Do You Know When to Refer Your Patient to a Dietitian?

By Jamie Marchetti, MS, RDN, LD
August 12, 2020

During my tenure as a dietitian in a rural community hospital, I provided all the outpatient nutrition counseling for the facility. Sometimes patients sought out my guidance on their own, but most often, they were referred to me by a physician. While most referrals were made in a manner that was timely and appropriate for the diagnosis, some were not.

This post, therefore, is a dietitian’s perspective on best practices for physicians referring patients for nutrition care that can be delivered in a way that is helpful to support medical care. Continue reading “Do You Know When to Refer Your Patient to a Dietitian?” →

The Role for Health Coaching in Primary Care

By Monique Tello, MD, MPH
July 25, 2019

It’s remarkable to me that while overweight and obesity are major epidemic medical problems resulting in many clinical complications, and we have solid scientific evidence showing us safe, effective interventions that actually help people to lose weight, we are not yet incorporating these methods into primary care. What’s our problem?

Want to know more about what works for weight loss? I’ll tell you: behavioral change support, in the form of a health coach. Continue reading “The Role for Health Coaching in Primary Care” →

Promoting and Implementing Size Inclusivity in Health Care

By Jamie M. Marchetti, MS, RDN, LD
March 14, 2019

Beth was obese. She had been bigger her whole life, so this was not news as she reached her late-twenties. Beth (her name has been changed to protect her privacy) was getting married and ready to start a family, so she went to her obstetrician/gynecologist to have her intrauterine device (IUD) removed and to discuss the implications of her polycystic ovarian syndrome (PCOS) on fertility. The doctor scoffed and stated, “I don’t know how we’re going to get it out. At your size, I’m not even sure how they managed to get the IUD into you.” Further, it was discovered that Beth had grapefruit-sized cysts on both ovaries, and the doctor told her that neither he nor any doctor would do surgery to remove the cysts given her body size. Beth was desperate, so through her hurt and anger, she chose a crash diet to follow, which resulted in acute renal failure within weeks. Heartbroken and at the end of her rope, Beth found herself crying in a dietitian’s office, convinced that the well-balanced diet she was already eating must be harming her since doctors insisted she must not be nourishing herself properly if she wasn’t losing weight. Beth explained that she was content with her body, but that she was tired of seeking medical care and being treated poorly because of her size. Continue reading “Promoting and Implementing Size Inclusivity in Health Care” →