7 Things to Expect During a Dietitian Appointment

7 Things to Expect During a Dietitian Appointment

Deciding to work with a nutrition expert (a registered dietitian nutritionist (RDN)) can be one of the greatest decision you ever make.  However, sometimes not knowing what to expect can lead to a delay in making that decision.  Read on to find out what you can expect during an outpatient dietitian appointment.

Preparing for your dietitian appointment

Medical records Medication and supplement list Recent labs Questions Health priorities or goals Paper and pen An open mind
What to bring to your dietitian appointment

To get the most out of your dietitian appointment, you can absolutely prepare. Here are a few things to take with you:

  1. Recent medical records
  2. Medication and supplement list
  3. Recent labs
  4. Questions you would like addressed
  5. Health priorities or goals you would like to achieve
  6. Paper and pen for taking notes
  7. An open mind.  Your dietitian is so excited to help you find the nutrition answers you seek!

Identifying your health priorities for your dietitian appointment

Think big picture.  If you closed your eyes and you were living your best life, what would it look like? Where would you be? Who would you be with? What activities would you be doing? How would you feel?  Take your time with these questions.

After completing this practice, jot your vision down.  This vision includes your health priorities (people, health, activities, etc.)!  As you can see, health priorities are not just about numbers on the scale, lab values, or medical diagnoses.  Health priorities are what gets you excited…what motivates you to create change!

Length of an initial dietitian appointment

The first dietitian appointment can range from 45 minutes to 90 minutes.  Typically, the appointments are close to an hour.  You will spend a good amount of time getting to know each other and building trust.  Feel free to ask a lot of questions. Dietitians love questions! This is no joke!

7 things to expect during your dietitian appointment

1.      Introduction – Get to know each other

When you arrive at the dietitian’s office, make yourself comfortable.  Getting to know each other can be so enjoyable!  Your dietitian will ask several questions to get the ball rolling. Some of the questions may include:

  • How can I best help you?
  • Tell me about yourself.
  • Why is your health important to you?
  • What would you like to get out of today’s appointment?
  • What are your personal expectations?
  • Do you have any specific questions/priorities you want to be sure we address today?

Be sure to share your medical records, lists, questions, and priorities with your RDN during your introduction.  You will be off to a great start!

2.      Assessment

Your dietitian will collect more information from you to drill down to the specific needs of the appointment.  Information gathered may include:

  • Diet history and eating habits
    • Food preferences (personal or religious)
    • Need for altered textures of foods/beverages
    • Food security or access to nutritious foods
  • Medical history
  • Current medications
  • Current nutrition supplements
  • Nutrition Focused Physical Exam (NFPE)
  • Current labs
  • Estimated nutritional needs

3.      Diagnosis

Using the information gathered during the appointment, your dietitian will identify a Nutrition Diagnosis. This diagnosis will help your RDN decide which nutrition intervention is the best fit to achieve the desired outcomes you stated during the appointment.

The Nutrition Diagnosis is not a medical diagnosis.  Rather, a nutrition diagnosis describes issues/variances related to your nutrition.  There are three aspects to a nutrition diagnosis:

  1. Problem = (P)
  2. Etiology or cause = (E)
  3. Signs and/or symptoms = (S)

If you review your chart notes, you may see the PES statement included.  It can appear something like:

  • Nutrition Diagnosis (Problem) ____________________
  • Related to (Etiology) ____________________________
  • As Evidenced by (Signs and symptoms) _____________.

Typically, your dietitian will narrow things down to one specific PES statement for each appointment.  In some cases, there might be 2 PES statements.  The goal is to address each PES statement with an intervention that will help improve or resolve the nutrition diagnosis.

4.      Intervention

The nutrition intervention is recommended specifically to address the nutrition diagnosis. 

There are six domains for nutrition interventions: 1) Nutrition Prescription (NP), 2) Food and/or Nutrient Delivery (ND), 3) Education (E), 4) Counseling (C), 5), Coordination of Nutrition Care (RC), and 6) Population Based Nutrition Action (P).  In the outpatient setting, RDNs typically use the four below:

Food and/or Nutrient Delivery (ND)

Food and/or Nutrient Delivery interventions could include supplementation.  In the inpatient setting, this could include change in diet, nutrition support, or inclusion of vitamin/mineral supplements.

Education (E)

Nutrition Education is a sharing of information where a lack of nutrition knowledge may have been identified.  Nutrition education is meant to teach a skill, improve a skillset, and increase your confidence and knowledge.

Education topics can include specific nutrition guidelines, physical activity guidelines, or health behaviors that are linked with certain outcomes.

Counseling (C)

Nutrition Counseling is a collaborative process between yourself and your dietitian.  Your dietitian will guide/coach you until you are able to name specific goals. This will help you to set up specific actions of self-care while owning more responsibility in your healthcare. 

Coordination of nutrition care (RC)

This can include coordinating your nutrition care with other healthcare providers, professionals, or institutions. 

SMART goal setting Is your goal specific? Is your goal measurable? Do you have an action plan? Is your goal realistic? Do you have a time limit?

Goal Setting – S.M.A.R.T. Goals

Goal setting is an important part of your nutrition intervention.  Your dietitian may collaborate with you to establish S.M.A.R.T. goals.

S.M.A.R.T. goals are action-oriented goals and should align with your priorities.  Your goals should be small enough for you to achieve them by your next appointment, and large enough so you notice improvements in signs and symptoms.

The S.M.A.R.T. goal acronym stands for:

Specific

What, why, or how?

Measurable

How much/many?

Action oriented

What steps will be taken to achieve the goal?

Realistic

Start with small/doable goals

Timely

How often – start soon! Set a deadline.

Example of a S.M.A.R.T. goal: Starting tomorrow, I will walk first thing in the morning for 10 minutes 3x a week (Monday, Wednesday, and Friday).

The table below highlights the different aspects of the S.M.A.R.T. goal.

Specific:Walk first thing in the morning.
Measurable:Walk for 10 minutes.
Action-Oriented:Walk (not just think about doing it).
Realistic:Walk for 10 minutes rather than an hour.
Timetable:Start tomorrow and walk 3 times over the next week.

5.      Monitoring/Evaluation

Monitoring outcomes (signs and symptoms) helps your dietitian see if the nutrition intervention was impactful.  Ways to monitor an intervention can include physical activity, food, or symptom trackers, lab value changes, changes in blood pressure or weight over time, or observed changes in intake (ex. eating and tolerating more solid foods vs. liquids).

6.    Follow-up planning

You will work with your dietitian to decide if follow-up is needed. Together you can fine tune your goals and nutrition care plan so you can achieve your health priorities.  Don’t underestimate the value of small goal achievements.  They really do boost confidence!

7. What NOT to expect from a dietitian appointment

No Judgment
No Judgement

Dietitians are not here to judge you.  Rather, dietitians are here to help you create positive and peaceful relationships with food, activity, and the behaviors you choose. 

Dietitians are the food experts for many reasons, but one of the most important reasons is they understand the many complexities that come with food and eating.  There are no bad foods! Dietitians are here to help! 

To find a dietitian (nutrition expert) in your area, click here: Find a Nutrition Expert (eatright.org).

For more information about The Dietitian Resource, visit our site or check out the blog.  Thanks for visiting!

References:

https://www.eatrightpro.org/practice/quality-management/nutrition-care-process

https://www.ncpro.org/nutrition-care-process

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More About Rochelle

Rochelle Inwood MS, RDN, ACSM EP-C

Hello there! I’m Rochelle Inwood, a Registered Dietitian Nutritionist (RDN) and Exercise Physiologist (ACSM EP-C). With over 14 years of experience, I have sharpened my expertise through diverse roles, including weight management program co-coordinator, patient/employee gym supervisor, outpatient dietitian, program manager, dietetic internship preceptor, and more. I am passionate about learning, creating, teaching, and supporting personal growth and development.