With so many options for a finding a health professional to help you move towards your health goals, how do you know how to choose? Let me be clear that your medical doctor is your first partner but you only get so much in-person time there! Let your doctor help guide your decisions about what to work on; then find a health professional to find the best strategies to get it done!
First, figure out how you want to approach your goals – do you want to focus on nutrition, on activity, or on a combination of many things: sleep, stress, time management, consistency, overcoming your typical challenges? This will guide you to the best person to help you. Second – and so important – is to find someone who makes you feel comfortable. Finally, make sure they have relevant education and hands-on experience. You want to make sure it is safe before you put your trust and health in someone’s hands!
Before jumping in to the many types of health professionals you can choose from, let me start with some key differences.
Nutrition Education / Nutrition Recommendations / Medical Nutrition Therapy.
Anyone, even you, can provide nutrition education as long as you are not paid. You can look up credible guidelines (American Heart Association USDA’s Choose My Plate, etc.) and share the information one-on-one or in a group as “nutrition education” in general terms. Now, if you decide to charge people for the education, you should probably check out the laws in your state because that changes things. In the 46 states in the U.S.A. that have license laws for nutrition , only certain professionals can (legally) make nutrition recommendations or practice Medical Nutrition Therapy. A nutrition recommendation would be giving you a meal plan or recommending a specific food change/supplement. To illustrate the difference, giving education is saying, “What we know about X is Y;” making a recommendation is saying, “If you are concerned about X, you should do Y.” Medical Nutrition Therapy / MNT is giving recommendations about a dietary/nutrition approach for any health condition from a gluten sensitivity to heart disease or cancer. This does not involve diagnosing health conditions but it does include dietary “treatment” for health conditions.
Exercise Education / Exercise Foundation / Exercise Training.
Exercise education is like nutrition education. Anyone can speak in general terms about credible information regarding exercise and activity if not paid. An exercise foundation is getting someone started with exercise. It may be assessing you for exercise readiness, screening you to find out you should talk to your doctor first, or helping you start a beginner’s program designed by an exercise agency/trainer, such as an easy walking program. It should not make you breathless, involve lifting anything, or be hands-on exercise guidance one-on-one or in a group setting. Exercise training (personal training) is making recommendations by giving you a workout routine they designed or doing hands-on instruction and guidance (leading you through a work out).
As an aside for both of these definitions of terms: many people are more successful when given education and having a discussion with their health professional about how to apply it. Getting a recommendation is what many people think they want, only to find out those recommendations don’t stick for long. We all know that someone else telling you what to do rarely works for long… we tend to start tweaking things or just straight-up stop, right? A health professional skilled in having the conversation with people about behavior and lifestyle changes can be just as – if not more – helpful in the long-term than someone who can make recommendations.
Types of Health Professionals
Certified Health Coach. If you want to focus in many areas, this is your go-to professional! Just know that there are many different types of coaching certifications with some being intensive and some being laughable – so ask questions. The more intensive certifications can require a NCCA-accredited certification/license or an associate’s degree in a health-related field as a prerequisite, followed by additional education (classes, readings, practical videos, critiqued practice of coaching skills) and a proctored exam. They can coach you in many areas of health and wellness including nutrition education, exercise education (and possibly building your exercise foundation), sleep, stress, time management, consistency, overcoming challenges, etc. They should also be skilled in motivating you to change and dispelling health myths.
Certified Personal Trainer. For exercise, this is your go-to professional! The same agencies that certify Health Coaches may also certify Personal Trainers so the requirements for this certification are similar except that only a high school diploma and current CPR certification are required. Personal Trainers can do exercise education, foundation, and training. They will know how to work around any injuries you have; but they cannot diagnose or treat injuries (that’s medicine) or help with injury recovery (that’s physical therapy). They can lead you through workouts or design an exercise program for you to follow on your own. For nutrition, dig a little deeper into their training. Legitimately credentialed personal trainers will have some education in nutrition and they can obtain extra certifications in nutrition (quality of programs vary); however, they are limited to nutrition education. They should also be skilled in motivating you to change and dispelling exercise myths.
Registered Dietitian / State-Licensed Nutritionist. For nutrition, this person is your go-to professional! They will have an undergraduate (or master’s) degree in health / nutrition science and have completed 1,200 hours of hands-on practical internships. They can do nutrition education, make recommendations, and provide MNT. “Registered Dietitian” and “Dietitian” are legally protected titles in most U.S. States. “Licensed Dietitian/Nutritionist” is a title for those who have a license from their state’s Department of Health (same as a medical or trades license). In terms of exercise, they can provide exercise education and let you know if your “calories burned” part of the energy equation is low; but they cannot do any exercise foundation or training work with you. They should be skilled in motivating you to change and dispelling nutrition myths.
Nutritionist / Nutritionalist / Nutrition Counselor / Etc. Go make yourself a web page and business card – I’ll wait – congrats you are now a nutritionist! Would you put your health in the hands of someone simply because they have a good eye for design and a compelling way with words? Or because some new and interesting eating or exercise thing they did worked for them? Please be smarter than this. Some “schools” will give people a nutritionist title and it may mean nothing (very little training) or it may be more intensive; either way, unless they are a “licensed nutritionist” they can still only legally do nutrition education in many states. Ask questions before working with someone with this kind of title.
Mental Health Counselor. At times (lots of times), food and exercise issues are rooted in emotional and mental health. The previously listed health professionals help you with the “outside work” (doing things) and can help you work through some of the smaller internal mental challenges with creating new lifestyle habits. They can also help you identify if some more involved “inside work” (thinking things) might be helpful and refer you to a therapist. This is a great person to have on your team; just be sure to find someone state-licensed.
Where do I fit in? I’m so glad you asked!
I am a Certified Health Coach (American Council on Exercise), Registered Dietitian, and State-Licensed Dietitian/Nutritionist (Florida); but my approach is different from many other RDs.
I have had clients tell me they were not interested in working with me because I am an RD; but they gave an RD one last try. After a while, they confessed this to me that all they got before were handouts and food rules and it was not helpful. There was no flexibility; just “here, do this.” Thankfully, I do not speak about all RDs here – as practitioners, we are as different as the people you will find in any other helping field. You will not get a handout, some food rules, and a plan from me and I will not tell you how you should go about reaching your goals. Someone else’s plan (even mine!) will not work for you for long – and it certainly does not get you near the goal of making changes stick for a lifetime.
My job as I see it is to help you examine your goals and how they fit into your lifestyle, break your food rules, and explore the many options you have to reach your goals. Then we set about finding a few small, flexible, realistic ways for you to move towards those goals. I will not tell you what you should or should not do.
Don’t enough people already try to tell you what to do?
Yours in Good Health,
-Alexia Lewis RD
This article is Part 2 of 4 in “Health versus Weight as a Focus for Wellness.”
Part 1: The Continuum of Approaches to Health: Thoughts from a Curvy and Healthy Dietitian Health Coach
Part 3: If Diets Don’t Work, How Can a Health Coach Help Me?
Part 4: What Is This No-Diet / Anti-Diet Thing Anyway?
References & Resources:
Health Coach Certification, American Council on Exercise: https://www.acefitness.org/fitness-certifications/health-coach-certification/default.aspx
ACSM Certified Personal Trainer, American College of Sports Medicine: https://certification.acsm.org/acsm-certified-personal-trainer
5 Steps to Become a Registered Dietitian Nutritionist, Academy of Nutrition & Dietetics: http://www.eatrightpro.org/resource/career/become-an-rdn-or-dtr/high-school-students/5-steps-to-become-a-registered-dietitian-nutritionist
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