What to Expect from your Dietitian Appointment

If you’re feeling a little anxious about having an appointment with a dietitian, that’s totally normal! Any appointment with a new specialist brings with it a host of questions:

• Will they listen to my concerns?
• Will they have answers for me?
• Will they judge my food choices?
• Will they say I can’t eat my favourite foods anymore?
• How hard will it be to actually follow their suggestions?

You probably have these questions and lots of others going around in your head! Understanding a bit more about what to expect, can certainly help you to feel more confident, relaxed and comfortable at your appointment.

Now obviously, not every dietitian will do things the same as there are many different areas we can specialise in. At Everyday Nutrition we specialise in food intolerances and IBS, so we might ask slightly different questions to a dietitian who sees people with a range of different concerns. Let’s talk about how we run our sessions at Everyday Nutrition.

What does a dietitian do

The truth is dietitians do lots of different things. Just like you have GPs who see a range of conditions and then you have other doctors that specialise in diabetes or gynaecology or broken bones. Dietitians also specialise. Some dietitians specialise in diabetes, some do eating disorders, some do weight loss, and others, like us, work with gastrointestinal conditions.

As gut health dietitians who work with people who have IBS and food sensitivities we generally want to help people calm their gut, identify their triggers and establish the most liberal diet possible. We love food, and we know that there is a whole lot more to settling symptoms than just nutrition. We want you to be able to enjoy all different types of food and be able to enjoy eating out with friends and family without it resulting in pain and suffering. This means we need to help you get the most out of your dietitian appointment.

How to prepare for your initial appointment:

The most important part of preparing is to think about your goals and what you want us to help you with. The more we know about this, the more we can target recommendations.

When you book with us you will get an email with an online intake form. This form covers some basics questions about your symptoms and medical history as well as asks for some of the common foods you eat. If you don’t have a food diary, that’s fine, if we want more detail, we will ask for it during your consult. The intake form also covers off some of the legal stuff like privacy and consent for treatment. So, it’s important to complete the forms prior to your appointment.

Beyond the intake form and list of common foods you eat, its super helpful if you can share the results of any blood tests, scans or investigations you’ve had. It’s also a good idea to make yourself a list of any questions you want to ask us during your appointment. You can even email these to us before your appointment if you like.

We know that it’s normal to feel anxious when going to a new specialist, so if you want to bring a friend or family member with you to your appointment, that’s fine too. Sometimes an extra pair of ears can be useful. Rest assured, we are here to listen to your needs and understand you. We like to build a good level of trust with our clients to allow them to feel comfortable opening up about their concerns.

What to expect from your first appt

Your first appointment, whether it be online or in clinic, will last for about 1 hour and always starts with an in depth assessment. We want to get to know you so that we can tailor advice to fit your specific needs.

Assessment stage:

The first part of this appointment is what we call Assessment and involves a long list of questions. The most important thing to know about this assessment, is that our clinic is a “no judgment zone”.  We are gut health dietitians because we love food. If you ate a pizza last week, all we want to know is how good it was and how your gut handled it.

About you: We want to hear a little about you, your home life and your work life.

• What do you do?
• Who do you live with and do they have any dietary needs to consider?
• Do you shop and cook for yourself or does someone else do this for you?
• What do you do for fun?
• What is your biggest problem right now that you want us to help you with? 

Your story: We want to hear all about your symptoms

• What symptoms do you get? (yes, that means bowel movements too)
• When did they start?
• Have they changed over time?
• Do they interfere with other parts of your life?
• Have you noticed any patterns?
• What have you tried that helped, sort of helped, or didn’t help?

Medical history:

• What tests have you had and what were the results?
• What medications or supplements do you take?
• Any major illnesses or hospitalisations?
• Do you have any medical conditions we need to consider with recommendations?
• Does anyone else in your immediate family have gut issues or food sensitivity
• How are your sleep, energy and stress levels?

Measurements: 

We don’t have scales in our clinics and we don’t need to weigh or measure you. This doesn’t tell us anything about your IBS nor help us work out what food you are sensitive to. At Everyday Nutrition, we work though a HAES lens. If you’re not familiar with HAES, it generally means that we don’t judge your health by looking at you and we believe that everyone can be the healthiest version of themselves regardless of size or shape. There are only 2 occasions we are interested in measurements:

• To make sure a child is growing and developing
• If you have unexplained weight loss

Food: We need to know about your eating patterns so we can create a plan for you.

• How is your appetite and how regular are your meals?
• What food you eat regularly? We are most interested in what foods that you eat all the time. Usually about a week’s worth of “normal eating” is enough. We don’t need to know everything you ate and experienced over the last six months. Generally speaking, this is unclear and misses the wider picture. If we want more detail on a particular product or ingredient, we will ask
• What foods or activities are you suspicious of triggering or worsening your symptoms?

Goal setting stage:

We need to know what is important to you and what your priorities and expectations are. For many people we see its about feeling better and identifying the foods that trigger their symptoms. While knowing your triggers doesn’t take your IBS away, it does remove the frustration and unpredictability and makes it much easier to manage.

Recommendations stage:

In our perspective, this stage of the consult is where the magic happens. This is where we take all the information from the assessment and discuss with you what patterns we are seeing.

What we are looking for at this stage is patterns that we can build together to make a jigsaw puzzle and give us an indication of what is likely going on. Patterns with symptoms. Patterns with test results. Patterns with what you’re eating. And patterns with what your triggers are. When we tie this altogether, more often than not, it points in a certain direction. Once we have this picture, we will discuss with you what patterns we are seeing and what this means for your goals and priorities.

When it comes to IBS and food sensitivity, there are no reliable tests that tell us what you are sensitive to or what your threshold is. We are even learning that breath tests are not as reliable as we used to think they were. The gold standard for identifying a sensitivity is a process of elimination and reintroduction. If we can remove something from your diet and have you feeling better, this indicates we are on the right path. It’s when we reintroduce something and purposely cause a symptom, that we can be sure of a trigger. I know this sounds a bit scary – no one wants to purposely make themselves unwell, right? We get this and will be there to support you through the process. We will help you test foods at your pace and make things as gentle as they need to be. Just tell us how you are feeling about it.

Now, there is often more than one way to help you manage your symptoms. At this stage we have a point A (where you are now) and we have a point B (where you want to be). But, there are likely a few roads that you can take to get from A to B. At Everyday Nutrition, we like you to be in the driver’s seat and choose your treatment path. So, we will often give you a few options to get between point A and point B and discuss the pros and cons of each option with you. You get to choose which one fits best and is the most “doable” for you. Afterall, you’re the one that has to go away and actually implement the plan. Elimination diets are seldom easy straight off the bat, but they become a lot easier and manageable with a good support team around you.

Finally, once we have a plan, its then time for us to give you the practical resources to implement it. Usually we will go through what you are currently eating and identify what needs to be modified and what you can have in its place. We like to focus on what you can eat and we also want to make sure you have some “fun food” options too. Our team will help with recipes, products and meal planning tips along the way.

Follow up

Nothing is ever erfect and life likes to throw curve balls so sometimes we need to tweak that plan as you progress through your health journey.  This means we need to follow up after the first session in case things didn’t go as expected. Perhaps the results we expected didn’t add up or perhaps something happened and the plan was no longer realistic. Usually, identifying a sensitivity is a gradual process that comes with many surprises. Some pleasant, and others that set off lightbulbs. Our team will act as detectives to figure out what is going on.