Friend Hired the Wrong Nutritionist Not Sure What to do

#1

My friend who does know Keto hired a nutritionist to see her teenage daughter who also has some food allergies (wheat). The friend was not concerned, did not think her daughter has disordered eating or anything else more than any other kid her age. However, she has been refusing to eat red meat and has been subsisting off of mostly carbs lately. My friend really only wanted her kid to get suggestions for better meal options (which she is more than willing to make for her, keto or not as long as the meal is balanced in terms of fat and protein). The kid had Covid last month so lost 5 lbs from that but otherwise is pretty weight stable.

EDIT to ADD: The kid asked to see the nutritionist, some of her friends have nutritionists and she wanted one too! This was not the momā€™s idea (even though the post implies that) the idea came from the kid. The mom was ok with it because it is completely covered by insurance. One of the kidā€™s friends also uses this nutritionist and loves her!

My friend normally makes keto friendly meals with a vegetable and carb side dish that she does not eat but her family does. For example a steak with some type of high fat sauce, a side of avocado, broccoli with olive oil and a potato on the side.

My friend very strongly believes that people who are still developing should not eat Keto unless they really want to and have done the research and are in tune with themselves. This is not her kids! I support her in this and would never encourage her daughter to eat Keto. However, after the first meeting with the nutritionist (I think she is a registered dietician), she was told a whole bunch of nonsense, first that the kid is showing signs of disordered eating so she should be encouraged to eat whatever she will eat! There are no bad foods! (One set of grandparents have prediabete/diabetes, the other had cancer! there are plenty of bad food options in that situation in my opinion but what do I know!) When my friend told the dietician that while she will buy Icelandic yogurt with sweeteners, she personally does not see a difference between her kid eating that or eating a cookie with milk, the nutritional profile is similar! The dietician said right now the goal is to get her daughter to eat regularly, have at least 3 meals a day and make sure she is not skipping meals. Of course the kid likes the nutritionist even though to my friend it goes against everything in her experience! The nutritionist went on and on about how skipping meals (which my friendā€™s daughter does because she is not a breakfast eater, is very busy at school and hates the food options at school) causes changes in the gray matter of the brain. My friend said as she is telling her this, all my friend can think about is her last multi day fast!

She does not have a lot of options in terms of her insurance (this person came highly recommended by another friend who can afford the best but is not up on keto). She does worry that if she fires the nutritionist her daughter will both be upset and what if she is wrong that her daughter is developing some type of eating problem. Any nutritionists out there who can offer suggestions?

(Michael - When reality fails to meet expectations, the problem is not reality.) #2


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(Robin) #3

I understand caring about your friend and her daughter. but this seems to be something youā€™ll probably only find locallyā€¦ look up keto nutritionist. or tell your friend to.
One ward of cautionā€¦ if a parent is trying to change a TEENAGERS diet, good luck. Youā€™re giving them one more thing to resist. I go for being a model instead of trying to convince anyone to change. Especially a teen. There are enough mountains to die on, already.

#4

Thank you.Her daughter really does not want to eat Keto and the nutritionist thinks the kid may have an eating disorder which telling her not to eat carbs will make worse (according to the nutritionist). My friend spoke to me about it at length after getting off the phone with the nutritionist. She is alternating between thinking the nutritionist is creating a problem or reinforcing something that really does not exist and is taking an overly dramatic 16 year old at her word vs being concerned that she completely missed something that her teenager is having a problem with. Meanwhile she is getting instructions about making sure to give a 16 year old breakfast, a 16 month old, sure, a 16 year old?! If she is hungry she can make herself something, if she is not, then donā€™t unless I am missing something. Idk, perhaps I am not the model of clean eating but I think I have eaten breakfast maybe 5% of the time, if that ever (by breakfast I mean a meal eaten within two hours of waking up, I know there is also break the fast where people eat at 5PM, that is not what the nutrionist is saying.) I once gave my son breakfast before his SATs, he ended up getting a stomache because he was not used to it and blowing them!

(Robin) #5

By making an issue of a teen girlā€™s food intake, you are more apt to create an eating disorder than fix one. I speak from experience. Both my daughter and I had battles with anorexia. And you add power to the fuel by making a big deal out of it. Just my experience and my opinion.

(You've tried everything else; why not try bacon?) #6

Whereas I would say exactly the opposite.

My understanding is that growing teenagers need plenty of protein and fat to provide building blocks and fuel for their growth, and especially fat and cholesterol to build their brains. The brain is mostly fat, and cholesterol is a large percentage of that fat content, because it is essential to transmitting nerve signals.

Not only does beef have the idea amino acid profile to meet the needs of the human body, cholesterol is found only in meat, not in plant foods. This means that vegan eating is dangerous for both body and brain development until one has reached oneā€™s full growth (around age 25). During the teenaged growth spurt, the protein range we normally advise should be ignored, given this need to support the growth of the skeleton and muscles. And teens need plenty of fat, as well, to provide energy for their growth.

(You've tried everything else; why not try bacon?) #7

Ironically, Dr. Georgia Ede, the psychiatrist, uses a keto diet to help her patients recover from anorexia and bulimia. There is information on her Web page about this, as well as a couple of columns she wrote on the topic for Psychology Today.

#8

I think you have a pointā€¦ And the girl isnā€™t a little kid, she probably wouldnā€™t let people influence her diet too much anyway.

I doubt forcing her to do keto or to eat breakfast is a good idea. She needs proper nutrition but if she isnā€™t a breakfast eater, she isnā€™t. I hated breakfast as a kid, it caused various problems to me and I heard it from other people. We need much food as kids but we donā€™t necessarily need to be force fed at early dawn. I so, so, so hated that, I just wanted to sleep and my body wasnā€™t ready for food at all. And I easily can imagine doing bad to her mental health if the point of eating breakfast is stressedā€¦

#9

Love Pauls response!!

for me, ALL humans should eat Ketoā€¦from birth to death. THAT is what real food was, now what I am saying is some go ā€˜keto insaneā€™ but if one thinks, keto eating is just whole foods, watch the carbs to the level you do well on and eat real fresh actual meat/seafood fish and fowl. I mean that is the diet of the entire planet before any farming came onto this planet and ā€˜food manufacturersā€™ came into this world soā€¦

not eat ā€˜ketoā€™ as in THAT was what life wasā€”ketogenic was life from the start. Everyone was damn near all ketogenic bodiesā€¦our glucose burning bodies CAME into existence after agriculture and farming kicked in so it is not the normal for the body in my actual thoughts from reading what real life was all about on this planet for human evolution.

NOW that is me, personally I would listen, give a few GOOD articles about how ketogenic menu was the norm from a gazillion years ago cause there was NO farming and crap food and then I would back off.

and 16? come on, let the kid do her thing. They are gonna jump from vegan to veggietarian to zc to fasting on water only to? Might last a day or week or ? They read and absorb alot. Too much focus causes issues, as I have seen thru my 17 yr old, they ainā€™t infants, they got brains ya knowā€¦ Let the phases hit thru but ā€˜ever so gentlyā€™ guide and control thru some chat.

my 17 DD is steady on cause I was all about ā€˜low carbā€™ eating from when she started life and I gave her more meat than one can handle and she sucked it down and still loves it to this day cause I preppred that in her, but donā€™t think she ainā€™t sucking down damn Gummy Bears at warp speed also HAHA

16 is not young, 16 knows alot and at some point, back off on this control ya know but of course WE PARENTS know our kids, so you might be getting just not enough info to even chime into this familyā€™s issues ya know??? You really donā€™t know this whole situation at all.

So let it goā€¦simple clean food advice and let this family work thru their times is how I would handle it. As much as we want to heal, help, save and more, we canā€™t :wink: but small usefull on point info given is all we can do along with just being there and listening and that support is good for your friend to hear.

Now that is how I figure it all out in life :slight_smile: others mileage may vary on it.

#10

Absolutely - this was my first thought too. In my experience too, arguments and reprimands about what to eat (or not eating), starting in teenage years, are more likely to create disordered eating habits.

This is not because the motherā€™s suggestion for the child to eat healthy is bad, but because a teenage girl who is already struggling with newfound feelings of self-acceptance, self-esteem and body image with perceive arguments around food as attacks on their body image. Hence likely to restrict food even more.

The nutritionistā€™s advice is crappy - obviously. However for now, since the daughter is already having eating disorder tendencies, the best things I think the mother can do (in my humble opinion as a non-nutritionist) are :

  • Make available the healthiest possible versions of meals/foods/treats the daughter likes and eats.

  • Set an example of healthy eating around her daughter.

  • Encourage eating e.g they can make the food together etc

  • Donā€™t make a big issue about the daughters eating habits e.g regular arguments and reprimands about it

  • Let the daughter see a therapist if situation does not improve as eating disorders can be tied to wider issues.

Even certain ā€œketo expertsā€ recognise that keto may exercebate eating disorders in some people so perhaps the initial effort should be focused on getting her to have a good relationship with eating and food (which can be achieved without being in a keto diet).

#11

This is something that I have a great bit of experience with. My 16 year old daughter was diagnosed with severe food allergies to peanuts, tree nuts, shellfish, and fish when she was 18 months old. Through no fault of her own (we really emphasized the danger of those foods from the time that she can remember) she has become a very picky eater.

She isnā€™t overly large, approx 130 lbs and is very muscular/athletic. However, over the last couple of years, she is starting to show signs of developing metabolic syndrome, high blood pressure, blood sugar spikes, etc. No doubt it is from the years of living off of pretty much pasta, bread, and grains. She was never a meat lover.

Fortunately (unfortunately for meā€¦LOL) my severe fatty liver disease brought me to Keto. She is the only hold out in the rest of the family that hasnā€™t adopted this lifestyle after they witnessed how quickly Keto is turning my life around. However, she is finally trying some new foods and actually is starting to like steak, eggs, bacon and other healthier food options. We have a long way to go to still break the carb love that she has. But, we are heading in the right direction.

As mentioned above, probably the worst thing that you can do is lecture the teens. They are very good right now about doing their own research. Iā€™ve been sending my daughter some links to videos from Ken Berry, Jason Fung, Eric Berg, and Autumn Bates. I could say the same things to her a hundred times and she wouldnā€™t listen. But let it come from one of those YouTube channels and suddenly she is telling me about the content.

Itā€™s a slow process to change their habits. Keep steady, be positive, and they will eventually see the light.

(Joey) #12

Donā€™t know if thereā€™s much one can do to influence a 16 yr oldā€™s eating (I had zero influence over my girlsā€™ eating choices once they were teenagers - and ever since). And as painful as it is to watch children make poor choices, it comes with honoring their basic self-control and freedom.

Immediately life-threatening choices? Yes, they deserve your focused intervention.

Long-term poor hygiene/health choices? No. Give it up (for now).

A nice gift for this friendā€™s daughter might be the Ted Naiman pdf book on ā€œP:Eā€ eating. It might be of interest to this girl becauseā€¦

1 - It explains some basic food pros/cons in nearly cartoon fashion.
2 - It isnā€™t preachy and leaves a wide range of choices open for how to eat healthfully.
3 - Itā€™s in electronic form, which is something a teenager can carry around without getting caught :wink:

Worth a look, perhaps to see what her mother thinks of such a resource?

(Itā€™s $20 online and can also be found at certain [unnamed] web libraries).

#13

Thereā€™s no such thing as the right nutritionist. If theyā€™re a nutritionist, theyā€™re certified to push a bad diet.

Which is most likely the correct approach for whatever sheā€™s got going on, especially if her disorder is bordering on Anorexia.

(Robin) #14

Agree.

(BuckRimfire) #15

Yes, but brain scan research has shown that the brain is still maturing up until about age 25, which may explain a lot about the bad (often self-destructive) choices many people make in their late teens and early 20s. People in that age bracket tend to inflate short-term considerations and not think about long-term consequences.

Itā€™s surprising to me that, if my limited understanding is correct, a couple of centuries ago many/most people were married and starting their own families and supporting themselves at that age. Youā€™d imagine they might have screwed up constantly, but maybe they were reined in by living with/near older relatives who had more cultural and literal authority in those days, as well as more wisdom. ā€œPatriarchyā€ may have been a double-edged sword, with some benefits weā€™ve forgotten as well as the negatives that the word now connotes.

(Joey) #16

Indeed. Before oneā€™s prefrontal cortex has fully developed, the reptilian amygdala rules the thought processes of pre-25 yr olds.

Before then, weā€™re old enough to make some really bad choices - and too young to appreciate the long-term consequences.

(You've tried everything else; why not try bacon?) #17

You may have a point about patriarchy providing some guidance, but besides that, people were eating a lot more meat and a lot less carbohydrate, so their brains were in better shape. While mental illness has always been with us, there is a lot more of it since people started following the dietary guidelines, as compared to when I was a child. Autism and Alzheimerā€™s disease were virtually unheard of, before the guidelines.

And yes, I know that correlation does not equal causality, but I suspect that if we really went into it, we could meet most of the criteria Bradford-Hill used to blame smoking for lung cancer.

#18

Thank you for the kind and thoughtful responses.

Couple of things, while it was not clear in the original post, the kid is the one that wanted a nutritionist because she and her mom were not finding lunches and dinners that she liked, especially within the constraints of her allergy. The idea was this person would suggest healthy options. There is also an element of monkey see, monkey do in that at least one or more of the kids at her school see a nutritionist. I edited the original post to make clear this came from the daughter originally, not sure if that changes any of the responses. @Fangs the mom saw my post before I posted it (she is not one to post on forums and asked me to as I got her into keto) there is no hidden information and I have known this kid since before she was born.

I completely agree as does her mom! Yet it feels like that is exactly what the nutritionist is asking her to do. She asked the nutritionist about that and she said that if there is already an existing eating disorder then you can and should ask them about their eating! Seems weird to us both. I have always tried to de-emphasize food and eating with my kids, my dogs and so on. My friend is the same. We were both part of the clean plate club as kids and we saw how that backfired. The only thing I ask my kids to do if they are not finishing food is to put it in the dogā€™s bowl rather than waste it (assuming it is something the dog can eat).

@Midnightmoon enjoyed hearing your perspective. Friendā€™s DD has always been picky, even before the wheat allergy. Always hated red meat but not universally, loves her momā€™s corned beef, steak, not so much! She really did try to like steak but she just does not. I can understand, I have never been a fan. I have learned to like it through keto but if they had a pill that allowed you to eat anything, I would start scarfing down Sicilian pizza tomorrow and not stop!

Bottom line my friend likes the nutritionist as a person but thinks the advice is either the height of idiocy or my friend is missing something major with her kid and the nutritionist is right

#19

that is really good to know. more info that is real can mean others can give advice that hits home easier.

yea allergy issues are tough. the limitations are always hard to work around, not a darn doubt about that.

(You've tried everything else; why not try bacon?) #20

Thanks for a great post. It helps to know more of the background. Let me just reiterate my suggestion to check out the Web site of Dr. Georgia Ede, www.diagnosisdiet.com. She is a psychiatrist in the health service of a college in Massachusetts (used to be at Smith, but Iā€™m not sure whether sheā€™s still there) and sees a lot of young women with eating disorders, apparently. She finds that a ketogenic diet, if she can only persuade the patient to start one, does a great deal to settle some of the issues these young women have with their food.