The “Just Tell Me What to Eat” Trap

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In the FAQ section, I touch on why the “just tell me what to eat” approach to counseling is often unproductive.  In fact, many of my clients are people who previously tried this technique with other dietitians and came away dissatisfied.  Oftentimes the patient blames the practitioner when really neither one of them, but rather the approach, is at fault.

Yesterday, a new patient and I fell into the “just tell me what to eat” trap together.  After she told me about her issues and goals, we discussed different options for moving forward.  I suggested a collaborative approach, but she felt she could benefit from starting from scratch and having me create a meal plan for her.  In other words, she wanted the “just tell me what to eat” approach.  We discussed the pros and cons of this method and eventually went ahead with it.

As soon as she looked at the menu I created for her, I could see the disappointment and frustration on her face.  “Do you have kids? she asked me.  She continued on that the meal plan I created would not work for a mother of young children like herself.  The irony is that I created her plan using meals and snacks that I know from experience have worked for other busy parents, but the point is not whether or not they work for other people but rather that they did not work for her

I take the blame for this.  While I agreed to the “just tell me what to eat” approach because I wanted to respect the client’s wishes and because I wanted to give her the benefit of the doubt that she might be the rare exception of a patient who responds well to it, in hindsight perhaps I should have tried to be more persuasive about taking a different approach.

The problem with the “just tell me what to eat” technique is that everybody is indeed different and what works for one person is not automatically going to work for another.  After all, we are dealing with real people, not homework case studies in some nutrition textbook.  Real people have likes and dislikes, time constraints, children and spouses with their own food preferences, etc.

The client is the expert in his or her own life, not the practitioner.  Therefore, a much more effective approach is for both the client and the practitioner to bring their expertise to the table and figure out together how to create change.  I would welcome the opportunity to sit down with this woman again and this time collaborate on a plan that will not only help her towards her nutritional goals, but also work in her life instead of just on paper.

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