Practitioners Speak Out: Why It's Tricky To Get Patients To Stick To Their Commitments

Nutritional practitioners of all kinds (RDs, RHNs, CNPs, NDs, Integrative Nutritional Therapists, etc.) arguably all share the same goal: to help their clients master their health by implementing healthier eating habits.

From what to how to when to why. 

Unfortunately, it's often easier in theory than in practice.

I interviewed a variety of practitioners (some of which wished to remain anonymous) about WHY it's seemingly impossible to get patients to maintain the commitments they initially walk into their office with. 

How on earth are practitioners supposed to "hold their clients' hands" through every step in the healthy eating journey, if they're only seeing them (in-person or virtually) on just a weekly or biweekly basis?

For some clients family support is an issue. They are committed, however the family is not supportive and it becomes too much work to prepare multiple type of meals for each family member. Some clients will come in just because their doctor asked them to come. There is no “buy in” from the client and that is a huge hurdle. For others it is the “all or none” mentality. Hence keeping them on track is a challenge.
— Alka Chopra, RD & CDE

Good intentions aside, it's practice that makes perfect - shifting mindsets and changing bad habits. It was interesting to note how conscious nutritional practitioners are about external forces beyond their control.

Let’s me start by saying, Change is challenging and takes time. With my patients, a lot of external factors that I can’t control are what get in the way of progress (like distance, transportation costs and time off work/school). If we are able to work around these outside barriers, I’d say the top activity barriers that can become major hindrances are perceived lack of time, low self confidence and social and family influence. At the end of day, what works is consistent check ins, small sustainable goals to help them feel successful and support from family and close friends.
— Allie Lougheed, Exercise Therapist at The Hospital for Sick Children

Of course, working at Meal Garden, I put a lot of faith in the transformational power that meal planning and related tools and resources can provide for those looking to get on a path to optimal health. With that said, I've had frank discussions with various RDs, who claim that offering clients custom meal plans - or even spending time on creating any sort of "menu plans" is simply NOT for them...

Here are some thoughts from a few Toronto-based RDs I chatted with:

  • "I no longer build meal plans for clients because I’ve found that at the end of the day, people just don’t follow them!"

  • "Often times clients’ don’t like at least some of the recipes you’ve chosen for them."

  • "Clients want (or think they want) a custom-made meal plan 'just for them' - not a standard meal plan they can purchase/download off my site for example. With that said, once they’ve been given this 'special' meal plan they claim they require, they usually make excuses as to why it doesn’t really work perfectly for them."

  • "It’s just not an efficient use of my time; for one-on-one consultations I charge $150/hr, and creating a 2-week meal plan for a client (including all necessary recipes and grocery lists) takes anywhere from 5-6 hours of my time. Yet no one wants to pay more than say, $20 for a meal plan, when in reality if I were to price it fairly it should really be around $750, but that would seem ridiculous!"

  • "I’d rather teach my clients the underlying skills so that they can make their own meal plans and make better nutritional choices for themselves."

  • "For me, education has outweighed specifically detailed instructions in terms of time efficiency and overall effectiveness when it comes to the success of my patients."

I also had the chance to speak with a RD who works specifically with senior patients, who openly shared the struggles they come across at their own practice: 

At the end of the day, “fast” results are not seen and thereby my clients tend to loose confidence. Forming smarter habits takes time and structure - with a positive self talk. To make matters more difficult, there is often no support from family/friends, they may not know how to effectively prepare meals and is embarrassed to say so during a session, and of course there may be financial constraints and life stressors involved. I’ve also noticed “busy” seasons (weddings, Christmas, BBQs) seem to get in the way of positive progress in the right direction.
— Anonymous RD

While the reality of nutritional practitioners' work may seem bleak at times, I think RHN Heather Allen sums it up nicely:

Being a Holistic Nutritionist means so much more than handing someone a meal plan, a few recipes and sending them on their way. Just as a personal trainer can’t get you six pack abs in a single workout, making sustainable dietary changes takes time and a commitment your highest potential.

And yes, change can be hard and relying on willpower doesn’t work, but what I have found that does work is a system of accountability and support. You could call me a personal trainer for you diet (a.k.a- your biggest cheerleader). This includes touching base regularly through accountability coaching calls where we discuss what is and isn’t working, creating solutions to break through those barriers and set new goals so we can reach your ultimate state of awesome.

We make these shifts at a realistic rate, using real food and getting real about what is holding you back from being your best self (aka- real talk), because if you change nothing, nothing changes.
— Heather Allen, RHN

Are you a practitioner? Meal Garden has just launched a progressive Practitioner Pilot Program alongside building out a fully comprehensive platform for work with clients.