Nutritional counseling with a registered dietician nutritionist (RDN) will identify how many calories to eat per day to lose weight steadily and safely through a planned healthy, nutritious diet designed specifically for your lifestyle and healthcare needs. Also, a registered dietician nutritionist can treat any chronic obesity-related diseases with medical nutrition therapy.
I am therefore glad to bring readers this question-and-answer session with Susan Harrow Rago, a Registered Dietician (RD) and Licensed Dietician Nutritionist (LDN) who counsels her clients to lose weight. It helped me — and I am sure it will help you to understand what to expect from nutrition counseling for weight loss.
Twenty years ago when I practiced, I had implemented a program for clients who had 50 or more pounds to lose. Now, 20 years later, it’s not unusual for me to see clients with 100 or even 200 pounds or more to lose with BMIs over 40, some as high as 60.
Susan Harrow Rago holds a Bachelor of Science in Food Science and Human Nutrition from Michigan State University and a Master of Science in Human Nutrition and Foods from the University of Arizona. She completed the Commission on Dietetic Registration Certificate of Training in Adult Weight Management in 2001. Further, Susan Rago has more than 30 years experience in healthcare programming focused on establishing and enhancing healthy lifestyles to prevent and manage disease.
Among her many credentials, Susan Rago is a Nutrition Consultant, experienced as a Consulting Dietitian, and practices medical nutrition therapy with client referrals from cardiologists, endocrinologists, gastroenterologists, and gerontologists. She was a consultant for an in-house addictions program and along with behavioral health staff, developed a weight management program for members who were 50 pounds or more overweight. You may view the professional profile for Susan Rago on LinkedIn. And be sure to follow Susan on Facebook and visit her website Transcend Health.
In this first interview, Susan Rago and I explore how she counsels clients to lose weight. In a related vein, do-it-yourselfers may want to get the book Counseling Overweight Adults: The Lifestyle Patterns and Approach Toolkit by Dr. Robert Kushner. This manual features tools and resources designed for registered dietician nutritionists to help their clients overcome weight loss obstacles.
Who Seeks Nutritional Counseling
My Bariatric Life: Who is the typical person that comes to you for nutritional counseling?
Susan Rago: It’s really alarming to me the extent to which obesity has become a problem. Twenty years ago when I practiced, I had implemented a program for clients who had 50 or more pounds to lose. Now, 20 years later, it’s not unusual for me to see clients with 100 or even 200 pounds or more to lose with BMIs over 40, some as high as 60. The age ranges go from teenagers to mature adults; men and women. I see blue collar workers, professionals and stay-at-home parents.
Obesity effects everyone. One common thread is usually the person is so busy with life, work family, etc. that they are not taking the time to take care of themselves. Read: Staying Fit When Life Gets In The Way
Many people I see are now suffering the consequences of their poor lifestyle habits throughout many years and now have diabetes, heart disease, kidney disease, and a myriad of other chronic conditions related to obesity.
How to Lose Weight with Nutritional Counseling
My Bariatric Life: How do you approach counseling clients who are obese to lose weight?
Susan Rago: My first question is, “Why do you want to do this now?” Making permanent lifestyle changes necessary to achieve permanent weight loss is hard. Unless clients have a compelling reason for making changes that are going to carry them through all the challenges and obstacles to making the necessary changes, their likelihood of success is dismal. One of my clients wanted to lose weight and be more limber because she buys a season pass to Great Adventure and rides the roller coasters with her grandchildren. Read: 10 Easy Steps to Permanent Weight Loss!
My second question is, “How do you think I can best help you?” My approach is individualized for each person. Based on his/her eating history, we’ll develop goals based on identifying changes the client is willing and able to make.
My Bariatric Life: What happens during the consult, what support tools do you provide, and how long will a client work with you?
Susan Rago: Our first session together is usually an hour long. That first session gives us a chance to get to know each other. I’ll obtain a diet history, review medical history and medications, weight history and then we’ll set some preliminary goals. It’s really helpful if I can obtain some records from the client’s physician including most recent labs so any co-morbid conditions with nutritional implications can also be addressed.
Clients are encouraged to contact me via email, text, or phone if they have any questions between sessions. Since my practice is primarily insurance-based, insurance often dictates how often we follow-up. For instance, the local Blue Cross plan covers 6 visits per calendar year for nutrition counseling. I have some clients who I have been seeing for 3 years using that benefit. Typically I see clients on a monthly basis.
I have a FaceBook page on which I often post timely articles relevant to my clients.
How to Get Nutritional Counseling
My Bariatric Life: Where can people find reputable referral sources to get nutritional counseling for weight loss?
Susan Rago: To find a registered dietitian nutritionists people can go to the Academy of Nutrition and Dietetics website and use their free find a dietitian service. Also, people might want to call their health insurance customer service center to find a dietitian nutritionist who is in-network with their insurance.
My Bariatric Life: How can a person best prepare for her first appointment?
Susan Rago: First, I would make sure that the registered dietitian nutritionist is a good fit for you. Before your session, ask what will happen in the session and what is usual follow-up. Ask if he/she has a website you can review. Bring copies of your last labs to your visit. It would be helpful to keep a food record, either paper or electronic for a week before your visit to share with the dietitian nutritionist. Also bring a list of all of your medications and supplements as well as the dosages. Have the name, phone number, and fax number of your physician with you. Know and understand what your insurance will cover as far as nutrition counseling.
My Bariatric Life: What advice would you give the person who cannot, for whatever reason, undergo nutritional counseling?
Susan Rago: Talk to their primary care physician about local resources. Think about joining a Weight Watcher’s Group or Weight Watchers online or other online program. It’s very difficult to do this on your own.
My Bariatric Life also recommends the 8-week free online weight loss course offered by the Center for the Study of Nutrition Medicine at Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital.
Get Weight Loss Tips from Expert Susan Rago in my second Q&A session with Susan Harrow Rago, MS, RD, LDN.
Living larger than ever,
My Bariatric Life