Can we trust dietitians for keto advice? That is what my blog attempts to answer today.
The evidence may surprise you.
Can we trust dietitians for keto advice? That is what my blog attempts to answer today.
The evidence may surprise you.
I have never gained weight more quickly than when I was strictly following a dietitianās instructions. Seriously, like ten pounds a month for three months before I stopped.
The great, great majority of dieticians are unthinking followers of agripharma propaganda, and following their advice, except in specific circumstances related to particular diseases, will make you sicker and sadder.
Of course, there are a handful of actually intelligent free-thinkers, but theyāre very difficult to find.
Before I discovered keto, I was referred by my doctor to consider bariatric surgery. The bariatric clinic put me on a programme leading up to surgery to first try to lose weight by diet and exercise.
The dietitian immediately cut all my fats as I think these were the easy targets to bring down my daily calories. It was low or zero fat everything and detailed food journaling. A panel of ādiet expertsā reviewed my situation and they calculated my basal metabolic rate to be 2600 (k)calories per day and dropped my intake to approx 2000. I started gaining weight. Down to 1800 and I still gained weightā¦Down to 1600 and I still (very very slowly) gained weight. At this point I started feeling like crap. Lethargic, mentally tired, sore, dizzy spells, constantly growling stomach. All the while Iām trying to work a fairly active job. After more than a year of no weight loss and some gain, the dietitian had the nerve to suggest that I must have been cheating on the diet. After that last visit I sat in the parking lot in my car and cried. Did I mention that was also feeling depressed and hopeless on the no-fat diet?
Then I stumbled on to Richard and Carlās podcast after googling for successful weight loss strategies and decided to give keto a go. Down 40+ pounds in six months is successful in my book. No hunger pangs anymore, energy and mental clarity are back better than I can ever remember. I donāt count calories and just eat to fullness when hungry.
So, no, I donāt trust dietitians. Everything my dietitian spouted was conventional, formulaic and convenient for them. When I suggested trying keto my dietitian turned white and said it would be a death sentence. My last complete blood work up says alomost the exact opposite and Iām no longer a candidate for bariatric surgery. Surprise!
Edited: a couple of dropped words.
Amazing story @keehan.
Dietitians, MDs ⦠thereās really little difference is there? They are teaching what they have been trained.
But when you see that your training is not producing good outcomes, why would you not seek a better approach?
Cognitive dissonance
In psychology, cognitive dissonance is the mental stress (discomfort) experienced by a person who simultaneously holds two or more contradictory beliefs, ideas, or values, when performing an action that contradicts those beliefs, ideas, and values; or when confronted with new information that contradicts existing beliefs, ideas, and values.
A dietitian has to believe how they have been trained is good science, thousands in the occupation over decades, so if the training is right they are left with 2 options, they are incompetent or the patient is cheating. Iām a good person who is doing the best I can to help others, iām following what I have been taught to a tee, if it is not working then they have to be cheating.
Working in a Histopathology laboratory, there are a few⦠universal ātruthsā:
Given that anecdote, Iāll answer the question:
Tl;dr conventional wisdom is not > or = biological functionality.
Iām a personal trainer, recovering dieter, and have embraced keto. I recently viewed an online training that discussed plant based diets. I have a client who is veg for religious reasons (which is why I watched the video) and doing keto. This dietician described ketosis as making you feel lethargic, brain fog, and dangerous due to high protein levels. She also went on to advocate very high carb from fruit and veg because all the fiber fills you up and creates satiety, but fat is bad because it has no fiber. OMG, I was livid! I watched for 2 hours and never got the info I was seeking regarding actual nutrition concerns on a vegetarian diet.
I also stood in a hospital room as a visitor to a family member who has T2D and listened to the hospital dietician tell him to eat more grain!
So, no I donāt trust dieticians or physicians. Physicians have very little nutrition training and itās in the first year, if at all, and is quickly forgotten.
Thank you for sharing your arduous journey to health improvements, happy to hear you were able to avoid surgery despite the worst dietary advice and then accusation of cheating. Stay strong and continue to question everything
The funny thing at least to me is that if I had just listened, really listened to what my body has always craved, I would have been OK all along. Iām in my mid-40ās now and have battled weight all my life. Iāve always craved fatty foods, but unfortunately theyāve always been accompanied with high carbs too. Iāve dieted on and off over the years but always cut the fat since weāre constantly told fat is the offending calorie source. Had I only cut carbs and sugars instead! But even now, when friends and family are now really noticing my weight loss, presented with my proof, after I show them the science, show them the masses of other successful weight loss stories from keto, show them the dangers of high sugars, they still just frequently chortle to themselves about how much of a fool I am for eating fatty foods. They see it as an attack on everything they believe and automatically go into a defensive position. Iāll never push keto on anyone, rather Iāll just show them the science and show them the results. It just takes a little open mindnessā¦thatās all.
You should not trust any provider, whether they are a doctor, counselor, or nutritionist, without assessing them.
Do not doubt you are a consumer first and a patient second. This is the way our healthcare system is. You must be educated and assertive in order to get the care you require. Donāt hesitate to do this by any means necessary.
Unless the dietitian has the word āketoā somewhere in their title, the short answer is No.
Dietitians do the same thing (recommend low calorie, low fat diets) over and over and get the same poor results, and continue doing the same thing. They blame the patients instead of seeing whatās happening and questioning their own paradigm. The very definition of insanity.
One thing that contributes to this problem is the fact that insurance reimbursement for dietitian consultation is very short term. When a sick, fat person changes from SAD to almost any dietary recommendation there is some immediate weight loss and improvement in health. So the dietitian sees āsuccessā. But 6 or 12 months down the line thereās a 98% failure rate. Because of the initial improvement. The dietitian gets to claim success and blame failure on the patient slacking off without her āhelpā.
I have no faith in someone who refuses to recognize that their beliefs are ineffective and continues to blame others for their failure.
Itās personal to me. I worked for twenty years in another allied health profession. A lot of what I was taught in school and what was believed in my profession was not effective or true. I got to the point where I couldnāt stand the charade anymore, or the insurance games I had to play to get paid for what I really did when it was helpful and effective. I eventually went back to school and got a degree in another profession that is 180 degrees opposite and I have 100% autonomy to do the very best job I can possibly do.
There are a growing number of dietitians out there refusing to play along anymore, they are the only ones Iād trust.
The faint scent of bacon in their clothes is the prime tip-off.
Iāll share what I call the āMaxim of Circular Dietitiansā, which is based off of my observations of many (of course there are exceptions) dietitians over the years:
THE MAXIM (a work in progress):
There are two main phenotypes of dietitians:
A. Those who have never struggled with weight and thus never questioned the current guidelines.
B. Those who did have a weight issue, but were lucky enough to have good results with the guidelines, thus they never question the guidelines.
This is awesome.
Reminds me of the famous phrase:
Those who were born on the finish line believe they have run the race.
Also, from Upton Sinclair:
It is difficult to get a man to understand something when his salary depends upon his not understanding it.