Finding the Best EMR for Dietitians

Maybe you’re ready to limit your commute time and start seeing clients virtually via telehealth. Or perhaps you already have a private practice established but you want to run HIPAA compliant virtual nutrition support groups for clients who can’t see you locally. There are literally so many options when it comes to taking the plunge into telehealth for dietitians.

While shopping for an electronic medical record (EMR) to use for telehealth as a dietitian in private practice, I came to realize what I thought are the three most important things to get out of an EMR (whether you offer telehealth or not):

  1. Properly protecting patient privacy and confidentiality under HIPAA laws
  2. Creating a positive experience for my clients using technology that will help improve their outcomes
  3. Having a system that can help save me valuable time and resources

Before we get into this, I think it’s important for you to realize why dietitians need electronic medical records, and what the benefits are. Give yourself 5 minutes to read through all the information here, so that when you’re really ready to pick a product you have some solid understanding of what you’re looking for in an EMR.

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It’s time to drop out of diet culture

Guest post by EDRDpro Member Sara Upson of My Signature Nutrition:

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Do you know what diet culture is? Most people don’t, yet we live in it daily! We have become so inundated with diet culture that it just seems normal. However, it’s time to end diet culture- or at least drop out of it- so that we can focus on well-being.

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Have you developed all or nothing thinking? The one thing that may help you change

Have you ever wondered why you have the tendency to be so all or nothing oriented with your thinking? Here are some examples of all or nothing thinking:

If I can’t do this perfectly then I don’t even want to try.

Today I’ll clean the whole house, or stay on the couch all day.

I have a paper to write. I must do the whole paper now, or I won’t even start and I’ll put it off to the last minute.

I’m going to train for a marathon, or never start running at all.

A night out means I’m either out all night and nursing a hangover in the morning or I I’ll stay in and mope about FOMO.

To get in shape, I need to go to the gym 5 days a week. If I can’t do it 5 days a week I’ll never improve my fitness.

Binge, or stay on the diet.

And back and forth you go.

In all or nothing thinking, or black-and-white thinking as it’s commonly referred to, where is the gray?

After working with clients as a nutritionist and eating disorder specialist for close to ten years, I’ve come to realize a thing or two about all or nothing thinking. It’s common among high achievers, perfectionists and passionately driven individuals and I also notice it’s just as common among those of us who outwardly appear less driven, less successful, or less passionate to perform.

All or nothing thinking is like a mental paralysis or lighting a stick of dynamite. You’re stuck like you have two feet covered in concrete because you’re afraid of something not working out, or you’re feeling the urgency and it works very well in the short term to make shit happen. We develop the brain pattern of all or nothing thinking to, in part, keep ourselves safe from uncertainty. It feels better and safer in many ways to be an all or nothing thinker because it gives a false sense of more control. You feel like you know exactly what to expect or at least that’s what it feels like on the surface. 

When it comes to our health and our bodies specifically, all or nothing thinking can become problematic. Putting it very simply, it can be harmful because we develop the belief that If we’re not perfect at health, the workout regimen, the diet, then we are failing and why even try?

Getting comfortable with the idea of uncertainty can help:

The number one thing affecting people who struggle with all or nothing thinking is they are uncomfortable with uncertainty. Uncertainty is something many people don’t even want to talk about. By talking about it, realizing it, and accepting that we are always living with a certain level of uncertainty you can actually start to see how welcoming uncertainty in your life can be the doorway to learning how to stop the all or nothing-ness. Now, of course, not everything in life is uncertain. We have a great deal of power of choice in many, many aspects of life – just not with everything. We can not totally control our health, other people’s thoughts and actions, or random events.

Let’s pause right now and realize that you do have the brainpower, the intelligence and the capacity to slow down and respond in the moment to what is going on in the vast majority of life situations. This is called being present. There are are, of course, a small number of situations when you actually physically will have a very difficult time being present, such as when being chased by a lion. Then you are just running your ass off to survive and being present would most likely not help you at all.

How to start being okay with uncertainty to get out of all or nothing thinking: 

You can start by telling yourself that you trust yourself. That’s right,  fake it till you make it baby. The brain is one powerful beast and what you hear and say to yourself does affect what how you behave.

You can make decisions as needed rather than having to predict and plan for every little thing. You can learn that being okay with uncertainty is part of life, and remind yourself how all or nothing thinking to avoid dealing with uncertainty is actually causing you more pain than comfort at times.

Let’s break down all or nothing eating as an example. The “all” is when as soon as you have one bite of your forbidden food you believe you’ve “screwed up” so it no longer matters how much you have because you’ll start again tomorrow on your diet. Keep in mind the “nothing” part of all or nothing eating involves deprivation and/or restriction, which  we have scientific evidence to show creates a stronger reward feedback signal to your brain when you do finally have that delicious bite of food, making the pull to overeat even stronger. (As a bonus you then tell yourself you can’t be trusted, leading you right back in to all or nothing-ness). 

There is a complex system of neurochemicals and hormones that play in to binge eating. It is not as simple as all or nothing thinking and I certainly do not mean to form that impression; however, the mental tape recording of what you say to yourself once you’ve had the first bite is very, very powerful in the unfolding of a binge. In fact, what you say to yourself at any time, beyond your relationship to food, is a very powerful predictor of your reality.

When you want to have some chips, telling yourself that you can pay attention as you’re eating, and notice when you’ve had enough chips is a simple example of being present while eating. You can try that.

Uncertainty, for a dieter in particular, is “I don’t know how many chips it will take to feel satisfied, and I’m scared that I’ll overdo it”. The number of chips to eat (as if there is one right number of chips) is a gray area. All or nothing thinking does not allow for any chips, and then that belief perpetuates the over-consuming of chips once you start.

Once you get the hang of this, you will see that uncertainty is the pot of gold at the end of the rainbow. It is where your answers lie if you simply follow the rainbow and trust. Uncertainty is where you need to go to learn to trust your own instincts and thoughts. By building trust you will no longer need your old all or nothing beliefs. This doesn’t mean you don’t have choices, control or shape the direction of where you go in life, it simply means that you gain MORE power by being present versus being in autopilot all or nothing thinking. 

You can go out with friends and decide an hour later you’re ready to go home.

You can be physically active differently on different days depending on your energy and how you feel without beating yourself up.

You can enter in to a difficult conversation with a loved one, and trust that you’ll stay present with your emotions and speak accordingly, staying true to yourself.

You can have all the different foods that you wish, and decide at any moment that you’ve had enough, or you need some more.

*

Sumner Brooks, MPH, RDN is a registered dietitian nutritionist, Certified Intuitive Eating Counselor and the founder of EDRDpro which offers continuing education services for eating disorder professionals.

Where to start when the idea of self love feels impossible

A guest post by: Claire LeGresley, Registered Holistic Nutritionist

Like so many others, I spent years at war with the closest thing to me. I learned self-criticism at an early age, having grown up in front of a mirror as a dancer. Since my body type didn’t fit the mold of a classical ballerina, I hated and treated it as though it had betrayed me.

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Instilling the Message of Health at Every Size at the Heart of Motherhood

By Crystal Karges

 

“Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.” – Harriette Hartigan

Today’s mothers are faced with intense scrutiny when it comes to their bodies and appearances.  Raising children in our current culture has taken a dramatic shift in the age of social media and with the Internet at our fingertips.  The reality is that the postpartum period for mothers is perhaps one of the most vulnerable and sensitive times for a woman.

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Being in Your Body

By Rhea Bergmann

How did we get to this point of being so utterly obsessed with our bodies – yet completely disconnected from the only home we will ever have?

Many of us are yet to fully realize that body dissatisfaction arises as a culturally and socially developed phenomenon, which is shaped by a dominant story. Body hate is a product of social constructs – it is a learned state – it isn’t with us from birth but thrust upon us as we grow. It is a product of living in an environment which places emphasis and high value on the outward appearance. That prioritizes how we look above all else and even deceptively convinces us that our entire worth as a human being can be concentrated down to the size of our bodies.

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Intuitive Everything: A Crossfit Coach Weighs in on ED Recovery

By Kortney Karnok

Find Kortney at Fueling Strength on Facebook or  Instagram @fuelingstrength

Today I lifted weights again for the first time in months. I snatched*. I squatted. I even took my shirt off because I was hot, sweating, and I will no longer be confined by rules that say only a six-pack is worthy of comfort in the gym.

Granted I was alone in the gym, but it’s still progress. Would I have rushed to cover up with my shirt had someone come in while I was training? My instincts would have said, “yikes! hide!” but my resolve and determination to get over my fear of exposure, my fear of being revealed as “not perfect”, my fear of judgement, my fear of being “not good enough” will only be tackled head on. And so, I would remain vulnerable and topless.

(ummm, with a sports bra!)

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Reflecting on Recovery: A look in to this client’s 3 year journey to heal from an eating disorder

When I look at where I was and where I am now, I know there is hope for anyone.

When you’re isolated in the prison of your own eating disorder it may be all to easy to hear thoughts about how you’ll never get better. How it feels completely impossible, and the stories of others who have recovered, absolutely must be – MUST BE – fabricated.

I’m sharing Mallorey’s story with you for this very purpose – to give clients, as well as nutrition therapists, a glimpse in to the reality of the struggles so often faced, and the reality of recovery.

Mallorey was someone I worked with for a long period of time and it was an honor to be a part of her journey. Now, after diligently pursuing and fighting for her own life, free of an eating disorder, she is a therapist helping others [chills and tears welling here]. It’s a message like this, that gets me to my core, and reminds me, as the nutritionist, that patience, persistence and the right relationships will get you to recovery.

Q and A with Sumner (RD) and Mallorey (past client):

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Intuitive Eating Can Change Your Life

Imagine not living every day with 70, 80 or even 90 percent of your thoughts centered around what you can or can’t eat, how bad you were the day before, or your morning weigh in. For some of you, you really can’t even imagine. But try…

In this imaginary world, you wake up and you think about your day, not your size. You have thoughts of what you want and need to do. What you’re looking forward to, or what important thing is happening. You’re not beating yourself up, you’re not feeling disgust, and you’re just – you.

When it’s time for breakfast you’re willing and even happy to find something delicious and satisfying to eat. You feel glad that you’ve learned to eat to fuel your body and that what you eat tastes good to you. You’re trusting and confident that it’s okay to eat and you don’t have to overthink it anymore.  There is more to life than food and weight – so much more.

I’ve been learning about, teaching, and living Intuitive Eating for about a decade. To me, and to others I know who eat this way, it’s THE game changer for anyone who lives the diet cycle.

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The One Key Element to Loving Your Relationship With Food

You can have all the information in the world about what nutrients you need, what a balanced plate looks like, and how many grams of protein your body probably needs for fuel and still struggle with your eating. That’s because there is one key element to how you eat that will help you have a peaceful relationship with food for good. Notice I said, HOW, you eat…not WHAT you eat. I am a huge fan of focusing on the how and not the what of eating. Fact: you can binge on cherries; a food full of vitamins, fiber and nutrition – but it is the binge itself, the HOW, not the what, that matters and makes you feel terrible.

It’s how you eat, not what you eat, that matters most.

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