Thank you to EDRD Pro member Briony Blake for sharing some valuable lessons she has learned as a newly minted dietitian!
My name is Briony, I am a new-grad dietitian (read: brand new baby) working in regional Australia.
Since graduating in October of last year, I have had some seriously amazing opportunities come my way: I have been working in private practice (and loving the longer session times that outpatients bring!), doing one day a week at a local youth mental health service, and picking up the occasional clinical shift at the local hospital.
All through my studies and placements, we heard cautionary tales of burnout – warned about making sure we were taking time for ourselves and time off our part-time jobs (pretty hard to do when you live alone and needed to work on the weekends to pay your rent, but that’s a whole other blog post…).
One of the protective factors I found while at Uni was what I am fondly reflecting upon now as the “bubble of weight neutrality.” My peers were on the same anti-weight loss wavelength. My supervisors had seen enough malnourished inpatients to push back against (with compassion and kindness) those in their care who would lament that they could do with “losing a few pounds” during their admission, and lots of our teachers had experience with eating disorders.
And then, in February, I got my first weight-loss referral, then another, and then at least ten more each week ad nauseam. Hmm, what did these GPs not get? Didn’t they enjoy my presentation wherein I talked about the dangers of putting weight loss on a cure-all pedestal and how telling your larger-bodied patients that “losing weight is the only thing to help their elevated blood sugar, sore joints, fatigue etc.” runs the risk of isolating them and may actually prevent them from seeking health care in the future? Sure, they all had a hero story about a handful of clients for whom swimming or lite n’easy or calorie counting “worked” (and by “worked,” I mean helped them lose weight “get healthy”). The part that went unsaid and unacknowledged was that surely they see 100x more clients for which long-term sustainable weight loss hadn’t happened.
It really started to get to me when I wasn’t even receiving recent blood test results with these referrals. How am I meant to give these clients non-weight-related goals if I didn’t even have a baseline?
So, back to burnout: call it naivety, call it strength in conviction, but I don’t think I was prepared for how many times in a session, let alone a day, I would have to subtly and less subtly nudge a line of conversation that was wobbling on the fence between internal fat bias and straight up disordered eating. From clients who when I asked, “What can I help you with today?” just gestured down at their body as if that should tell me everything I need to know, to the doctors who kept upping their larger-bodied patients’ diabetic meds despite them having BGLs readings below diagnostic levels.
I am only just past the six-month mark in my career now, and I can really, truly see how burnout happens to a lot of people in this field. The amount of times I have been tempted to give someone a meal plan, go along with their weight loss attempts, or cheer them toward their goal even though it feels like watching a car crash has been many.
Pretty quickly, I decided that it was going to be up to me to pull myself up out of this feeling of drowning in diet culture, and here are some of the ways I went about it. I hope this piece can help other newbies in realising that they aren’t alone.
1. Talk to your supervisor, talk to your therapist.
I am really lucky to have very supportive people occupying each of these roles in my life, and being able to talk all the way through my frustrations and low feelings to reach the conclusion that, even though weight-inclusive practice is a much trickier and more taxing way of practicing, it’s also the right way. There’s no other kind of dietitian I would ever want to be.
2. Push back.
I started asking for bloodwork to be automatically included in ALL GP referrals. I explained why, I advocated for my profession, and I continue to give evidence of why dietitians are more than meal plan providers. Every time I can outline WHY I am not putting a client on a weight loss diet in my letter back to the doctor (like I have uncovered a long history of disordered eating, provided education regarding balancing carbohydrates has helped bring down their blood sugars, or discovered that the reason they were “binging” in the evening is that they were skipping meals all day long), I get a little boost of “I can do this; I am doing this”.
3. Don’t compromise your beliefs, but adapt your angle.
Going in guns blazing every time a client confides in you that they want to lose weight is going to leave you exhausted. Instead, get curious, reflect, and offer other options (motivational interviewing, anyone?) You’re not going to change the world in a single session, or even in ten.
4. Find community.
Podcasts, EDRD Pro™, other weight-neutral practitioners. Find your people, and talk to them often: air your frustrations, share your strategies.
5. Keep track of the little wins.
Every time someone says that I have given them something new to think about or have helped them in some way, no matter how small, I try to take a minute to thank them for sharing that with me or just simply bookmark the comment in my brain to come back to when I need it.
Well, that’s me, I would love to hear from you, whoever you are, and wherever you might be in your journey- let’s chat, there’s no such thing as too many weight-neutral practitioners. In writing this I found another pocket of renewed belief and energy for this work, and I can’t wait to see what happens in clinic next week.
Hi! My name is Briony, and I am a new grad dietitian, based in regional Australia. I have a strong passion for combining medical nutrition therapy with Motivational Interviewing to facilitate effective and lasting behavior change.
I am currently working in private practice, 1 day per week at a youth mental health service and the occasional clinical shift at my local hospital (and to think I moved out of the city to have a better work/life balance).
I practice a weight-neutral/non-diet approach and continue to learn a lot from the Health at Every Size (HAES) movement, and compassionate practitioners everywhere.
When I’m not working, I love to drink soy cappuccinos, swim at the beach, and listen to trashy celebrity podcasts.