Coach, Dietitian, Nutritionist, Counselor…

One of your friends is seeing a nutritionist, another has an appointment with a registered dietitian, and you’ve heard good things about a certified nutrition counselor in your neighborhood. Maybe your employer will pay for you to have telephonic meetings with a wellness coach. Who can you trust and how do you know who is best suited to help you?

There are no formal regulations for health or wellness coaches, and there is no single governing body. Some health coaches have been trained in behavior change, nutrition, and physical activity and they act as a “guide” or a “support person” for individuals looking to change their lifestyle, whether by quitting smoking, modifying their diet, or becoming more physically active. What a health coach shouldn’t do is prescribe or recommend a specific diet or exercise regimen, unless they also hold another credential, such as being a Registered Dietitian.

According to the International Coaching Federation, the coach’s responsibility is to:

  • Discover, clarify, and align with what the client wants to achieve
  • Encourage client self-discovery
  • Elicit client-generated solutions and strategies
  • Hold the client responsible and accountable

Some companies only hire coaches that have health care backgrounds and experience in the actual practice of their expertise and insist that coaching technique and methodology must be professional and based on the science. Unfortunately, this is not true of all companies, and while some coach-training companies are offering wonderful programs, others are providing low-quality training. The National Consortium for Credentialing Health and Wellness Coaches compares apples to apples when promoting wellness coaching and when researching the benefits of coaching. NCCHWC is on a mission to “create national standards and certifications of health and wellness coaches as a key milestone in the professionalization and scale-up of a new evidence-based field. Eligible individuals can now apply to become a National Board Certified Health and Wellness Coach (NBC-HWC)”. Questions that you may want to ask a coach before entering into a relationship:

  • How long have you been providing coaching?
  • How do you measure improvement?
  • What is your qualification? How were you trained?

As described by the Academy of Nutrition and Dietetics, Registered Dietitian Nutritionists (RDNs) have met academic and professional requirements established by the Commission on Dietetic Registration, the Academy’s credentialing agency. This includes earning a bachelor’s degree from a regionally accredited college or university and completing an accredited, pre-professional experience program. RDNs must also pass a rigorous national level examination and complete continuing education requirements to maintain their credential. Some RDNs hold advanced degrees and additional certifications in specialized areas of practice.” Dietitians can work in many different fields including healthcare systems, home health care, food service, business, research, and educational organizations. In hospitals, dietitians provide medical nutrition therapy (MNT) to treat an extensive range of chronic conditions, illnesses, or injuries (think of diabetes, liver disease, kidney disease, heart disease, inflammatory bowel disease, cancer, etc.) An RDN must abide by a professional code of ethics to maintain their licensure and registration. An RDN can attain specialist certification in pediatric nutrition, renal nutrition, gerontological nutrition, oncology nutrition, or sports dietetics. A Certified Nutrition Support Clinician is an advanced practitioner able to tailor the amount, type, and route of feeding (enteral nutrition or parenteral nutrition) to each patient to improve outcomes, minimize infections, and allow patients to maintain their lifestyle as much as possible.

The term “nutritionist” is unregulated and, In many states, anyone can declare themselves a nutritionist without any education or qualifications. As unbelievable as this seems, it’s sadly true. In 2013, the Academy of Nutrition and Dietetics began to offer the optional Registered Dietitian Nutritionist credential, in addition to the Registered Dietitian credential to differentiate the rigorous credential requirements and highlight that all registered dietitians are nutritionists but not all nutritionists are registered dietitians.

Graduates of the Institute for Integrative Nutrition (IIN) receive a “health counselor” certificate and are automatically eligible for “board certification” by the American Association of Drugless Practitioners (AADP), which has no scientific recognition. Because IIN is not accredited by an agency recognized by the U.S. Office of Education, the coursework can’t be used toward meeting the degree requirements for dietitians. Education through IIN includes learning about “more than 100 different dietary therapies”, many of which are known to be unproven such as Ayurveda, the Blood Type diet, the Five-Element theory, and macrobiotics. As thoroughly and eloquently covered for The Huffington Post by Stefanie Sacks MS, CNS, CDN in a blog post entitled The Health Coach Demystified, some of the misrepresentations of IIN by the school and its graduates include:

  1. IIN offers a health coach certificate program
  2. IIN uses big names in health and wellness to entice you to buy their program
  3. IIN misrepresents what a health coach really is – they are neither “nutritionists” nor “wellness authorities” unless they have obtained additional credible training
  4. IIN affiliates themselves with credible universities to offer their “credentials” some measure of cachet.

The bottom line is that whom you choose to trust with your wellbeing depends on what you are hoping to gain from the relationship. For example, are you merely looking for some motivation to lose weight or are you struggling with a health condition that requires a specific diet? Ultimately, it’s a “buyer beware” scenario right now, and you absolutely owe it to yourself to do research and interview the person that you are considering entrusting with your health and personal information before committing to anything.