DOES A RD VISIT COST MONEY?
A visit to the RD will likely mean an out-of-pocket cost. Find out from your insurance company in advance what will be covered and what will not be covered. Medicare does provide coverage for meeting with RDs under certain conditions, and many private insurance policies will cover appointments if the RD is associated with an American Diabetes Association Recognized Diabetes Education Program or American Association of Diabetes Educator’s Accredited Program (see the box How to Find a Professional). With so much “free” nutrition information out on the web, on newsstands, and in magazine racks (some of it valid, most of it utter nonsense), many people wonder why they should pay a RD. It helps to remember they are medically and professionally trained and they are working with you. There is a lot of free general medical advice available as well, but we still understand the importance of visiting our doctor for a checkup. The same is true of a RD.
WHAT WILL YOU GET FROM YOUR VISIT?
Meeting a RD is much more personal and useful than being given a free “diet sheet” from a tear pad at the doctor’s office. Why? Because you are an individual. From the minute you started putting food in your mouth, your reaction to food was unique. At about 12–18 months old, when you became independent with your spoon, you gained control of what you did and did not put in your mouth. From that time on, you learned to make your own choices.
An individualized plan designed for people with diabetes allows choices as well. How could a copy of a preprinted 1800-calorie diet with a one-day menu possibly work for everyone? People with diabetes come in different ages, sizes, and shapes and each has different medical needs. One plan does not fit all. To make sure you get the most of your appointment, ideally ask for a consultation with an established American Diabetes Association Recognized Program or American Association of Diabetes Educator’s Accredited Program. Look for someone who is a Certified Diabetes Educator (CDE). A CDE is a professional who has met standards and passed a qualified exam to be designated as someone knowledgeable and experienced in diabetes care. See the box How to Find a Professional for more information on how to find these professionals.
GET THE MOST OUT OF YOUR VISIT TO THE RD
ASK YOURSELF WHAT YOU WANT OUT OF THE VISIT
Do some soul-searching before your appointment and determine what you want to learn from your visit. You will also likely be asked to make some changes; what are you willing to do? You should be in a state of mind to receive suggestions and act on them. If you feel your first RD doesn’t meet your needs, don’t give up; ask for another RD.
STAY POSITIVE
Forget the negatives you’ve heard in the past and start from scratch. If you are anticipating the worst, this negativity will set the stage and will become the inevitable outcome of the visit. Unfortunately, friends, family members, and health care professionals may have said some unkind and hurtful things to you about your weight, food choices, or food behaviors. Start your new relationship by viewing the RD as someone who is there to support you, and remember that it may take a few visits to formulate the right plan.
BE TRUTHFUL
Hiding information about your eating habits or behaviors will make it impossible to develop a personalized meal plan that can work. For instance, if you have a weekly date out with friends at a local restaurant, tell the RD. He or she can help you make the best choices at this restaurant and not force you to give up important parts of your lifestyle. Tell the RD what your favorite foods are—any plan that cuts out these foods completely will be difficult to follow.
SET SHORT-TERM AND LONG-TERM GOALS
Goal planning is an essential part of changing habits. Food habits have taken years to establish and will take time to change. A proper goal should answer three questions:
1. What? What you want to achieve (the change)
2. When? When you plan to achieve it (the timeline)
3. How? How you will achieve it (the strategy)
EXAMPLE: “I will substitute a 15-gram carbohydrate food choice for my mid-morning snack at work instead of a candy bar (1). I will start doing this next Monday (2). I will go to the store on Saturday and select some new things that have about 15 grams of carbohydrate in them (3).”
Without these three elements, it is difficult to initiate change. During your appointment, write down your goal and include these elements to provide a clear concept of your plan. Your goals should be realistic—losing 20 pounds overnight is not a good short-term goal. In setting only a few realistic goals at a time, you will be better able to make changes that will last a lifetime, rather than just a few days.
REMEMBER, NO ONE’S PERFECT
No matter how great your meal plan, there are going to be times when you fall off the wagon. Ask your RD about relapse prevention and strategies on what to do if you get off track. One very important tip: Do not call your plan a “diet.” This word has a negative and short-term implication. Medical literature calls it a “medical nutrition plan,” but most RDs will simply call it a meal or nutrition plan. Another word to drop from your food vocabulary: “cheating.” Instead, you make “choices” with food. Learning how to incorporate your favorite foods into your plan will help you stick with your plan.
BRING IN A FOOD DIARY
A food diary can help you identify some previously unrecognized food behaviors, such as unconscious eating (nibbling while you cook, snacking while watching TV, grabbing a handful of something as you breeze through the kitchen) or nervous snacking (eating while you are stressed or nervous). See the food diary sample in Table 1 for an example.
TABLE 1. SAMPLE FOOD DIARY
TAKE THE SHOPPER AND CHEF WITH YOU
The person who prepares your food should, if possible, accompany you to the RD visit. No, this does not mean you should hunt down Ronald McDonald. But if your