Read up. Wellness, your way.

The world of health and nutrition can be confusing and overwhelming, especially when there are so many conflicting messages and advice available. Even as a professional in this field, I see many mixed messages that can end up being really harmful. It can be challenging to know who to turn to for help and which professional is best suited to guide you on your journey toward optimal health.

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Before you determine which expert you need and at which time, let’s explore the roles of physicians, dietitians, nutritionists, and registered dietitian nutritionists (RDN), and I’ll help you evaluate which of these professionals you need at various stages of your journey to wellness.

Combining Clinical Experience With Research Knowledge

When it comes to nutrition, there is often conflicting information and opinions in the media and online. It's important for healthcare providers to stay up-to-date on the latest research and to be able to critically evaluate studies and statistics to provide evidence-based advice to their patients.

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While research is important, clinical experience and intuition are also valuable tools in nutrition counseling. Healthcare providers should be able to combine their knowledge of the latest research with their understanding of their patient's unique situations and preferences to develop personalized recommendations that are both effective and sustainable.

Physicians and Nutrition

Physicians play a crucial role in the management of our health, but their focus is primarily on diagnosing and treating diseases rather than prevention and management through nutrition & lifestyle medicine. They are not the experts in nutrition medicine nor the people to go to for in-depth nutrition education and counseling.

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However, many physicians are now recognizing the importance of nutrition in preventing and managing chronic diseases. A physician can provide general nutrition advice and may refer patients to a registered dietitian nutritionist (RDN) for more specialized and personalized nutrition counseling. Physicians and RDNs are a wonderfully powerful combination when it comes to preventing and managing ongoing health conditions with diet and lifestyle therapy.

The Role of a Registered Dietitian Nutritionist

Registered dietitian nutritionists (RDNs) are qualified health professionals who have completed a Bachelor's or Master's degree in nutrition and dietetics. They have undergone extensive training in the science of food and nutrition and are equipped to provide evidence-based dietary advice and medical nutrition therapy.

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Dietitians work in a variety of settings, including hospitals, private practice, and community health centers. They can help with weight management, disease prevention, and management of chronic diseases such as diabetes, heart disease, and cancer.

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In essence, a dietitian therapeutically treats disease through nutrition. How amazing is that? I highly recommend working with an RDN to accomplish lifelong wellness goals.

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In 2024, to become a registered dietitian will require a master's degree. That means aspiring dietitians will have to complete all of their nutrition training, chemistry, biochemistry, and physiology requirements, and clinical hours in addition to their master’s degree.

What is a Nutritionist?

The term "nutritionist" is not a protected title, which means that anyone can call themselves a nutritionist, regardless of their qualifications. While some nutritionists have received formal education and training in nutrition, the majority have not. Therefore, it's important to do your research and ensure that the nutritionist you consult has appropriate credentials.

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The challenge for those of us in the medical field of nutrition and lifestyle medicine, however, is that many people search for the word “nutritionist” when they are looking for nutrition therapy, education, and support to help them on their health journey using food as medicine.

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So, registered dietitians added the word nutritionist to their registration to clarify to the public they were the experts in nutrition therapy and education. With my doctorate in clinical nutrition and my desire to truly reach the masses with the nutrition research and knowledge I gained over my decades of formal education and training, I still include the word “nutritionist” as part of my title so that my potential patients can find me and be assured I am a trusted source of nutrition medicine.

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My advice is to be very cautious and discerning when you see this title used on its own. Qualified registered dietitians are the experts in nutrition therapy, but they will not call themselves solely “nutritionists.” They will reference themselves as registered dietitian nutritionists.

A Doctorate in Clinical Nutrition (DCN)

I became a Registered Dietitian Nutritionist in 1997 from Loma Linda University, and after graduating, I was amazed at how nutrition science and nutrition research was changing so fast. I quickly realized that I had an endless desire to keep learning more about nutrition science, and I wanted to understand how to do research and properly understand how to interpret other research so I could be at the cutting edge of nutrition and have solid answers for my patients.  I wanted to know what were the best foods to heal the body and how to combine them to create an ideal diet that I could feel confident recommending to best prevent and manage lifestyle-related chronic diseases.  And I was on a quest to discover if it was possible to reverse disease after it had already been diagnosed and what foods could heal the body with the power of medicine.

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Essentially, I wanted to know: could we really use food as medicine? I had endless questions that I wanted to understand more, and this led me to pursue a doctorate in clinical nutrition at Rutgers University.

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This advanced doctoral degree allowed me to gain extensive nutrition science and education while learning to conduct research and evaluate clinical trials. It also included a nutrition medicine residency to advance further my understanding of nutrition and disease prevention, management, and even reversal.  

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I loved every bit of my doctoral training and being a student. I conducted my own research over the seven years that I worked to receive my doctorate in clinical nutrition, which is when I saw the need to develop a Healthy Diet and Longevity Score made up of the best foods and lifestyle habits found in cutting-edge science found to have a significant role in prevention and/or management of disease and longevity.    

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I desired to show patients the best foods and the daily dose to give them a medicine-like effect.  The Score was designed to be a tool a patient could complete on their own and know that higher scores were correlated to improved health outcomes and longevity.  The Score could be a health assessment tool in clinical practice, a nutrition education tool to empower people to know what to eat and how much for optimal health, and The Score could be used as a research tool to measure food as medicine for research outcomes.

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The transition from my research-based environment and acute care clinical setting to a private practice specializing in nutrition and lifestyle was met with some unexpected challenges. Insurance models that didn't cover nutrition education and therapy, deeply ingrained mindsets around food choices, and a culture that equates happiness with weight loss all contributed to my desire to help make nutrition education more accessible and affordable and challenged me to inspire people to move wellness into their own hands.

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I also realized that if the food I recommend as the best medicine doesn't taste good most people will never eat it, which drove me to focus on my concept of "what to do more.” I shifted from my traditional training that asked patients to stop eating "bad" foods and focused on eating more of the foods that heal. I found that this had the greatest lasting effect on my patients.

Challenges in Nutrition Counseling and Insurance Models

Despite the proven value and importance of nutrition counseling in improving health outcomes in patients, many insurance models limit the number of visits that patients can have with a dietitian or RDN. This can be frustrating for patients who require ongoing support and guidance.

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Additionally, the current healthcare system often focuses its insurance-approved medical dollars on treating diseases with pharmaceutical medications and procedures, with very little of the healthcare spending going toward prevention and education, which can make it challenging for patients to receive the necessary support and resources for preventative care and treatment through nutrition and lifestyle medicine. Weight loss often isn’t covered unless the patient has more than 100 pounds to lose to get to a healthy weight. Obviously, there are many patients we treat who need to lose 30, 50, or 70 pounds and won’t have their treatment covered by insurance. Unfortunately, diabetes education has limited lifetime visits after the initial diagnosis, which leaves people without support for their struggle with diabetes after 4-8 sessions.

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I bumped up against this problem many times when I was starting out treating patients in a clinical setting. Insurance might only cover a few visits for consultation, but I would feel a strong sense that they needed more from me if they wanted to stick with the plan we were setting out for them. This was a huge motivator in my development of TakeTEN^® and The Score and key in creating Dr. Cheryl Wellness.    I knew wellness needed to move into the hand of the patients, and they needed the tools and empowerment and inspiration for this to be successful.

The Frustration of Limited Visits and High Fail Rates

The limited number of visits with an RDN can lead to high failure rates for patients who require ongoing support and guidance. Nutrition counseling and health behavior change are not a quick fix, and it can take time for patients to make sustainable changes in their diet and lifestyle.

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Health professionals can become very frustrated in the challenges of creating health behavior changes in their patients that stick for a lifetime. The alarming statistics show that 95% of patients that have started a weight loss diet or a therapeutic diet and lifestyle change will return to their previous lifestyle within two years. This can become very discouraging to health professionals who are focused on nutrition and lifestyle medicine, and health behavior changes for the prevention and treatment of chronic diseases, with only 5% of their patients predicted to stick with the change beyond two years. It was becoming apparent that the clinical model of changing life habits wasn’t working, and I needed to explore why and what we could do to improve these bleak outcomes and help people be inspired to make health behavior changes that last.

The Complexity of Giving Up Foods We Love

Here is what I discovered. When it comes to dietary changes, one of the biggest challenges is asking people to give up the foods they love. Many people have strong emotional attachments to certain foods, whether it's a family tradition, a comfort food, or a favorite treat. For some, the thought of giving up these foods can be overwhelming, and it's important to approach the topic with sensitivity and understanding.    Others connect healthy eating with foods that will taste bad, and great-tasting foods are the foods that are not good for them. I discovered that taste is a huge part of people's enjoyment of life.  

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I began to explore strategies to help. I looked for the most healing foods that had the power of medicine and meals that would keep them full for four hours, AND they would love the taste.   In fact, I wanted people to crave the foods that healed. Could we add more of the foods that heal and create healthier alternatives to comfort foods without sacrificing taste?   For example, if someone loves pizza, they could add a side salad or load up their pizza with veggies or add a cup of berries and ten nuts to their breakfast oats.  

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My goal was to help people do more of what makes them well and love the meals they eat.  I wanted to support my patients to understand that how they feel and their quality of life is connected to the meals they ate previously. But the last thing I wanted to do was make people feel guilty. This leads to another huge obstacle in the world of nutrition and healthy eating is dealing with that inner food police and daily guilt trips so many people live with. The pattern of adding foods that are labeled as “bad” or “unhealthy” fuels this inner food judge and can make people feel only deprived if they have to give up foods they love or feel depressed when they fail to eat “healthy” on that super fun vacation or birthday celebration.

The Inner Food Police and Celebrating vs. Skipping Visits

Many people feel guilty or ashamed if they don't stick to their prescribed diet or exercise plan perfectly, and this can lead to a cycle of self-blame and negative emotions - which can result in patients feeling deprived and depressed.  Over time I found my patients dealing with this would skip their nutrition consults if they felt ashamed of eating foods they thought were bad or “cheating” on their diet. Yet when they had a great week, they would arrive early to their weekly visits feeling proud of their accomplishments and wanting to share the excitement with me.  I quickly learned that the people who were skipping their nutrition and medical consults were many times related to patients feeling like they had a “cheat week” and wanted to try to fix the problem on their own before coming in for a medical visit.    

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This cycle of skipping visits because of guilt or shame is counterproductive to the journey.    I was challenged to become real with my patients and openly discuss these challenges in making changes in how we eat and how we live and creating a safe space for them to be real with me in their lifelong wellness journey.  Being open and transparent was the key to me being able to support and inspire them along the way.

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One way that I encouraged my patients was to share my own personal struggles with choosing the right foods all the time. I’m a human who loves to cook and eat! Food is a huge part of my life, and I’m absolutely a part of the camp that would rather live ten years less than give up foods I love and foods that taste great. I wanted to make eating healthy foods easy and delicious and find foods and a lifestyle that fits each person focusing on what to do more and not simply all the do-nots.

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However, when we start to look at the quality of life that our diets can offer us, it becomes clear how important it is to discover healing foods we love that we can incorporate into our daily routines.

The Problem With Tying Happiness To Weight Loss

Everyone is born with a unique genetic blueprint that determines our height, bone size, and body shape, yet society has set a gold standard that everyone should look a certain way regardless of their body shape and size. Societal pressure to conform to certain body standards can be a major source of stress and anxiety for many people. A countless number of patients have come to me with the primary health goal of simply weight loss – easy, permanent weight loss. When I would ask them their “why” for losing weight, it was many times losing weight for a large event like a wedding or class reunion, or vacation or to make their spouse happier.

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But the sad part is how many people spend decades of their life chasing the belief that simply losing 5 or 10 pounds would actually make them happier and their life better. Happiness is very tied to many people's perception that they will be happier when they lose weight. And the sad part is that whatever the diet is that promises quick, easy permanent weight loss is the diet they want without the concern for long-term health – I call this mortgaging future health for the false promise of weight loss.    

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I believe that healthcare providers should strive to create a judgment-free zone where patients feel comfortable discussing their health concerns, body image issues, and diet and lifestyle habits without fear of being judged or shamed or asked to give up everything they love, with no good options to replace them.

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It is important to recognize that weight loss does not necessarily equal happiness or good health.   Many factors contribute to overall well-being and happiness, and future health, including mental and emotional health, social support, health habits, and physical activity. I try to intentionally focus on helping my patients make sustainable diet and lifestyle changes that improve their overall health and well-being, and happiness rather than simply chasing a number on the scale or a false promise of weight loss.   This is how they truly reach their goals, through positive, affirming, encouraging, and accepting their body and being aware that their body weight will not equate to happiness.  

Final Thoughts On Nutrition Counseling

As patients, it’s critical to understand common challenges on our wellness journeys and how to avoid them. One of the best ways to do that is first by finding the right provider for you, one that is trained in nutritional medicine and health behavior change and understanding the body image challenges that are so common but are also deeply connected to the difficulties that one faces with finding foods that are easy to make and taste good and also the issues outside of food itself  - issues like cost, insurance, societal norms, and mindset.

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When you join Dr. Cheryl Wellness, you get the whole package: an informed, educated guide on your journey totally committed to simplifying the process it takes to achieve optimal health. As an expert in nutrition, lifestyle medicine, and health behavior change, I bring cutting-edge nutrition directly to the hands of my members, with tools like The Healthy Eating and Longevity Score and The Plate as a tool to make foods combos that keep you full and crush hunger and balance blood sugar and that take the research and make it applicable to their everyday lives, immediately.

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If you’re ready to start your wellness journey with a true expert who has walked this same path with hundreds of patients before you, take this 20-question Score to learn Your Daily Healthy Eating and Longevity Score. This research-backed scale is a proven way to assess your current healthy eating and lifestyle habits and develop a plan for a healthier lifestyle today that fits you.   I’m here, ready to help you understand your Score and ready to inspire and encourage you as you make steps toward your health goals.

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