How to pick a dietician

Beware of the quack offering a quick solution

I have a friend who has left no dietary stone unturned. In the past decade, she has been to the most well-known (and expensive) conventional dieticians, to the freakiest new-age ones abroad who recommend bizarre things like a nicotine diet to kill hunger. She hasn’t given up yet, and her weight hasn’t given up on her; she remains the exact same size as when I first met her.

Losing excess weight is not something to be derided, though. It is ideal to be your optimum healthy weight, to keep illnesses at bay. But somewhere along the way, we have managed to turn weight-loss into a big money-churning industry. Every day you see advertisements declaring the latest “diet that works”, which usually translates into you losing 20 kilograms in three months. These unreasonable diets have soft targets like brides-to-be, often in a hurry to fit into all the clothes they bought too soon.

“Short-time programmes with fad diets are not only harmful in the long run, creating different deficiencies or excesses, but they also often have a rebound effect when stopped,” says Rekha Sharma, former chief dietician, AIIMS, Delhi, and former president, Indian Dietetic Association.

As if things weren’t bad enough, a recent advert of the company Just Diet (www.justdiet.in), claiming to be the “best doctor for weight-loss in Delhi” targets school children, offering them the best diets to beat stress during exams! While we can enjoy a little laugh at their expense, such clinics are no laughing matter, for the unsuspecting parents they suck in with these dubious promises.

Unlike in other countries, where only Government-certified dieticians can practise legally, there are currently no defined regulations on who can call themselves a dietician in India. This leads to quack-a-minute diet centres coming up across the country, promising sensational weight-loss with minimum effort, which naturally tempts people, who have been struggling with weight for years.

Who is qualified?

Much confusion prevails over the words dietician and nutritionist in the first place.

In developed countries, where these things are regulated, dieticians and nutritionists are Government-certified, trained practitioners, with two very different sets of certifications.

In India, the Indian Dietetic Association certifies dieticians. “Technically speaking, a registered dietician should have a degree and a post-graduate degree in Home Science or Food and Nutrition in a full-time course (not via correspondence). The person then needs to do either a six-month internship or should work in a hospital for two years. They are then eligible to take the exam that will give them the right to call themselves a registered dietician. They will get an RD number, which is something you can check to make sure you are going to a person who is qualified,” says Ritika Samaddar, Regional Head — Department of Clinical Nutrition and Dietetics, Max Healthcare, Delhi.

Unfortunately, anyone with a short diploma in food and nutrition can call themselves a nutritionist, as there are no laws in this space, leading to people circumventing any potential legal irregularities quite easily.

Getting legit help

Some hospitals call their registered dieticians ‘clinical nutritionists’ to emphasise that they are not just laying out diet charts, but are also involved in counselling patients in disease management. It’s important to understand that dieticians are not doctors, but allied healthcare professionals. So anyone who uses the Dr preceding the name is suspect, unless they have a PhD.

Again, anyone guaranteeing weight-loss in large amounts (for example, 1 kilogram a week for three months), without even meeting you, is suspect. American Board of Nutrition-certified dietician Lovneet Batra, based out of Delhi, says, “Twelve weeks is enough time to assess, to make required dietary interventions for long-term behaviour modification, encouraging a holistic approach, rather than quick weight-loss.”

Interestingly, in India, a certain amount of stigma is attached with the word ‘dietician’, as it indicates someone who makes you “diet”, whereas people assume a nutritionist is someone with a more holistic approach. Some RDs, then, call themselves nutritionists or clinical nutritionists, to counter this perception problem — adding to the whole confusion.

Luckily, soon, more concrete help will be available. “The Government is in the process of creating a paramedic council, wherein a registration will be issued to practise, after clearing the minimum desirable qualification to practise dietetics,” informs Sharma. Once this is in place, it will be easier to weed out the frauds from the friends. Till then, be careful who you trust with your calories.

Do we need a dietician at all?

On the face of it, weight-loss is a simple equation of deducting the number of calories you burn from the number of calories you intake. But for most people, it isn’t that simple. Many of us suffer from hidden digestive or gut-related issues that come in the way of regular weight-loss. Dieticians help us lose weight in a regulated, holistic, manner, without allowing damaging nutritional loss. Everyone is a nutritionist in the days of the mobile Internet, but to know which diet will work for your particular physiology, you need to consult a qualified dietetics expert. The Internet will give you confusing and conflicting answers that may lead to complicating health issues, so it is best to go pro. And if you’re looking for special needs, such as say, weight-loss for a child or nutrition management for a sporting event, a dietician does help.

All said and done, it comes to that all-important matter: self-discipline. “The best dietician can give the required information and get you started, but discipline plays a very important role,” agrees Batra. A dietician will help you get tuned in to your body and provide the right tools and guidance, but in the end, it is up to us to follow the good advice long-term.

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