Frequently Asked Questions: Nutrition Counseling

Although these two professions sound alike, nutritionist and Registered Dietician are distinctly different things and the titles cannot be used interchangeably. In order to legally use the RD designation, a person must: 

• have an undergraduate degree or post-graduate degree in dietetics or human nutrition
• completed an accredited internship to become registered with the Commission on Dietetic Registration (CDR)
• pass the CDR Registration exam may legally declare themselves as registered dietitians
• RDs also have to complete 225 hours of continuing education every few years

These additional requirements afford the RD legal protections and additional government regulation that is not given under the title "nutritionist." In fact, in some states anyone can claim to be a nutritionist regardless of the education or training they have (or don't have)!  

There are states that require nutritionists to obtain an occupational license from a Board of Nutrition, but this still is not the same as the requirements for becoming an RD. 

The LD or LDN is for Licensed Dietitian (Nutritionist), which indicates the practitioner is legally licensed to practice nutritional counseling in their state. A person with an LDN has met state mandated education requirements necessary to practice. In some states it is a violation of state law to practice dietetics without a license. The LDN signifies to the public that a person has the education, training, and experience to provide safe, effective and evidence-based nutrition counseling. In other words, the LDN is the state's way of protecting the public interest.

This peer-reviewed credential issued by the International Association of Eating Disorders Professionals identifies a medical (MD, RN) or healthcare professional (RD, PhD, PsyD, LPC) who has completed a high level of training (over 10,000 hours) and has passed an examination demonstrating their expertise in the treatment of eating disorders. The CEDS credential is the professional designation for healthcare providers involved with eating disorders patient care.

Nutrition therapy for eating disorders has evolved tremendously in the past 25 years. Initially, the role of the RD was focussed primarily on food for weight restoration and providing scientifically-based information about food, nutrition, physiology, health, and weight. Registered Dietitians followed a protocol, based on a medical diagnosis and an assessment of a person’s physiological and nutritional needs. The result was an individualized food plan to support energy demands and nutrient needs to support physical recovery. All of this is still an essential part of eating disorder recovery, today, but what this original approach overlooked was the deeper meaning of food and the meaning of the body entranced by the eating disorder. And that is where today’s nutrition therapist plays a crucially different role in eating disorder treatment and recovery.  

You see, a person who struggles with an eating disorder has become embroiled in a struggle with food, weight, and body image. They have adopted faulty, harmful beliefs about food and the body, causing them to lose connection with themselves, physically and emotionally. To the outsider, the eating disorder is destructive and “doesn’t make sense.”  For the person living with an eating disorder, it has become the mechanism by which they protect themselves and feel secure. The aversions and compulsions that develop from the eating disorder are not going to be silenced just by giving nutrition education. This is where the role of the nutrition therapist has shifted.  

In helping a person recover from an eating disorder, a nutrition therapist meets the client where they are on day one...and partners with them to uncover and understand the faulty thoughts and behaviors, the purposes they serve, and the mechanisms through which they evolved, resulting in the development of the eating disorder.  Together, they gently examine the ways the eating disorder has integrated into every aspect of how that person interacts with the world. As connections between food and the body, and the client’s fears, anxieties, and triggers come to the surface, the nutrition therapist helps a client with an eating disorder release the power that the eating disorder holds over them through their relationship with food and their body. This process, which is unique for every client, helps a person to reframe the meaning of food and the perception of the body. Gradually, they begin to explore new experiences involving food, social settings, movement, experiences, and relationships. The nutrition therapist is an integral member of the treatment team and the eating disorders recovery process, making  it possible for a person to restore hope, to experience healing, and to bring vitality back into their life.