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Becoming a Dietitian: Nutrition Q&A + More with Christina Constantinou

Three Things We Dive Into In This Episode:

  1. Failure, pivoting, and the winding road to becoming a Registered Dieitian

  2. The difference between nutritionists, dietitians, and therapists.

  3. Why we DON'T focus on the pursuit of intentional weight loss at our practice


📌Episode Highlights

[01:38] Kindness for Yourself

  • Take a quiet moment to be kind to yourself and spread that kindness with each other.

  • Being kind to yourself can give you the energy to do things and build good relationships.

[12:03] Who is Christina?

  • Christina Constantinou is a registered dietitian with experience working in different roles. She is a clinical dietitian and fills an outpatient role at Full Soul Nutrition.

  • Her Greek origins are a significant part of her identity.

  • Many would describe her as a warm, cozy, and down-to-earth person. People often find themselves comfortable talking to her.

  • Christina’s work as a dietitian brought out the best of these characteristics within her.

[15:41] The Many Hats of a Dietitian

  • As a clinical dietitian, Christina works in an inpatient setting at a hospital alongside doctors and other dietitians.

  • She counsels patients whose treatments include diet and lifestyle changes. Usually, she would only have a short time with them.

  • Christina works one-on-one with her patients for an hour each at Full Soul Nutrition. She discusses several different things regarding nutrition and better health.

  • The counseling skills she honed as a clinical dietitian carry over in her outpatient role.

  • Christina first was a relatively new dietitian when the pandemic hit. She learned to be adaptable and work well under pressure.

[21:24] Step-By-Step Guide to Becoming a Dietitian

  • Christina’s journey to becoming a dietitian was one of her biggest challenges.

  • The first step is to take prerequisite nutrition and science courses in your undergraduate studies.

  • The next step is to apply and match with a dietetic internship and complete hours of supervised work.

  • To match for an internship, you have to apply to different offered programs and rank them. There's a 50% chance of matching with your preferred program.

  • Lastly, you must pass your board exam to become a registered dietitian.

[25:30] Overcoming Obstacles

  • One of Christina's terrifying moments in her journey was when she didn't match with any of her preferred programs.

  • Fortunately, she found out that she could apply for programs that hadn't filled their spots. She applied everywhere she could.

  • Christina matched with a program from home and moved her whole life from New Jersey to Missouri.

  • Despite the change, she completed her internship and passed the board exam on her second try.

  • Christina and I both found that the real learning starts once you begin your career as a dietitian.

[32:03] Christina’s Internship Experiences

  • Christina had to move to Missouri at 21 years old and face terrifying challenges alone. Despite that, she found it was one of her best decisions.

  • Christina’s struggles made her stronger. What she thought was the end of the career she dreamed of became the beginning of her journey.

  • She learned to be more sensitive and find value in her experiences. It's hard to do what's best for you, but Christina persevered.

Christina: “Taking each day by day and really finding value in each of these experiences and everything that was happening in my life at that time. Professionally, personally, and spiritually, all of these things made me so much stronger. It made me such a better clinician.” - Click Here To Tweet This
  • Christina had thought she was an incompetent dietitian because of her failings. Similarly, I also faced failure in the form of other people's judgments.

  • Our failures don’t define our abilities as dietitians. Instead, it built our resilience and taught us to grow stronger.

[42:46] Defining Dietitians

  • Dietitians vs. Nutritionists: dietitians must be licensed or registered to practice. However, nutritionists are not regulated.

  • Dietitians vs. Therapists: therapists often work to understand the reasons behind your behavior, thoughts, and feelings. They take action to improve mental health.

  • Dietitians won’t psychoanalyze you. Though there may be overlap, they focus on proper nutrition for better health.

  • Dietitians educate their patients about nutrition and explore their relationship with food and their bodies.

  • It’s okay to have a therapeutic relationship with your nutrition counselor. Working as a dietitian goes beyond teaching what’s healthy and not.

[50:31] Weight Loss and Better Health

  • Restriction of food is one of the most consistent predictors of weight gain. Focusing on weight loss can mean focusing on shame.

  • Restrictions stop you from being your whole self. It promotes negative emotions rather than a positive mindset.

Christina: If the end goal is supposed to be positive, how are we going to get there with all of these negative emotions and negative steps? So I think shifting the light and shifting the mindset of noticing and realizing that if you're going to be at your most positive and best self, you have to do so in a positive way and in positive mindsets.” - Click Here To Tweet This
  • Remember that weight is not a reliable indicator of health. It’s more important to look at behaviors.

Caitie: “Weight is not a behavior, individuals and an individual's body shape or size does not tell you anything about how they live their lives and how they do or do not intend to pursue health.” - Click Here To Tweet This
  • Society today is fatphobic; this stigma negatively impacts your health more than weight.

  • Stay tuned for part two of this episode, where Christina and I answer more of your questions!

About Christina

Christina Constantinou is an Associate Dietitian at Full Soul Nutrition and a clinical dietitian. She's a registered and licensed dietitian, a certified Intuitive Eating Counselor in Training, and has a Master's degree in Health Communication and a Bachelor's degree in Nutrition Science. Her individualized approach to nutrition helps her educate and empower people's relationships with food.

Connect with Christina and learn more about her on Full Soul Nutrition’s website.

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Christina Constantinou: Having lived through the pandemic and having worked as like a health care provider during the pandemic, it's just everything's changing right in front of your eyes and all you have to do is adapt. There's really nothing else that you can do. Being a relatively new dietitian when the pandemic hit, that was the scariest thing ever, just again, walking into a room with three doctors that have face shields and masks on. All you can see is their eyes, and you're like, “hi, I'm here to talk about nutrition.”

Caitie Corradino: Welcome to Whole, Full and Alive, a podcast exploring the art and science of falling in love with your life, with your story and with who you truly are underneath your titles, your resume, your relationship status, and your bank account. I'm Caitie Corradino, a registered dietician nutritionist, certified fitness and yoga instructor, eating disorder recovery coach, Reiki healer, and founder of Full Soul Nutrition, but underneath my titles and resume, I’m a big fan of kitchen dance breaks, early mornings, all things chocolate truffles, world traveling and serendipity.

I'm here to share no bullshit stories and actionable tools to help you feel unshakably worthy. You have everything you need within you to feel whole, full and alive right here, right now. Let's get into it.

Hey there, welcome back to another episode of Whole, Full and Alive. I am coming to you from Denver, Colorado. It's Tuesday, November 1st. I went to the Lizzo concert last night. It was amazing. My eyes are very heavy right now, as I'm speaking to you, the most worth it kind of heavy ever though. I love, love, love, love, love Lizzo. I think she is just an icon in every sense of the word. This episode is not about Lizzo and why I love her, and I could probably do an episode about Lizzo and why I love her. But I'll try to pull myself over and not talk too much, but actually am feeling called to share one thing about the concert last night before I dive into today's episode.

Something she said that just really struck me in how profound it was because it was so simple. She said while she was on stage, in the middle of one of her songs, she was like, “hey, when was the last time you said something kind to yourself? Seriously, when was the last time you actually said something truly, legitimately kind to yourself?” She was like, “my challenge for you right now is to close your eyes and say something super kind to yourself about yourself.”

“If you can't think of anything, just say,” I think she said something like, “you're beautiful, and you are strong, and you can do anything,” something like that. She was like, “now, open your eyes. That level of kindness, that level of care that you just gave to yourself, go and give that to somebody else.” So as soon as you're fully filled up with your own kindness, with your own love, now go and give that same attention, that same kindness, that same sincerity to another person, just one other person.

She was like, “because that shit, that shit expands. That's gonna magnify, like the good energy that we have in the world.” Just you saying something kind to yourself and then using that to kind of fill yourself up and then taking that and giving it to somebody else, and it sounds very much like a on the surface, something like Mr. Rogers or like Barney would say. But what it's delivered by someone like Lizzo, it’s, first of all, more people are gonna hear it because she's freaking awesome, and the way she delivers things is amazing.

Also, it just reminds you that really is something that we can all do. We really can take a quiet moment to close our eyes and just say something kind to ourselves. Being kind to yourself is not being complacent. Being kind to yourself is giving yourself the energy to be able to do the things that you actually want to do, rather than the things that just quiet your inner asshole for five minutes.

Being kind to yourself and being on your own team gives you the ability to enter relationships that are actually good for you rather than the ones that just, again, kind of quiet the inner asshole. You don't settle for breadcrumbs, because when you're on your own team, you don't need breadcrumbs for other people. You only need good, juicy, fulfilling relationships. So yeah, a message from Lizzo at her Halloween concert in Denver last night that I was lucky enough to attend, just feeling called to share that with you in today's intro.

Now, let's get into to today’s episode. It’s a special one, and let's see if I can like smoothly transition my way into an intro after that little rant about Lizzo. So today's episode is special. Today's guest is my associate dietician, Christina Constantinou. When I say associate dietitian, I mean that she is the other dietitian who sees clients at my private practice called Full Soul Nutrition.

So in other words, Christina is the first person that I've ever hired as an entrepreneur in private practice. Christina is the other person that my clients have the opportunity to work with when they come to do one-on-one work at Full Soul Nutrition. So Christina is also a registered dietician nutritionist and a certified intuitive eating counselor.

She works in Outpatient Nutrition Private Practice at night, and during the day, she works in clinical dietetics, so she works for a hospital in both their inpatient and outpatient units there too, I believe. So she's a very well rounded dietitian, lots of knowledge not only about eating disorder recovery and intuitive eating, but also a good degree of knowledge about medical nutrition therapy and working with people in various stages of hospitalization, which is very interesting.

She'll talk a little bit about that. Let's see, how can I relate this to Lizzo and kindness and all of that. Well, I think the obvious thing is that Christina is an incredibly kind person. She has a very, very warm energy, and that is the reason why I was so confident about hiring her. Yes, she has credentials and education and a genuine interest in practicing holistic nutrition in the same way that I do, which is very important that her mission and values were aligned with my practice.

But also, Christina is one of those people that sprinkles kindness around. She is definitely one of those people who you can tell is comfortable enough with herself that she is not threatened by other people, and is kind enough to herself that she has energy to be able to give to other people, that is something I think I say at the beginning of the episode. She's just a very, very cozy person.

As someone who doesn't have all that much experience hiring that many people and as someone who also went to school for nutrition science and not for hiring an HR and things like that, I really did have to kind of make up my own interviewing process and kind of work my way through the process of finding an associate who I felt comfortable bringing into my practice.

I'm so thankful that I found Christina because she does have both the tangible and intangibles that I was looking for in a teammate at Full Soul Nutrition. I'm so excited for you to meet her today.

If you are interested in becoming a registered dietitian, this is going to be a particularly important episode for you to listen to because we actually talk a little bit about the process of becoming a registered dietician, and Christina talks a little bit about some bumps in the road that she hit while she was trying to become a dietitian, and really courageously and thankfully shares about an experience she had with rejection from a school and how that kind of made her reroute, and how that also changed her life for the better in a lot of ways.

Christina and I were planning to only talk for like a little bit about her journey towards becoming a dietitian, and then we're gonna dive into nutrition Q&A based off some questions that we received on Instagram. But we ended up talking a lot about her journey to become a dietitian, like for a while, and we have a really nice conversation about failure and trusting the path and reframing this concept of everything happens for a reason, because that's not helpful, right?

But yeah, it ended up being a really good conversation with a lot of good nuggets to take away. So that is going to be the first part of the episode and then we do a little bit of the Q&A. Towards the end of this episode, we start answering some questions that we received on Instagram, but we're actually going to finish answering those questions in a part two that will be released on Wednesday this week.

This is going to be a two parter. Christina will be on two episodes, and we're also going to have two episodes released of the podcast this week, which is very exciting. One more thing before I dive into this episode with Christina, I want to let you know that next week. Next week, Thanksgiving week, we are releasing an online course. Now before you run away from this word course, I want to say that it isn't like this super dense thing with 90 minute long lectures and modules and things like that.

This is actually a really action packed, experiment-based, journal prompt-based kind of online course with just some really short but super juicy modules and audio things for you to listen to you. This course is called Whole, Full and Alive because it's meant to accompany this podcast.

If you like some of the concepts that we're talking about on this podcast, if you're interested in working on nervous system regulation, self worth, body image, intuitive eating, could nutrition, healing your relationship with exercise, all the different things we talk about on this show Whole, Full and Alive, the simple, digestible, yet palpable and juicy online course is going to be for you.

It's gonna help you create energizing routines and rituals that actually feel good that don't have anything to do with rigid and restrictive dieting. It's basically a way for you to work on your health and wellness, while still healing your body image and regulating your nervous system and things like that. So I'm really excited for that to be launched next week. Look out for it, definitely doing a sale on it for Black Friday.

With that, let's get into my interview with my amazing associate dietician, Christina Constantinou. Christina, thank you so much for being here today.

Christina: Thank you for having me.

Caitie: So this is so similar to what we do every other week on Zoom, but we're just recording it now, which is really exciting. It's been the best to have a team member. Being a solopreneur is pretty damn lonely. Sometimes I've got my little networking groups and things like that, but sometimes I just want someone in my corner who's doing the exact same thing as me.

It's been so, so, so nice to have a teammate in Christina, and I'm so excited for you all to meet her right now. So, Christina, before you tell us more about what you do as a dietitian, please tell us who you are.

Christina: I'd love to. Firstly, thank you for all the kind words. The feeling is very much mutual. I've loved having someone in my corner as well, so so happy to hear you say all those nice things. But who I am as a person, I would say the first thing that comes to mind anytime somebody asked me that question is I'm Greek. It's a huge part of my identity culturally and just like spiritually as a person.

My parents immigrated to the US when they were in their 20s, and so it really is a huge part of my life. Greek was my first language. I was like that little preschooler that didn't speak any English in the States when she first came to school, so huge part of my life. I lived in Greece for a couple years, so that really is like a huge part of me. Then apart from that, I would say I am obviously a dietitian.

That's also a huge part of my identity, but apart from that, I would like to think that I'm like a warm and bubbly person. Those are like words that have been used to describe me before.

Caitie: Own it, just own it.

Christina: But yeah, I would say those are probably like the biggest parts of me.

Caitie: Yeah, I also because I interviewed and hired Christina. I feel I can speak to who she is beyond what she does. Christina is a very just down to earth and just comfortable, cozy person. When you're hanging out with Christina, you don't feel judged, and that is a really important thing. When you're spending time with Christina, you feel like you can just be yourself, and she's not going to be fazed by it.

Working with me, slash for me is not something for everyone. I'm a lot. I am a lot. Christina is just such an anchored person that I can be like, “hey, we're changing everything. We're burning everything to the ground, scratch the whole plan,” like just about every week. She is just so go with the flow, so calm, so centered, that she can be along for the ride, and I absolutely love it.

I think we're a really good team in that sense because if we were both like me, I'd be insane. Maybe if we were both like you, Full Soul Nutrition wouldn't exist. So we really need this sort of yin and yang, and I feel like we're just such a good team in that sense.

Christina: I totally agree. Again, thank you for gassing me up and saying all of those nice things. Cozy is like my all time favorite word, so for someone to tell me that I am cozy is just like I could cry.

Caitie: I love that so much yeah, and she was just wearing really like somehow super cozy looking clothes but also very fashionable. Your sweaters are cozy but also just so much more fashionable than the way I dress. I'm sitting here in tie dye pants and a crop top on October 18.

Christina: Own it. Own it, girl.

Caitie: Owning it. So beyond who you are Christina, what do you do? What do you do in the world?

Christina: I am, as we all know by this point, a dietitian, but I like to tell people that I wear a lot of hats as a dietitian. I am a clinical dietitian by day and then I am an eating disorder, holistic dietitian counselor by night, so I do wear kind of a lot of hats in the nutrition world. All of those nice things you said about me about being an anchor, I feel like I owe it to being a dietitian and to my journey of becoming a dietician, so I'm excited to talk about that, too.

Caitie: Yeah, so what do you do as a clinical dietitian versus what you do as like an outpatient counselor focusing more on eating disorder recovery and holistic stuff?

Christina: Yeah, so as a clinical dietitian, I work in an inpatient setting. So in a hospital, on a team of seven dieticians — I work for pretty smaller hospital. We're a level one trauma center, and we get a lot of traumas. So sometimes my day is full of just traumas essentially, and patients that aren't eating, and I have to manage their tube feeds if they've come in and are put on a ventilator, and can't eat by mouth.

Some days, my day is counseling a newly diagnosed diabetic, or somebody who has hypertension and doesn't know how to treat it with diet and lifestyle changes. Sometimes it's a mixture of the two, so I see a lot of that during the day. Then in the evenings, I am in an outpatient role at Full Soul Nutrition, and so I work with clients one-on-one in a completely different setting than the hospital, right?

I would say in the hospital, I probably spend about 10 minutes tops with a patient, and then as a counselor, I spend at least 60 minutes or 55 to 60 minutes, one-on-one with my client, counseling them on whatever they need, and that could be an eating disorder. It could be just learning how to heal their relationship with food. It could be a multitude of different things.

So it's very black and white, my day and night jobs, and so it's interesting. I mean, it's great, because I have gotten the world of experiences in the past couple of years as a dietitian, but very, very different roles.

Caitie: Yeah, I mean, there is that so much that's different about working in inpatient clinical setting, and then working, obviously, in the outpatient counseling setting. Also, there are some things, I mean, I worked inpatient for a little bit. It was a brief stint, but I did do it. There are some things that you learn from inpatient clinical dietetics that you can carry over into your role as an outpatient counselor, and I'm curious, like, what are those things that you think can carry over?

Christina: Yeah, I would say a lot of my interviewing, like motivational interviewing skills and my counseling skills have really come from my inpatient settings, since that was my first job right out of school. I mean, they teach us that in school, right, like how to interview somebody and how to have like a counseling session. But I think once you're fully immersed in it, and once you step into your first role as a dietitian, you never really know exactly how to do that.

So for me, I stepped right into the hospital and right into an inpatient setting, and so I had to quickly adapt and learn how to talk to these people. So I think a lot of my counseling skills I've kind of developed in the hospital, and I've definitely carried them over with me in my outpatient role.

Caitie: Oh my gosh, there's nothing scarier than going into your first patients. I remember it clear as day like the first time I had to go into someone's room, due to just have a triple bypass. They were like, go talk to him, and I was wearing my white coat for the first time. It's still like crinkly from like being folded up, and I'm like, oh, my gosh. When you're just thrown into that, you have to become so comfortable talking to strangers about really personal things, and you have to become comfortable holding space for people in that capacity.

It's not easy. The only way you learn is by doing, for sure. But if you I think if you can do that, you can counsel someone in that setting, if you can, oh my gosh, the worst is when you walk into a room, there's like three doctors in there, oh my gosh, with patient, and they scowl at you. If you can do that, you can do anything. So I feel like that skill of just throwing yourself into a patient's room or throwing yourself into a shark tank of three doctors that are observing the patient, like what can't you do after?

Christina: I could not agree more and I will say like having lived through the pandemic and having worked as like a health care provider during the pandemic, it's just everything's changing right in front of your eyes, and all you have to do is adapt. There's really nothing else that you can do. Being a relatively new dietitian when the pandemic hit, that was the scariest thing ever.

Just, again, walking into a room with like three doctors that have like face shields and masks on, and all you can see is their eyes, and you're like, “hi, I'm here to talk about nutrition.”

Caitie: I can't even imagine being in the hospital during that time. Yeah, I mean, adaptability is probably a huge skill that you pick up, and you have to be adaptable when you're counseling someone for an hour. Anything can happen in that space, in that time. An hour's a long time to be sitting face to face with someone having a personal conversation with them. So yeah, yeah, thanks for sharing that.

So I always ask my guests, what is a challenge you've overcome in your life that has brought you to where you are today in your career, that has brought you to doing the thing that you do? You and I are going to talk about something specific today, because before we got on the Zoom call, I put out a question sticker to Instagram asking people what nutrition questions do you have.

One of the questions that came up is what is the difference between a nutritionist and a dietitian, and that inspires me to ask you about the process of becoming a dietitian, because I know that was a challenge for you. It was a winding road and a story and definitely one that brought you to where you are today, not only in your professional life, but also your personal life. You can definitely speak to that. Yeah, so take it away.

Christina: Yeah, for sure. I love sharing my story, so I can sit here and talk about it all day. So please stop me if I'm rambling. So for those of you who don't know about how one becomes a dietitian, I will touch a little bit on that. But it certainly was like the biggest challenge for me thus far in my life, going through the process of becoming a dietitian and landing where I am now in my career.

So again, the process of becoming a dietitian is a long one, and no one really talks about it enough, so I'm going to do that. Starting with, you have to have undergraduate like prerequisite nutrition courses. You cannot move forward until you have those. So for a lot of people and for me, I went into college not knowing what I wanted to do. I was undecided. I was like, I'm just gonna figure it out, right?

That's what like college is for, and I somehow landed in a nutrition course. Eventually, someone told me that like dietetics was a thing, and I just kind of fell into it. I mean, of course, I love what I do, and it all happened very like serendipitously. That's not a word.

Caitie: Absolutely a word.

Christina: But you essentially have to have all of these nutrition and science courses under your belt before graduating, and it could be from a four-year program or a two-year program, whatever it is. You have to have these courses done. After having these courses done, you then have to match to a dietetic internship, is what it's called, and I'll talk a little bit more about what that means. But you have to match to an internship and complete 1200 supervised hours.

Caitie: Unpaid.

Christina: Yes, unpaid. You're basically paying them. But 1200 supervised hours before you can sit for your board exam. So the nutrition courses are a prereq for the internship, and then the internship is a prereq for the board exam. You cannot take the board exam without having done those things.

Caitie: You also need your masters now too.

Christina: Now, you need your masters. I mean, both of us have our masters, and we were kind of grandfathered into that but moving forward if you have the decision to have your masters. So that is the chronological order of the way things have to go to become a dietitian. So your senior year or your last semester of whenever you're fulfilling these courses, oftentimes there's a course designated for the matching system and for preparing you for the dietetic internship.

I remember being like so terrified my senior year of college. All of my friends were doing business and having the time of their lives their last semester and here I am taking 18 credit hours with organic chemistry and learning how to apply for the dietetic internship. So basically, they tell you that you have to apply to these programs. The way that it works is if you're familiar with residency programs for doctors, it's essentially an algorithm.

You rank the programs that you want to go to, and they rank you. Then you get put into an algorithm, and you either match or you don't match, same thing for dietetics. So we typically are in this course where they tell you that there's a 50% match rate, and there's a 50% chance that you'll match, and there's a 50% chance that you won't match. Those are your odds. So you apply to your programs. They essentially rank you, and then you either match or you don't on Match Day.

Caitie: Ah, match day. I have [inaudible] just thinking about my match day, but anyway.

Christina: Oh, me too. So Match Day rolls around, and essentially, you open your email and you figure out if you've matched or not. I opened my email on Match Day and didn't match. I had applied to all programs on the East Coast where I had wanted to stay. I went to Rutgers undergrad, and I wanted to stay at Rutgers. I was open to other places on the East Coast, but I wanted to stay in New Jersey ultimately. So I was petrified.

Tears were had, and no one really prepared us, or at least, I felt like no one really prepared me for what happens if you don't match. So I was terrified on Match Day after opening that email and realizing like, okay, now what. So after some like crying, soul searching, whatever, I reached out to a couple professors and reached out to some people that I had known from the previous graduating class.

There's apparently or, well, there is something called scramble day, the day after a match day where all of the programs across the country that have not filled all of their spots, because remember, it's an algorithm and so you fill these spots. They send out a mass email saying we have X amount of spots in our programs, please apply. So I did just that I applied anywhere and everywhere.

I had decided that I wanted to go, I wanted to pursue this, and I wanted to be in a dietetic internship the following year. I mean, you could always take a gap year, and there's options for people, but I knew that this was what I wanted to do. So I applied everywhere in the country. I think I applied to every single school on that list, and I matched second round, essentially, to a school in St. Louis, Missouri, which prior to that day, I did not know existed.

I then picked up my life two months later, and moved to St. Louis, Missouri, completed my dietetic internship and sat for my board exam, failed the first time, which was okay, and then took it a second time and passed, and then I was a dietitian.

Caitie: Oh, my gosh, I think it's worth mentioning that, okay, well, there's a few things that are worth mentioning. First of all, Match Day, oh my god, 50% match rate, it is intense. It is so intense. I remember, and also I applied for programs all around too, and I wanted to stay in New York, New Jersey, so I put them at the top, but I put some other schools in other places. I was like, “oh, my God, this is my life. I could have to pick up and move somewhere too if I match somewhere else, so that was really scary.”

For me, I had no idea what I was gonna do. I also was not in the best financial situation. I'm like a fricking 21 years old. I can’t move anywhere, so that was really scary. But also, after you do these 1200 hours of supervised clinical practice, you're not given any preparation for your board exam.

The board exam, let's just put it out there, has absolutely nothing to do with the work that you do as a dietitian. I'm saying it. I'm calling out the Academy of Nutrition and Dietetics. They need to revise the shit out of that board exam. If you asked probably 50% of individuals who are dieticians, they failed the board exam the first time they took it. Because you're counseling people in your internship. You're creating meal plans in your internship.

You're doing tube feeds, TPN, all of these things, and none of that is on the board exam. This is a fact. The board exam asks you questions like how many ounces of tomatoes would be in a number 10 can in a food service kitchen. I shit you not, this is what's on the board exam.

Christina: I can tell you. I can tell you right now that at least three of my questions on the board exam were about what type of fire extinguishers are in a food service kitchen.

Caitie: That's insane. That's absolutely insane. I remember so much of my board exam was on the Krebs cycle, which is like, I actually don't even know how to define the Krebs cycle. Sitting here on this microphone, I'm like, yeah, I had to answer five questions about the Krebs cycle. I knew it then I don't know it now. The only reason I passed my board exam the first time is because I studied how to read questions. It was like studying for the SATs.

I studied, instead of content, it was like, how can I read this question in a way that's gonna think in the way the person who created the test is thinking. Then it was like, the whole thing was just manipulation, I felt. So anyway, you go through all of this stuff to become a dietitian. I feel that once you become a dietitian is when the real learning starts, like when you really immerse yourself in whatever…

For most people, one of their internship rotations end up hiring them, and wherever you start out, that's where the real learning that's going to take you through your career begins. I feel like a lot of it is kind of just meeting the Academy of Nutrition and Dietetics arbitrary standards for a while. Some of the internship stuff is really, really important. Don't get me wrong. We learn how to read labs and the internship.

We learn how to really make sure someone's medically safe, and there's a lot that we do learn about meal planning and things like that. But I think most of my learning really started post internship. How about you?

Christina: Oh, I couldn't agree more. I've learned way more in my career as a dietitian, and starting with the first patient I ever saw than I ever did during the studying exam, during the actual internship. Again, I completely agree. I think there are some completely invaluable things that we've learned during the internship, and some parts of it are very well structured, but it depends internship from internship.

I've talked to people that had a completely different internship experience that I've had, and so I think it really just depends on where you're doing your internship, which is also insane.

Caitie: Yeah. So let's return to your internship experience in St. Louis, Missouri, and this challenge that you overcame to do the thing that you wanted to do with your career. What happened after that?

Christina: Yeah, so I mean, and this is what I mean, when I say that I feel like a lot of these kinds of things you have to say about me being an anchor, and flexible and adaptable really stem from this experience, because I uprooted my life at 21 years old when I was not in a great financial state, had just graduated from college, and picked up and moved in a matter of two months to St. Louis, Missouri, where I knew not a single soul.

It was terrifying. In addition, and this was like a personal fault. But I moved to St. Louis thinking it was a city where I could get around with public transportation, got there and immediately realized that was not the case. You absolutely needed a car to get around. So there were just a lot of like, personal challenges I faced, but ultimately, in retrospect, it was hands down the best decision I've ever made.

I've made so many incredible connections. I met my boyfriend there. I have made so many lifelong friends. I had an invaluable internship experience. I was at an amazing hospital there. I realized that I wanted to be in an outpatient setting there. I learned a lot about myself, and they were two very formative years for me. The pandemic started while I was there, and I had to also then face that challenge of getting a job in the middle of a pandemic.

But yeah, ultimately, it was challenging, but it was one of the best decisions I've ever made. I always knew it was going to be temporary, or at least I had thought it was going to be temporary. Never in a million years that I imagined I would go to St. Louis and stay in St. Louis forever. I stayed longer than I intended to. My program was a combined master's and dietetic internship program, so it was 18 months long.

In my head at 21, I was like, “I'm gonna go in for 18 months and come right back out and straight back to New Jersey slash New York.” The pandemic kind of changed those plans to stay a little bit longer than intended, but again, that was like a wonderful choice. I started my first job there as a dietician, and it worked out really well for me. But I moved back to New York about two years after living in St. Louis. But yeah, overall, very challenging, but super rewarding, and I learned a lot about myself.

Caitie: If you know me, you know that I hate the phrase “everything happens for a reason. I hate that.” I think it's the most toxic positivity, like sparkly unicorn Band Aid thing that anyone can ever say to anyone and we use it to dismiss really horrible stuff. So I never say that. What I do believe, though, is that we can create meaning from many of the things that happened to us, and we can notice the beauty in all experiences, and we can acknowledge things that suck.

It sucked that you didn't match. It was really hard. Tears were had, as you said, and I'm sure, I'm confident that not passing the board exam the first time was also a really, really difficult experience. Also, how did those two things, like not matching and then not passing the board exam the first time, how do those two things make you a better dietitian today?

Christina: I think that's such a great question. This is so stupid and cliche, and it goes along with you just saying that you don't like using everything happened for a reason, but truly, what I’m going to tell you…

Caitie: Are you going to challenge me right now?

Christina: I'm gonna say that “what doesn't kill you makes you stronger.”I feel like I have never used that term for anything else in my life, but this moment, because truly, I mean, in that moment, when I didn't match, I thought my life was over for the foreseeable future.

Like my career flashed before my eyes. I had no idea where I was going from that moment, and going from living in this state that I grew up in where my family and my friends were to picking up and moving to a completely new city where I knew nobody was terrifying. It was so scary, but it brought so many good things, and it was hard. I'm not gonna sit here and sugarcoat it. I cried the first three months I was living there.

It was terrible, but taking each day by day, and really finding value in each of these experiences, and everything that was happening in my life at that time, like professionally, personally, spiritually, all of these things, it made me so much stronger. It made me such a better clinician, and I've always been a person that gives people the benefit of the doubt and sees things through rose colored glasses sometimes.

But I think I do it even more now, because I've realized that we really don't know what people are going through, unless you're sitting there and having a deep conversation with somebody. You don't know other people's shit, and people have had hard lives and hard things happen to them.

You have the ability to turn it into whatever you want and turn it into a positive experience for yourself and better yourself from it. Point blank, like bottom line, is just that it made me so much stronger as a person, as a dietitian, as just a human being in general.

Caitie: Yeah. Yeah, it sounds like it gave you the opportunity to say, first of all, do I really want this, right? Because then it was like, okay, if I really want this, if I really want to become a dietician and a good dietician, I have to pivot, and I have to go to an internship somewhere else, and I have to find a good program to get hospital and whatever. Thank you for sharing that you cried for the first three months that you were living in St. Louis, because I think that people tend to skip the nuances of relocating a lot.

It's something that's come up with a few of my podcast guests. Obviously, I just relocated from New York to Denver, so I talked about this a lot, too, is like, for the most part, I feel my life is expanded. I frickin love Colorado. I was always supposed to be here. There's also some moments that are really hard. I don't have a single family member that is in the same timezone as me.

It's not all sunshine and butterflies and rainbows, and I'm making new friends and my life is changing. Like I said, expanding and also it's hard. It's hard to relocate, and it's hard to do the thing that's best for you often. So I appreciate that you acknowledged the nuances of that. It's so true that you never know what anybody's going through. You never know. I mean, unless, like you said, you're having a deep conversation with somebody.

You never know what's going on for them, and you never know what the person who inspires you had to go through to get to where they are. I just said this to my little brother today. I was like “Michael Jordan did not make his high school basketball team.” I just remind people about all the time because it's true. Also, I matched, I passed my board exam. I was always very successful academically, and then when I started, when I was becoming a dietician, I had a mentor.

I didn't want to call this person a mentor at this point, because in retrospect, this person was not a great mentor. However, they told me that I was terrible dietician. They told me that I was a terrible counselor. It was the hardest experience of my entire life. It felt like such a failure. It felt like my life was over because I had this one person that did not approve of me, this one person that did not approve of my approach, this one person who, for whatever reason, didn't want to believe in me, and called themselves a mentor, but really just tore me down, frankly, no other way to sugarcoat what happened there.

But if I had not believed in myself enough, and I had not found other mentors, I would not be sitting here on this podcast microphone right now. I would not have met Christina, would not have hired Christina. I would not have my own private practice. I had to pivot from that failure of this person — long story short, tearing me down.

So you never know how many times someone has failed to get to where they are today. Also, the people who have failed are the people who have built resilience, and the people who have built resilience are the people who can really meet you where you're at, because they see what you're going through.

Just like a couple of weeks ago, I had a client who lost a job, and I was able to say this person, “yo, I had this boss at this one point who hated me, thought I was a terrible dietician. You will make it through this. This person doesn't need to have any impact on where you go from here.” I really felt this client, and I know that this client felt how much I was able to empathize with her.

Christina: Yeah, thank you for sharing that too, because I feel like that's so hard to hear from like someone else that you're a bad dietician, or that they think that you're a bad dietician. I think for a long time, I told myself I was a bad dietician, because I didn't match first round, because I failed my exam the first time around. But really, those are the telling things for us, and neither was probably your interaction with this person who thought you were that dietician, who probably, I don't even know where that came from, because anyone who knows you know you’re the most amazing dietitian ever, but it's so much more than that.

I think, coming from the way that we met and the way that we kind of just instantly clicked and knew that we were both like great dieticians individually and like going to be even better as a team. It's so much more than like your background and the way that we got to where we are, that makes us good dieticians, so, yeah, I think.

Caitie: Yeah.

Christina: Scre the lady who told you you were a bad dietician. Who knows — was it a lady, who knows? Yeah, I mean, we don't know..

Caitie: Also, we have 15 minutes. So we're gonna dive into some rapid fire questions that I got from Instagram. We spent a long time explaining the difference between a dietitian and nutritionist . Actually, what we said was what is a dietitian, and how do you become a dietician. So just to briefly explain, a nutritionist is not a regulated term. Anyone can be a nutritionist — anyone, anyone, anyone.

You, if you're listening to this podcast, can be a nutritionist today, tomorrow, in five minutes. There is no regulation on that term. Individuals who call themselves nutritionist don't need to have any sort of licensure or any sort of credentials. You maybe just took one online course or something like that, and you're a nutritionist. So it is important, especially if you're working with acute medical issues or need medical nutrition therapy, eating disorder recovery counseling, to work with a registered dietician, versus working with the nutritionist.

Or if you really like to have a deep desire to work with someone who's a nutritionist, whatever, it's some of them do have like a great knowledge base, right? We're not talking all nutritionists. However, if you are going to work with the nutritionist, it's important to understand where their education came from, because it didn't come from the regulated hospital system, clinical supervised practice system that a registered dietician’s education comes from.

They also don't have their undergrad or their master's in nutrition, and we have to have our undergrad and our master's in nutrition, which is a whole wealth of knowledge, that is, for some reason, not on our board exam, but it's in all the classes that we have to take an undergrad, organic chemistry, fun one. So yeah, that's like the schpiel on that. But we're going to rapid fire answer a few more questions.

And keeping this theme of this versus this going, the first question I got is what is the difference between the work you do with clients and the work a therapist does with clients? I will start this off because Christina knows I'm very passionate about this topic, and then Christina, you can add to it. So a therapist is going to work with you depending on what type of therapist they are, right? There's so many different types of therapists, but generally speaking, a therapist, especially a therapist who's doing psychotherapy, is going to work with you to understand why you are the way you are, why are you behaving the way you're behaving.

Why is your mental health the way it is? Going back and kind of exploring your childhood, processing trauma, things like that, trying to help you understand why you behave and think and feel the way that you do, and in most cases, creating a tangible action plan for bettering your mental and emotional health, getting a better understanding of yourself, creating meaning from your life, finding purpose in your life.

A dietitian is not going to go back and help you process trauma. A dietitian is not going to go back and be like, “okay, how did you end up in this toxic relationship,” or “how did you end up in this relationship? How'd you end up doing this thing,” whatever. We're not really gonna go back there and like psychoanalyze you, in that sense.

Where the lines get blurry, though, is that there are so many things in your life, that impact the way you eat, the way you feed yourself, your relationship with food, and your relationship with body, and inevitably, these things need to come up during nutrition sessions, because I can't just throw a meal plan at somebody and be like, here's how you should eat, here's what you need to eat, here's what you need to do in order to have a healthier metabolism, better energy levels, whatever, and expect them to just be able to implement that.

I'm not just a distributor of information. I'm also a counselor, and I'm going to help you figure out what is it that's blocking you from being able to implement the nutrition recommendations that I'm making. In that sense, we do go into some deeper stuff. We're not necessarily doing trauma recovery. We're not doing psychoanalysis.

But for example, that toxic relationship that you're in might come up during your nutrition session, especially if it's impacting your relationship to your body, especially if it's stressing you out so much that you can't hear your hunger cues, especially if that person you're in the relationship in with cooks all the food. There are so many ways that the same things that come up in therapy might come up in nutrition, however, the nutritionist is not going to be like, why are you in this toxic relationship?

What does your inner child need? Why are you fulfilling an old pattern by being in this relationship? The nutritionist might say, “this relationship sounds not healthy.” That might be something that eventually comes up in a nutrition counseling session, but we're not going to do psychoanalysis in that sense. We're providing nutrition education, and we're exploring anything that might impact your relationship with food and your body and your ability to feed yourself well.

So the lines can get blurry sometimes, and we're always focusing on tangible self-care practices as well, right? We're not just talking about food, because if you're not practicing tangible self-care that's regulating your nervous system. You're not gonna be able to hear your hunger cues and your fullness cues.

So we're talking about things like that are more holistic in that sense to you, and that's also something that might end up coming up in therapy. Yeah, your relationship with your nutrition counselor is going to be very therapeutic. It's just not going to be a substitute for psychoanalysis. How did that land?

Christina: I could not have put it better myself, I think, especially the sentence that you just said about your relationship with your nutritionist being very therapeutic. I resonate with the most and the amount of times that I hop on a care coordination call with my clients’ therapists, and we are overlapping on like topics we've touched on and like points of conversation that came up regarding like self=care, body image, and stress and all of these different types of things that we've both touched on. It's nine times out of 10, and so I think it really is important to note that we work together with your therapist, and both of these relationships individually are super important, and together, they're even more so important.

Caitie: Yes, so your relationship with your dietitian can be very therapeutic, and that's such an important thing to note, right? Relationships heal. Relationships are so beautiful. We heal through relationship, so it's important that you develop some sort of therapeutic relationship with your nutrition counselor, especially if you're recovering from an eating disorder or disordered eating.

I feel that that's a really important part of the process. Some people see dieticians as people who just hand out pamphlets of what's healthy and what's not healthy, but that's not what we're doing. We're building a relationship with our clients, and we're getting to know you on a deep and holistic level so that we can help you feed yourself and take care of yourself in a way that's energizing and sustainable and fulfilling for you. So there's some overlap there.

Christina, I think we're gonna have to do a second episode where we answer some of these questions.

Christina: I was just gonna say, I would love to do another episode because I feel like this is really mainly focused on dietitian versus nutritionist, which I think is such a huge and important topic, and I'm really glad we spent as much time as we did.

Caitie: Yeah, I think we're gonna have to do a Christina series. I guess we're gonna have a part two of this episode, but let's do one more before we wrap up. So someone wrote, why not focus on weight loss? There are so many reasons why we don't focus on the pursuit of intentional weight loss in our practice, like so many reasons. I actually wrote a 18-page research paper for my global public health class in my Masters on why the pursuit of intentional weight loss is harmful.

I've got a lot I can say about this. I’ve got a lot of ammo. But I do want to wrap up the episode by answering this question, because I think there's a way to answer it concisely. Some of the most important reasons why we don't focus on the pursuit of intentional weight loss in our practice.

Number one, the pursuit of intentional weight loss via calorie restriction, portion control, intentional restriction of food is the most consistent predictor of weight gain. Bottom line, restrictive dieting, yo-yo dieting, all of the programs, you hear about Noom, keto, Whole30, most consistent predictor of weight gain, there's a ton of research to show that it doesn't even work.

Second, beyond that, a focus on weight loss is a focus on shame. A focus on weight loss is saying there's something wrong with you. There's something wrong with your body shape and size, and we have to fix that. Shame is a very biologically potent emotion. When someone is sitting in shame and working with shame, not only are their cortisol levels going up, that could be causing a stress response in the body and slowing the metabolism and really having a negative impact on their health, it's also so difficult to be motivated by shame. Shame is not a sustainable motivator.

Being motivated by the things that are actually important to you, the things that light you up, the things that make life fulfilling, versus there's something wrong with you. If you change something about yourself, that's actually going to be a more sustainable motivator, to focus on those things that are aligned with your personal values and the type of life you want to live.

If you want to create sustainable change in any sense, but especially to your nutrition and wellness habits, it's so important that you're motivated by a love of life, not by a fear of weight gain, or shame of your body shape or size. Research and personal experience, and experience with my clients shows me time and time again that you cannot be motivated by fear of weight gain or shame of your current body size. You must be motivated by a desire to live a fuller life. That's how things are sustainable. Yeah, those are the things, like two points that I really want to hit on. What else?

Christina: Yeah, the main thing that I touch on when this comes up in my client conversations, or just in my personal life conversations, because let's be honest, this comes up all the time talking to your friends, talking to your family. This is a huge, I think, topic of conversation, especially recently. But the biggest thing for me is kind of what you said about living a fulfilled life and having that be your motivator.

It's not fun restricting, like point blank, that's not fulfilling at all. It stops you from being who you are. It stops you from doing the things that you enjoy oftentimes, and it promotes guilt and shame and all of these negative feelings. So if the end goal is supposed to be positive, how are we going to get there with all of these like negative emotions and negative steps, if that makes sense.

So I think shifting the light and shifting the mindset of noticing and realizing that if you're going to be at like your most positive and best self, you have to do so by in a positive way and in positive mindsets.

Caitie: Right, you can list all of the reasons how restricting is holding you back from being who you really are, how restricting dieting and rigidity around food is making you lose your spark. It's making you lose your spontaneity. It's making you lose your soul. And also, I think the last thing that I usually touch on in my elevator pitch that I forgot to say here, and I think it's so important, is that weight is not a predictor of health.

It's just not a reliable predictor of health outcomes. We have a lot of reliable predictors of health outcomes, right? Behavioral predictors of health outcomes. Weight is not a behavior. BMI was an arbitrary metric that was invented by a French statistician for the purpose of grouping the population into categories for a research study. It was never meant to be used as a proxy for health.

Does a sudden spike in your weight, or a sudden dramatic dip in your weight give us some medical information about you? Yes, I think it's important to acknowledge that extreme fluctuations in weight, in either direction, are giving us a piece of medical information because I think a lot of my clients get confused about that because sometimes I will say, I don't focus on the pursuit of intentional weight loss, but then I need to kind of like keep track on their weight for their medical safety.

They're like “I thought, you don’t focus on weight,” and I'm like, well, it gives us a piece of medical information. Weight trends over time may give us a medical indicator as to how you're doing. An isolated number on the scale does not give us any information. Generally speaking, weight is not a proxy for health. Weight is not behavior. I like thinking of it that way.

If you smoke, that predicts your health outcomes. If you drink heavily, that predicts your health outcomes. If you have a doughnut for breakfast, lunch and dinner every single day, that is a predictor of your health outcomes, but these are all behaviors. Weight is not a behavior. An individual's body shape or size does not tell you anything about how they live their life and how they do or do not intend to pursue health, and that is really important, because a lot of reasons.

A correlation does not equal causation. We live in an incredibly, incredibly, incredibly fat phobic society, and that fat phobia actually makes people in larger bodies’ health outcomes worse. Shame, and being ridiculed, and stigmatized for your body shape and size has more of an impact on your health than the weight itself.

There is a lot of research that shows that people in thin bodies who have been ridiculed for their body shape and size have worse outcomes, health outcomes than people in the same body size that have not experienced weight stigma. Weight stigma is what's killing us in a lot of ways. I think that's really important to say, too.

Christina: Yeah, no, I couldn't agree more with all each and every one of those points that I think like you and I could sit here and talk about this all day long.

Caitie: Yeah, we wouldn't have jobs if weight stigma wasn't so dangerous to people's health because people spend so much of their life trying to avoid weight stigma. So many people have had experience with weight stigma. I live in a thin body, and I've had experience with weight stigma. That is one of the things that is like killing our society.

That is one of the things that's impacting our health, and so what do we focus on instead of the intentional pursuit of weight loss? The intentional pursuit of health, of better energy levels, of lower blood pressure, of more muscle mass, going to the gym, working out, taking care of your body, better sleep, better mental health, a better relationship with food, less shame, more self-confidence, more self-worth, more vegetables, more fiber, better digestion.

The list goes on and on. There are a million things that you can focus on that don't have to do with the pursuit of intentional weight loss. Yeah, that's just where we're at. I'm so excited to have Christina come back for part two is more Q&A. Christina, anything you want to say as we're closing out here?

Christina: No, I can't wait for a part two, and I also want to read this 18-page paper that you have at some point or another because now I'm curious.

Caitie: I will send it to you.

Christina: Perfect, but thank you for having me. I love being here.

Caitie: I love having you as part of the practice, and if you enjoy today's episode, please leave a rating or review. If you're not going to give five stars, you don't have to but if you want to leave a five star rating and review — would love that.

If you're listening and you are having questions pop up, please feel free to email me.

I absolutely love hearing from you, and I know that even after part two of this episode, there's probably going to be a part three where we answer even more nutrition questions, and I'd be so, so, so happy to hear any feedback you have on this episode. Don't hesitate to reach out. I love the little community that's being formed around this podcast.

Thanks for tuning in. Have a beautiful rest of your week and we'll be back here next time with part two.


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