What would a day of eating look like? What would your social relationships look like? What would exercise look like? And usually the answer is still rooted in restriction or compensatory movement or just engaging in behaviors. And sometimes clients don't even realize that when they're answering, and then we have the perfect opportunity to be like gently telling them that we are seeing flaws with us pausing, given like what they shared. And sometimes it's not. And then it's sort of a deeper conversation of yeah, everything you said, Maggie, of like, well, can we change the care? Can we tweak it? Could we do things differently? If I strongly feel like clinically it's still appropriate for you to be here, but you really don't see it that way. I think it's at the very least worth a conversation of how can we find a compromise or be on the same page? Because I would be uncomfortable, you know, discharging or pausing or whatever it may be necessarily. You can't force a client to be there. I don't want to force a client to be there, but if I'm like ethically concerned with us pausing or stopping, that's a conversation worth having.

SPEAKER_03 17:25

Absolutely. Yeah. No, I liked both your answers. I thought they were great because it's it is a very uncomfortable conversation and like therapeutically, you guys are also teaching them such a great skill of honesty and like not avoiding and confrontation, which is something that like clients. I don't know if clients realize that there are so many things being taught in sessions in therapy and in dietary sessions that have nothing to do with the topic on hand. Just like this, right? Like you guys might be talking about whether or not it's necessary for them to see you guys, but this is also confrontation, right? They're being called out. They have to talk about their behaviors, they have to talk about their intentions. There needs to be some level of vulnerability and honesty, which their eating disorder tries to strip them of. They try not to talk about it. So it's just, I love that you guys do so much more than just talking about food and nutrition. And that's also something I hope people also learn from this episode today is that like you guys do a lot more than I think what people realize you guys do. And I don't know why that almost made me super emotional. I had to take a deep breath because I almost got bacterial. Oh my god, dramatic. But it's true, you guys do so much, and it's just so important for people to recognize everything that you guys

What Happens In RD Sessions

SPEAKER_03 18:52

do. So, like, even jumping into that, like I guess, you know, question for both of you, my dietitians, like, what exactly is it that you guys do in a session? Because I think what another thing, too, and then I will shut up, that people don't recognize is that like it's about nutrition counseling. And like that counseling piece, I feel like is so important to note, and that I really want you guys to explain. Because are you therapists? No, but do you do similar things to what I do on a different scale? I would say yes. So, what would how would you describe like a day in the life of an RD? What is that like? A session in the life.

SPEAKER_00 19:37

Yeah, I I feel like a day in the life is so funny. It's like all the same, but also all different. That's how I describe it to people. And probably therapy sessions are the same thing. It's like you're hitting on similar enough topics with different clients, but everyone's individual needs look so different. I think there's usually a lot of work around I feel like lately it's been a lot of meal timing, meal planning. But then, you know, besides like the practical stuff like that, I do feel like a lot of conversations around body image, eating disorder engagement or behaviors, you know, where all that's coming from, what is triggering what, um, societal pressures. I feel like that's a huge one with eating and like body image. So I agree with you. I think, I don't know, X amount of years ago, if you were to ask me what a dietitian does, or if my my mom, lover, was like, well, what are you gonna do all day when I said I want to be a dietitian? And I was like, I actually don't know. It's a great question. I should look into that. And I think a lot of people think clinical or yeah, the more practical side of things, a meal plan, you give me that, I go on my way, we meet once or twice and it's over. And it's so funny because that's just not at all what we do, or at least what I don't want to do. I think if I meet someone once or twice and they're on their way, I don't feel satisfied with that work. I know there's a lot of factors that can influence that. So it's not always the work that we've done, but I want it to be more meaningful and long-lasting than just a quick we meet briefly and then we're on our way.

unknown 21:20

Yeah.

SPEAKER_01 21:21

And I would just add to that too. I mean, I think what's so interesting about nutrition and somebody's like relationship with food is it's lifelong. It's one of the longest relationships anybody will ever have. And yet, so few people have actually had education when it comes to food and nutrition. And so I think like that's such a big piece of it, too, in addition to obviously like we're talking a lot about the counseling components and like the body image, and you know, kind of some of those like classic themes that we think of with disordered eating and eating disorders. And I think too, like, there's so Much nutrition education that goes into meeting with the dietitian, where I think that like that piece alone to me emphasizes like the long-term work, right? Because again, it's like we eat every single day, multiple times a day. We make hundreds of decisions around food every single day. And most people do that with like very little education, or the education, like quote unquote, that they have isn't actual education and it's just somebody else's experience. So I think like that's such a big piece of it too. And like to me, I'm like, there could be hundreds of questions around nutrition that somebody could come in, you know, asking and wanting to know more about. So I think like there's those overarching pieces of it too. And then like Mia's describing, there's a lot of like the day-to-day hands-on stuff, which I know both of us really like. Like I love the practical nutrition components. Like I love planning out somebody's week with them or like looking at their grocery order together, planning for a holiday or talking about it after. Yeah, you're like you do. I do love that stuff. Um love, love, love that stuff. And so I think like there's a big practical piece that comes into it too. But I think also there's such a big education piece that a lot of people, you know, a lot of people miss, and a lot of people don't get a ton of time with other healthcare providers the way they get with us.

SPEAKER_02 23:19

Yeah.

SPEAKER_01 23:19

I mean, I don't go to the doctor and spend an hour at the doctor every single week, like asking all the questions that you want to ask. So, not to compare us, you know, to a doctor, but just saying like you don't get a ton of time with most healthcare providers the way that you can get with a dietitian, which I think makes it so unique.

SPEAKER_03 23:37

You might wait in a waiting room in it for an hour, but you don't see providers all the time for an hour. Say that respectfully. I say that respectfully. But it's true, very true.

SPEAKER_00 23:48

I

Scope, Boundaries, And Team Care

SPEAKER_00 23:49

also would argue dietitians get put in this weird, and Maggie, you can like totally disagree if you're like, I don't see it that way. Like weird box of people come to us and are like, okay, so you're a therapist and a doctor and my endocrinologist, and my like, we just get put into everything where it's like, look at my vitals, look at my labs, talk to me about my body image, extreme distress. Like, and so sometimes I have to be like, I don't know. I we can't talk about that. Like, I don't have background on that. That is not my scope, but I do feel like for whatever reason, we're expected to somehow wear like all these hats with people. Whereas other professions, I feel like there are better boundaries or maybe just a better understanding of what those professions do. And maybe clients are confused. I'm not sure, but I do feel like we get put in a weird middleman situation. That's probably my fault.

SPEAKER_03 24:52

I was like sometimes I tell our clients they know everything is a lot. Because if you think about it, if clients get labs, yes, the doctor sees them, but you guys do too. So I'm like, they'll be able to talk to you about it. Don't worry about it. Or, you know, how many times do we have conversations about like bowel movements or like how things might upset our stomachs? I'm like, they'll figure it out.

unknown 25:15

Don't worry about it.

SPEAKER_03 25:17

So also my fault.

SPEAKER_01 25:20

I was gonna say, I'm like, this is me, you just describe mine and Jessica's relationship outside of work.

SPEAKER_03 25:27

Oh, all the time. If my husband and I are having a conversation, immediately I'm like, welcome to this bureau dinner table conversation. Can you please explain or whatever? Oh, all the time. Or I'm like, oh, my stomach hurts today, or like, here's how many times I poop this week. Like Maggie knows everything about my life. Sorry, Ed, you're welcome. But yeah, no, it's probably my fault. I can say for our clients, because and that's also for the clients that are very science-based or like very logical, or very like, I need facts to believe anything. And obviously in therapy, yes, there are facts, but a lot of things are not as with this. You guys are like the fact police, and like I always talk about throwing things at you. I'm like, go to them. They know what they know everything, like they have all the facts in the world. I forgot exactly where I was going with that, but I do say a lot that like you guys hold all of the thoughts and all of the knowledge on everything because in my head you do. So when I'm selling a I'm when I'm selling you guys to a climb, I'm like, they can teach you about all of the things. So I can stop if you want.

SPEAKER_01 26:39

No, but I think like when we think about the spider web around food, like it does touch everything. I mean, medical, social, economical, like it does. It touches every single piece. So, yes, me, I a hundred percent agree with that and feel that. And I also think it's like a very empowering and kind of cool feeling when somebody asks me something that's kind of out of the blue, and I'm like digging back in my brain. And I'm like, I do know something about that, right? I love that. And I also think, too, there's a really powerful and like very human piece of a provider acknowledging that they're not an expert in every single thing and they don't know everything. And I think I struggled with that for sure earlier in my career. And now I'm like, I have no problem saying to a client, like, that's an awesome question. I would love to do more research on that and get back to you because it's so important to me that I give you like the evidence-based factual information. And like I can also acknowledge, like, I am highly specialized at this point, right? And like that's a pro, but like in some ways, like that could also be a drawback because yeah, like I'm, you know, clinical dietetics, like that was a long time ago that I was working in a hospital doing tube feeds, for example, right? Like, I cannot do that right now. So, like, I also think it's okay when we have this like eating disorder specification to like stay in our lane, too.

SPEAKER_03 28:01

You are very good at saying that. And like and setting that boundary. And I think it takes a lot of confidence. And I say that because it is when you're sitting in the room, like even me, right? If clients bring up food, I will always say, I am not the dietitian. I have some information for however long I've been doing this, or however long I've been working with dietitians, which has been since the beginning, since you know, at higher levels of care, you are in literally the same space. But like I will always say, This isn't my scope, it's not my expertise. I can give you whatever is less than surface level, I can provide you with that information. But like you have to go to the experts. And I feel like both of you I've seen where if you don't know something, you have the confidence and there is no pride there of like I don't know, but like I can direct you to the best place for you to get that information. But I also think that's why I tell clients that you guys know everything because whenever there is a question, you always have an answer. So that's why you're welcome. You do guys have so much knowledge about everything.

SPEAKER_00 29:08

And I'm like, feelings. I like to think we do, or I do, and then someone will ask me something. I'm like, what? They'll ask about like a supplement they saw on TikTok or something. And I'm like, that's probably first of all, like not real. So let's just start there. Like online. And no, I don't know what that is. Let me let me look it up. But I am also someone who I don't I don't think I've ever struggled with telling people I don't know what they're asking. I don't think I've ever really felt that pressure to know everything. Maybe that's just the type of person I am. I'm just like, no one knows everything. That's obviously impossible. And so or maybe I just have been very lucky that clients don't maybe expect that of me. So it's just like gone over well what I'm I say. I'll I'll look into it and get back to you. But I think if I went to, I like to phrase it this way in my own head when I'm thinking about it. If I went to a clinician and they knew everything, I'd be skeptical. Because how do you know everything? That can't, you can't be right about everything all the time. Like, there's no way you're that well-versed and that well-knowledge. Maybe you are, hey. Maybe I'm like really shooting someone down here, but I would be skeptical. Like, do you really know what you're telling me if you have an answer for truthfully everything? That's such a good way to think about it.

SPEAKER_03 30:32

I've never thought about it that way. Maybe I'm Steve, I could answer every question, I'd be like, this is amazing.

SPEAKER_00 30:38

I have all my gut goal.

SPEAKER_03 30:40

I'd literally be like, hey, got a question, I got your answer. Don't worry about it. That is a really good point.

SPEAKER_00 30:47

And like maybe you do, right? I'm sure there are providers out there that somehow have casted, or dietitians, I should say, that have casted their nets so wide. But again, again, maybe I'm just a skeptic. Because then I think, like, is a jack of all trades really that good at anything? Like, I don't know, right? I I guess it just is personal opinion, but you cast it so wide, I would imagine you are surface level knowledge on everything, which to some degree is super helpful. But then if someone needs more specialized, unique care, you might not be able to offer that.

SPEAKER_01 31:24

Yeah.

SPEAKER_00 31:25

My husband and I always say, Oh, sorry, Jess.

SPEAKER_03 31:28

Oh no, I was just saying me a spit knowledge. Yeah, yeah.

SPEAKER_01 31:31

I was gonna say, my husband and I always say, like, some people know a lot about a little, and some people know a little about a lot. And I'm definitely a person that knows a lot about a little, and then outside of work, learn so many new things every single day because I know like nothing about any other topic besides this and baking, and that's probably it. Whereas like he has these random facts about like every topic you could possibly think of, right? Like exactly what you said, it's like a wider net. So I always think that too, and like dietetics, it's like, yeah, maybe people know like a little bit about a lot, but like I always wanted to like specialize and like really feel like I was an expert in something.

SPEAKER_00 32:11

Sure. Sure. Yeah, I have colleagues and like friends from grad school that are like one of my best friends works in the where is she? She works in a NICU somewhere, pediatrics. Not a clue. If you threw me in there, I would be lost. Like so I think dietetics is a beautiful field because there is so much variety and you can be specialized in such niche and really important things that often get overlooked, but it that's not really the case in outpatient. I feel like you don't need to be so niche, but also it's it helps to be specialized in certain things. So I guess it's a give and take, right? There's pros and cons to everything.

SPEAKER_03 32:58

Yeah, I would never even think about NICU dietitians. I know that's what I'm saying. Like so when we're like wild little babies.

SPEAKER_00 33:07

I know she loves it.

SPEAKER_03 33:08

Oh that's a special soul. I could never, I'd cry all day. And we already know I can't like you couldn't do that. But okay, so question for you, but Maggie, I feel like I want to ask you all these questions too. My diet, my dietitian duo.

Misconceptions And Food Neutrality

SPEAKER_03 33:26

All right, so I feel like we got on the topic of like misconceptions, right? Of like people feel like everybody you guys do everything. You're welcome. So, what other types of misconceptions about dietitians would you say are like out in the ether?

SPEAKER_00 33:46

There's so many, I feel the biggest one I feel like I see often is clients. How do we phrase this? Clients thinking I will have an opinion about the way that they eat, other than just neutrality. So I I definitely feel like clients will share their eating with me and will try to justify it. Like, well, I had ice cream, but I only had one scoop, I didn't have two. Or I had pizza, I only had one slice, I didn't have three. And in my head, I don't care. Like truthfully, I care about the client, but I could not care less if you had two scoops of ice cream or one. But I do feel like clients either feel the need to preface or provide rationale for the way that they eat because they think we either expect them to eat a certain way, or maybe even ourselves we eat a certain way. I've definitely gotten clients of like, well, you must eat all the veggies and all the fruit, and maybe that's a separate misconception. But I just think there's a lot of perception and ideas around what I am thinking about people's eating. Does that make sense? Oh, yeah. Okay.

SPEAKER_01 35:07

Yeah, and I think you use the word opinion, and I think that's such an important piece. I think that I agree with you. I think clients expect that we have a lot of opinions, aka judgments.

SPEAKER_00 35:16

Yes.

SPEAKER_01 35:17

But opinions are different than recommendations. Like we can give recommendations, but exactly like you said, right? It's like there's no opinion, there's no judgment, this is a safe neutral zone around food, which most oftentimes people don't have except for when they're meeting with us.

SPEAKER_03 35:34

Yeah. How do you? I know you said that there's a lot, so I don't want to completely skip over the question misconceptions. And how do you assist a client in hearing a recommendation as a recommendation and not as a judgment of what they should be doing in my air quotes because what they're doing is wrong. Does that make does that question make sense?

SPEAKER_01 36:00

Yeah, one word science.

SPEAKER_02 36:03

I love it.

SPEAKER_01 36:04

Explain the science behind it, right? Like our recommendations have to come from evidence and science. We can't just make a recommendation just for fun, right? It has to, it has to have something to back it. And so if there's question or their hesitation, absolutely, I'll explain the science behind it. So that way, you know, they can see like the factual evidence.

SPEAKER_00 36:27

And I always frame it as or try to, you know, not perfect, but try to frame it as a question of like how would it feel to try XYZ rather than it feeling forced or like yeah, what you ate or did was wrong. Here's how you fix it. Like, I don't, I obviously try really hard to not use language like that. Which I think to all of us comes naturally because we don't view it that way anyway. So it's it's always a suggestion rather than yeah, you did something wrong that's worth fixing.

SPEAKER_03 37:00

Yeah, because I was just curious, right? Because the way that you guys worded it made me think of it in a way that I don't think I have before, or maybe just not like consciously, of like you guys giving recommendations and uh simultaneously, if a client is feeling like they have to present a certain way, so you don't judge them or think something about the way that they eat, how do they then perceive and take a recommendation? So I was just really curious about that. So I could see clients being like, okay, well, they're telling me that this is what they recommend, so I must be doing something ABC and like how you guys support them and seeing that it's not negative of what's going on or judgment.

Honesty, Adequacy, And Being “Sick Enough”

SPEAKER_01 37:43

I mean, there's a lot of vulnerability in talking about food, right? It's vulnerable for a client to truly and honestly share what they're eating because of everything we're talking about, of like the fear of judgment, and unfortunately for a lot of people, like the actual judgment and the the spoken judgment that has come in from other people in their life. So there's a lot of vulnerability there. But like I always frame it too to clients like, I, you know, I want to be a hundred percent transparent with you. And if you can be transparent with me, like that's actually gonna be like most impactful for like this relationship. And at the end of the day, like your health, right? It's their relationship with food, it's it's their health that we're working on. And I also think just to answer that too, like I think it's about thinking of like what are the overarching goals, you know, because when we go back to those overarching goals, which you know is at at the foundation, right, is like nutritional adequacy. Like we always have to go back to that. And then we can talk about variety and consistency and you know, like some of these different elements. But I think if the goal is always nutritional adequacy, then like that's that that answers the question or you know, where some of the fear can come in.

SPEAKER_03 38:55

Yeah, love that.

SPEAKER_00 38:58

Yeah. I've had clients try to say that they are eating less than like maybe what they actually are. Like, I don't know, a child in session will share their day of eating, and then you talk to parents, and it's very different, right? It's like less, and then parents are like, no, they actually did eat dinner and they did eat all of these things. And I feel like that's where I see it often of having to have that conversation of I am best equipped to help you if we are honest with each other. I can only help you with the information that you tell me. And so if pieces are missing or it's incomplete, you're not getting the most out of this. And then you think of adequacy. And the ironic part is I think a lot of clients think we're gonna tell them to eat less. And literally never has that happened. Like every person almost. I'm like, you're not eating enough most of the time. And so, you know, they think they're I don't know. I'm not, I guess I can't speak for them. Maybe it feels safer to say you're eating less because they think that's what we want to hear, when in reality that's like the opposite of what we want to hear.

SPEAKER_03 40:09

Mm-hmm. Mm-hmm. And I also, with our the population that we see, I feel like there's so many things tangled up into the way that they probably identify and communicate what it is that they have, right? Because for a lot of clients, I know therapeutically, right, there's that whole thought of like, am I sick enough for you to care? Am I sick enough to be here? Do I even deserve treatment? Do I deserve to see a dietitian? Right. And so I know too, there are some clients that might say certain things. So you guys perceive them as more sick. So then they can stay because of the amazing work that you guys have done with them and they don't want to lose you on top of, like, you know, societally, if do they believe that they're eating too much and they don't write like we were saying before? So they don't want you to judge on top of, you know, you know, sometimes do they even understand how much it is that they're eating? And are they saying what it they think it is? But like Maggie, like even saying this whole time, there's not a lot of education. So is it do they even know how to articulate what it is that they had? I feel like it's so layered with that question.

SPEAKER_01 41:19

I think that's a one of the big misconceptions, too, is that like something has to be like quote unquote wrong, you know, for somebody to meet with a dietitian and or there has to be some like very, you know, acute or chronic like medical issue going on. And of course, there's lots of cases when when that happens, but there's also like what's so great and fun about being a dietitian, too, is like again, like food comes into so many aspects. So it's like, yeah, there might be sessions where somebody is like, we're just cooking together. Or, you know, again, like we're talking about groceries, we're looking up recipes, we're looking up different products, like, you know, to to help them add more variety in. So it there doesn't necessarily need to be like a like a problem, quote unquote, right? Like it could, it could truly just be like again, like we make hundreds of decisions around food every day. Like it's nice to have somebody to talk to about that, even if maybe there isn't something super like pressing or especially challenging about that. And I think for a lot of clients and you know, who have gone through like their recovery journey and are, you know, in maybe a like kind of more stable place in their recovery, like that's where a lot of like our long-term work does come in, where you know, we've maybe worked through a lot of those challenges in the past. And, you know, now they're in a they're in a spot that feels really stable and we can kind of transition to some of those other topics. But the other thing too is like there's always life happening in the background. So it's like a client might be like, hey, I don't know if there's that much to talk about. And then the next week they're like, I got engaged and now there's a ton to talk about, or like, I found out I'm pregnant and now there's a ton to talk about. Like, there's always gonna be something involving food coming up, too, that there doesn't have to be like a diagnosis or a you know, something, something wrong.

SPEAKER_00 43:15

Yeah. I do feel like a lot of our work is helping people connect the dots too, about their relationship with food and how, yeah, life, the world keeps spinning, life keeps happening. Why is it that you know you're in college and your boyfriend broke up and now we can't eat? Or yeah, I'm I'm pregnant now and like everything looks different and I need to change the way I eat or I want to. And you know, so often we're we talk with clients and we're the ones I think from like miles away that see the connection. And we just support them in seeing it themselves of like, oh, I actually do get really nauseous when I'm anxious, hence why I struggle to eat with me and my boyfriend. Of got like putting it together for them so that they're more equipped, whether we continue care or not, right? At some point, if it stopped, hopefully the end goal is always that they have the tools and the you know internal awareness to be good on their own. But that takes a lot of development and like guidance and support to get to that point.

SPEAKER_03 44:21

Yeah. And that's stuff that like I can't do. Right. Like, can I also can I assist in making that connection of like, okay, well, if you're feeling nauseous and you feel your anxiety in the pit of your stomach, you're feeling full. Like I can do all those things too. But like you guys take it to a whole whole other level than I never could. And that's why whenever clients come to you know, eating disorder treatment, they're like, Do I need a dietitian? I'm like, you don't even understand how badly you need one. And like, not in a negative way, not for me, just like not mean. It's just like there's it's such a missing gap that if you don't have one, like the treatment is just not the same. Like, I truly believe that like for recovery, you need both. It's not an if and or like it the it's a it's a duo for so many reasons. And it's not because you know, we just want you to have another provider. Like we understand having a lot of appointments in a week is a lot, right? Like, I don't want you to get treatment fatigue, but I also know that this work matters and this work works when you have the team.

SPEAKER_02 45:31

Yeah.

SPEAKER_01 45:33

And vice versa, because there's stuff that I mean, we have to draw a line in the sand sometimes with certain topics, right? Like we have to stay within that scope. It has to connect back to food. And food and emotion have so much overlap that, like, vice versa, right? Like, we need a therapist like you in the mix too to make sure that as we're working on things with food, like we can see you know, emotions be incredibly impacted, and like we need that supportive piece therapeutically as well.

SPEAKER_03 46:02

Absolutely, I agree.

What The First Session Looks Like

SPEAKER_03 46:06

Can I ask one more question? Yeah, we can go all day. I told you guys this. Listen, I'm on vacation. I could literally do this all day long. So do not tell me, okay. But for our listeners, right, who are contemplating, have thought about it, eating disorder or not, right? Just like Maggie said, you don't need a diagnosis, you don't need anything medical to see a dietitian. What would a session, like your initial session, look like for someone listening that is like curious about the process?

SPEAKER_00 46:38

I just have one, so I can relive it. I always tell clients like a first an intake session is really just us like getting to know each other. Like, tell me about you as a person, your interests, hobbies. I have all the music behind me. I feel like that always strikes conversation with people. Like, I want to know you, and then obviously, of course, like what brings you here. I usually preface by saying we will, in a way, I like you know, you kind of give a trigger warning almost of like we're gonna talk about food and relationship with food and eating behaviors, body image, weight trends or trajectory if like medically necessary, um eating disorder if you're diagnosed, you know, like when did that start? How did we get here? Is it has it worsened? Does it improve? Where are you at in that journey? How maybe bought into recovery are you? Stage of change, right? Like, where do you see yourself? I like to frame it as sort of as lax as possible. Again, to not have people like put their guard up of like, oh my, she's asking me like really vulnerable, scary things. Try to just be as casual as possible while obviously still being appropriate and like getting relevant information that we need. But I tend to be as a provider in general, just I think a little bit more lax. As a person in general, maybe a little bit more lax. Maybe type B. I don't really get all like riled up or stressed that easily, knock on wood. And so hopefully that translates. Like we talked in the beginning about my bio and the words I use to describe our sessions. And I do really try to stay true to that, even on intake.

SPEAKER_01 48:23

I love that. And I would just add too, I stole this from a very lovely dietitian I used to work with. But I always ask clients, like, where do you hope to see your relationship with food in six months?

SPEAKER_00 48:35

Yeah.

SPEAKER_01 48:35

Because I think that helps to set the scene of like, this could be longer-term work. This isn't like a one-off session and I'll never see you again, because there's so much that goes into building a relationship with food, but also kind of like allowing clients to reflect on like, oh, like, what do I want my relationship with food to look like? And like that, I think then gives us the stepping stones of like what we can like week to week and follow-ups work towards are like whatever those kind of long-term goals are. And that can ebb and flow for people, right? It's different during a semester in college than it is starting your first job, right? Like, so it's different with different stages of life, so it can always be edited and you know, changed, but I think it's like a really helpful piece and like kind of thinking about that, going into meeting with a dietitian.

SPEAKER_00 49:24

Yeah. Agreed. Yeah. I like to ask about the long-term goals, you know, like three months from now, six months from now, where do you see yourself? Where do you envision this work taking you? How can I be a part of that? What do you need from me? Or what do you want from me? And sometimes clients don't have answers to those questions. Like they're like, my therapist told me to come. I don't really know. And that's okay. And then there are other people that have, right? There are other people that have true answers to that, especially depending on where they are in recovery. There are some people that are like, I'm really tired of this. I want to be doing X, Y, Z in six months or whatever. And we don't stick necessarily to that strict of a timeline, but I agree, Maggie, it does encourage them to recognize that we are kind of in it for the long haul, and that's okay. That's kind of the whole point. Mm-hmm. Mm-hmm.

What We Hope Clients Leave With

SPEAKER_01 50:16

I have one question for you. And then unfortunately, I mean, I would love to go all day too, but unfortunately, I do have something that I need to transition to in a couple minutes. But yeah, sorry. Sorry to ruin the party. Yeah, I can leave and you guys can keep going. I mean, that's totally fine. But no, me, I'm curious to ask you like, what do you hope clients walk away from your work together with?

SPEAKER_00 50:48

Like if we're discharging, like we're done?

SPEAKER_01 50:51

Or like Yeah, yeah, but more of just kind of like uh overarching, like, I hope that clients that work with me get this out of our work together.

SPEAKER_00 51:04

I feel like that could like make me emotional. I hope I won't. Don't get excited. All of it together, but it could if I thought about it long enough. I I would hope that they feel like supported in not only like their journey, whatever that is, whether it's recovery or wellness or other things. So I obviously hope they feel supported in that. I also hope they feel supported like as a person. Like I said, I like to know my clients, I like to know about their lives and their interests. And so I always want my work to our work, I should say, to reflect that of I am in your corner, I support you, we do the tough conversations, we do the hard things, but ultimately, like I have your back as a dietitian in the most, you know, like appropriate, like not parasocial way. Like obviously boundaries exist for a reason. But I I find a lot of value in fostering like our true connection and helping people in that. And so, you know, outside of le them leaving, feeling like I have all my tools, I've built my toolkit, I feel prepared, I feel confident, I feel ready to embark on whatever the next thing is, maybe without a dietitian. I also want them to know that I support them and feel like genuinely feel that. I think everyone has left appointments with people and it, you don't feel it, doesn't feel there. It feels like they didn't hear you, didn't get you, didn't listen. I never ever, ever, ever want someone to feel that way. And so I try to be very attentive. I'm not looking anywhere else, I'm not typing a mile a minute. I'm like trying to be very present, and I think it goes a really long way, or at least I hope it does, because I think true recovery really hinges on having a team that you feel fully seen and supported by. And so I think ultimately that's probably my biggest goal.

SPEAKER_03 53:12

God, I adore you. And not too much. It's true. Oh, it is, and I and like I'm I said in the beginning, right? Like your actions match your words. Thank you. And I think it is hard. Sometimes to find, just like you were just saying, like, sometimes it's hard to find providers where you walk the walk and you talk the talk. Like sometimes it doesn't always, and that also is to say that you know, there are moments where like a client might feel that way, and it doesn't mean that you're it's not a great relationship, maybe it was just like you know, it like in the moment or whatever. But I think having a provider where like 99% of the time you're feeling that jive is like super, super crucial, and you do give them. But let me stop talking because I know Maggie, you have somewhere you have a client and I will keep babbling so somewhere to be.

SPEAKER_00 54:07

No, I can't stay with you ladies, which is rude. But I'll we could have had the first like four-hour episode. That's what I'm so busy.

SPEAKER_03 54:18

And Maggie went, This is Maggie's dedication to work for our clients, and honestly, I respect it, but am I jealous? I am.

SPEAKER_00 54:28

I'm like disappointing I'm like, uh but also, yeah, do what you gotta do. I also have a client soon, so I would also have to go. I'm just blaming Maggie. Sorry. But thank you both. This was so fun. I hope so. It was so glad you were here. Everything we dreamed of.

SPEAKER_01 54:51

It was amazing. Well, thank you. If people wanted to find you and get connected with you, how do they do that?

How To Find Mia And Closing CTA

SPEAKER_01 54:59

Oh gosh, I don't know.

SPEAKER_00 55:01

Hilltop's website. Right? Yes, I don't have any socials, I don't do none of that. So Google Hilltop and I will be there. You will find me. That was the best response we've gotten to that question. She's like, oh god. Some people have socials, like you know, and I'm like professional ones, and I'm no. So Google is brilliant. I love it. That's fair.

SPEAKER_03 55:35

Well, thanks for chatting. We haven't had an hour-long episode in a very long time, so you really push us to the brim this time.

SPEAKER_00 55:44

We're doing it. Yes. Have me back whenever you need an hour episode, whenever we feel like we need a long one, just bring me in. Stay less. You know I will.

SPEAKER_01 55:55

Right. Our first episode was like an hour and 40 minutes or something, and we were like, this is sustainable. We can totally do this. And then we're like, we need to make it 30 to 60 minutes.

SPEAKER_00 56:07

End it.

SPEAKER_01 56:08

Yeah.

SPEAKER_00 56:09

Oh, that's so funny. So funny. Well, thank you both. This was very fun. My nerves went away. So we're good. That's always our is that people feel comfortable enough that they want to stay and chat. Yes, you did it. You did it. And hopefully my answers made sense. You know, when you talk and you're like, I don't know, actually, know what I'm saying anymore. Like that's what I was thinking sometimes. I'm like, um, okay, let's wrap it up. I actually don't know what it's coming out of my mouth.

SPEAKER_01 56:37

No, you did great. Thank you. And thank you, everybody, listening. If you want to get connected with Mia, check out Hilltop Behavioral Health's website or connect with us, and we can always connect you too. Thank you. Thanks, guys. Bye.

SPEAKER_03 56:56

Thank you so much for listening to this episode of Nourish and Empower Podcast.

SPEAKER_01 57:01

We hope this episode helps you redefine, reclaim, and restore what health means to you.

SPEAKER_03 57:08

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