As a registered dietitian and certified diabetes educator in private practice, I have the privilege of working with many different patients. I coach, counsel and educate people with pre-diabetes, type 1 diabetes and type 2 diabetes. Patients come to see me for sports nutrition guidance, anorexia, IBS and celiac disease. But the majority of my practice focuses on people who want to achieve a healthier body weight.
Some of my patients are morbidly obese. Dieting doesn’t work. Ask anyone whose been on a diet for decades, and they will tell you that they’ve been on every diet in the book. In my practice, we work on changing our relationship with food. Our goal is to improve health and eventually reach a healthier body weight. Of course weight loss is important to a person who is morbidly obese. But a person can usually tell if they lost weight. Success is not always measured by the numbers on the scale.
The scale in my office only goes up to 350 lbs. Several of my morbidly obese patients are weighed at least once a month at a near-by hospital, where the scale goes up to 500 lbs. One of my patients who has lost about 120 over the past year, weighs over 400 lbs. He weighs in at the local hospital prior to our appointments.
The other day, my patient was walking from a local bus stop to my office. He truly looks forward to his appointments. Together we have spent over a year building his confidence and self-esteem. Along the way he has reduced his LDL (bad cholesterol) level and significantly lowered his blood glucose levels. It’s been an incredible journey thus far for both of us.
About a block away from my office, a man pulled his car to the side of the busy street. He got out of his car and shouted “hey you! Why don’t you lose some weight”? I’m not making this up. The man literally got out of his vehicle – in the middle of traffic – during rush hour – to scream at my patient. Clearly this was a troubled person. And of course I feel sad for him as he obviously is not a happy person. His outburst took a negative toll on my patient’s confidence. As soon as my patient came into my office, I knew something had happened. I knew it had nothing to do with being weighed at the local hospital. In my heart I knew that he had been hurt psychologically. He told me what happened and confessed that children often laugh at him as he passes by. He mentioned that people stare at him in stores and glance at him in disgust. He said that some of the doctors he had seen in the past told him that he is “very fat” and should stop eating junk all the time. He also told me that I was the first person that he’s worked with who actually worked “with him” I was the first person who allowed him to participate in his own weight loss program.
Sometimes it’s hard not to blur the line between nutritionist and therapist. Of course I stick to nutritional counseling, coaching and education. But the key being a successful nutritionist in private practice is “listening”. Not preaching… but active listening. My patient left my office with his head held high, and so did I. This week was a reminder to be kinder to one another. Not to judge. What do you think? Please share your thoughts and comments. But before you do, this obese woman was declared “Too Fat to Fly” by the airlines that took her to Europe, then would not bring her home. She died.