3 Big Challenges Nutritionists Face with New Clients

By Brian Bender, Ph.D.

Becoming a nutritionist can feel daunting. And let’s face it - there are way more than
three challenges to becoming a successful nutritionist. You need to understand the
ins and outs of metabolism, micronutrients, hormones, and even genetics and gut
microbiology have become increasingly salient.
But the biggest challenges faced by nutritionists aren’t usually whether
you know enough about nutrition.

Understanding behavior change methodology is the not-so-secret challenge to

succeeding as a nutritionist.

And whether it’s making a change in the first place, sticking to a change, or
understanding the changes they’ve made, clients will challenge you every step of the
way. There are as many ways to tackle these challenges as there are personalities
you will encounter. But here’s a few tips to get you started.

1. Clients Won’t Want to Change Certain Eating Habits

If a client sought your help, they are already motivated to change. They may even expect
you to say things like “eat less sugar.” (According to NHANES survey data, sugar
consumption in America is too high for over 90% of the population every day!)

But what they may not be prepared for is exactly what advice like that means in
practice. Like letting them know that a single nonfat Caffe Mocha from Starbucks
surpasses what the World Health Organization recommends for daily sugar intake
for the entire day.

Food is personal. Food is emotional. Our culture, our holidays, and our identities are
wrapped up in the foods we eat. Sometimes, clients may get defensive.

“Why is this a problem? This isn’t unhealthy.”

If your client doesn’t believe the switch is important, it will hardly be sustainable. And
you’ll have to contend with the never-ending onslaught of fad diets and bunk blog
articles. Many clients will have a hard time changing their mind, particularly advice
from a well-meaning, but ill-informed, friend.

“My friend eats the same foods as me, and she looks great!”

Sure, there are genuine genetic and microbiota-based differences that cannot be
ignored surrounding weight management and nutrient metabolism. But a famous
quote says it aptly, “genetics loads the gun, lifestyle pulls the trigger.”
This is a great opportunity to introduce how topics like stress, activity, and sleep
affect nutritional health. And they are almost assuredly misled about their friend’s
eating patterns as well (most of do a poor job of dietary recall).

And while beliefs about nutrition are challenging enough, changes that confront
quality of life issues are an even greater challenge.

“My wife loves this meal. How can I stop making this for her?”

Nutrition is a long-term game. And some indulgences from time to time won’t make
someone obese anymore than an occasional fast makes them skinny.

Integral to successful dietary change is managing quality of life. Because at the end
of the day, good nutrition is ultimately a worthwhile endeavor for improving health
and letting you live a long, active life.

One useful strategy is to substitute one ingredient in their beloved dish with a
healthier option, or simply eat their treat one less time per week. Reduce the change
to a level that seems achievable for your client.

2. People have difficulty sticking to long-term changes

Psychologists, behavioral economists, and nutritionists are just a handful of
professionals looking to solve this problem. In fact, the 2017 nobel prize in
Economics was awarded to Dr. Thaler, known for the concept of nudging individuals
towards long-term goals using small habit changes. One interesting nudge is to
change the client’s environment.

Dr. Thaler’s work was shown to increase sales of healthy foods simply by placing
them higher on grocery store shelves. Simply putting them at eye-level made more
people choose them. The same has been used in children’s cafeteria lines in school
to improve childhood nutrition.

Similarly, Brian Wansink’s work on Mindless Eating shows that using smaller plates
or changing surrounding colors can inspire behavior change without you even
knowing it.

The key to nudging is to start really small. So small, it might not even feel like you did
much of anything. For example, BJ Fogg - founder of Tiny Habits - suggests starting
with one pushup a day, or simply lacing up your running shoes without even going
for a run. His studies have shown that accomplishing these mini goals, and making
them stick as a habit, will gradually lead to an increase in activity over time.

And importantly, Fogg suggests tying the new habit to an existing one. The idea is to
use these existing habits as a trigger to remind you to do the new habit - like how
brushing your teeth can trigger flossing.
3. How do you know your clients have adopted these new changes
consistently?
What are your clients eating? Are they following your advice? Short of living with
them, food journals are pretty much your only option. But do food journals work? Yes
and no.

Nearly three decades of academic studies have consistently shown they can help
clients lose weight. And they are a go-to strategy for nutritionists to study their
clients’ behaviors.

But sometimes memories are fuzzy. Sometimes we don’t know the quantity of what
we ate, or the contents of a friend’s home-cooked meal.

Other times, we simply forget. It’s called mindless eating for a reason!

And unfortunately, facing your nutritionist and admitting you had a second slice of
apple pie, accidentally gets left off the list.

Having accurate and reliable dietary intake data is critically important. Not only can it
undermine a client’s potential for success, but it can also inadvertently steer your
recommendations in the wrong direction if results don’t materialize. Work with your
clients on figuring out the best habits for obtaining accurate dietary intake data on a
consistent basis. As Google recently published regarding team management,
the greatest factor that determines whether teams are effective or not is trust.

Conclusion
Behavior change is challenging, but conquerable. Miniscule changes that are easy to
implement work best for becoming ingrained as habits. Over time these tips can help
your clients meet their goals.

But each client is unique. That’s the fun part!

Don’t be afraid to experiment a little. Just do your best to measure and track
progress!