Losing weight and staying healthy can be quite a complex process. There is now a growing demand for trained, qualified medical professionals to guide us through these important changes. Learning the difference between dietitian and nutritionist can help you make an informed choice about the kind of nutrition therapy you’ll be getting, and to judge the authorship of advice, especially online. Although the two titles seem very similar, there are key differences between a dietitian and a nutritionist, and your choice will probably govern the quality of service you receive.
What Is The Difference Between A Dietitian And A Nutritionist? Do They Need A Master’s Degree?
Every registered dietitian is a nutritionist, but not every nutritionist is a registered dietitian.1 The basic task of both dietitians and nutritionists is the same: to assess a patient’s nutritional needs and provide dietary advice.2 Of the two, a dietitian is probably more formally qualified and is likely to have more hands-on experience. While nutritionists work mostly with individual clients, dietitians work alongside a range of stakeholders and professionals.
Registered Dietitian(RD) or Registered Dietitian Nutritionist(RDN)
The work of a dietician includes:
- Advising doctors and collaborating with other food and nutrition experts
- Working with policymakers in government
- Carrying out research on behalf of the food industry
- Helping market researchers to understand trends
- Partnering with educators to teach good nutritional practices
- Helping some individual clients as part of their private practice.3
The requirements for gaining the formal, protected title of Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) are:
- A four-year bachelor’s degree including coursework on nutrition science, food service management, and in related technological, economic, and scientific fields.
- A 1,200-hour professional practice commitment (sometimes called an ‘internship’). This lasts six to 12 months and takes place at a healthcare facility, community organization, or food service company.4
- Passing the registration exam administered by the Commission on Dietetic Registration. If they pass, the new RD/RDN can practice anywhere in the United States, but the exam requirements are more than a formality; almost half of RD/RDN candidates fail the exam, and over 40% don’t complete all the internship requirements.5
- RDNs must recertify every five years and stay current with the medical literature by completing 75 hours of self-study or coursework.6
In addition, more than half of RDs have advanced degrees, and many choose to gain further accreditation in areas of specialism such as sports dietetics, pediatric nutrition, or diabetes education.7
There is another accreditation with less stringent criteria than the RD/RDN pathway: Nutrition and Dietetic Technician, Registered (NDTR). This requires:
- A two-year associate degree
- A 450-hour program of supervised practice (i.e. an internship)
- Passing the DTR examination
- A commitment to continuous education
NDTRs work in hospitals, food service, community health programs, and the food industry, but will less often serve as government advisors or participate in pure research. This distinction is reflected in the anticipated (2011) salary level after four years in the job: $52,000 for an RDN compared to $36,400 for an NDTR.8
Nutritionists also work toward the same aim: improving health through assessing patients’ diets and providing advice. They focus on our food behavior and work largely with individual clients. The career activities of a nutritionist might include:
- Assessing a client’s overall health
- Advising clients on lifestyle and health goals
- Developing a diet and exercise plan
- Tracking progress
- Running cooking classes and other community outreach efforts
Experienced nutritionists can help you lose weight and achieve your health goals, but their decisions do not flow from years of formal education and accreditation. For example, a nutritionist cannot prescribe a diet in the same way a doctor prescribes medications, though an RD/RDN routinely does so. While an RD/RDN has food and nutrition as their sole professional focus, a nutritionist might also work as a chef or cook, yoga or meditation instructor, or even a dog walker. The formal title of RD/RDN is internationally recognized, but nutritionists may refer to themselves in other ways:
- Wellness coaches
- Registered (holistic) nutritionists
- Nutritional therapists
- Health coaches
- Nutritional specialists9
While some nutritionists hold a degree, and many offer excellent advice, none of these titles represents a formal accreditation. The use of ‘registered’ or ‘specialist’ does not mean the nutritionist is qualified in the same way as an RN/RDN or NDTR.
Can Registered Dietitians (RDs) And Registered Dietitian Nutritionists (RDNs) Help With Weight Loss?
Yes. Both in private practice and as part of working with companies, agencies, and government, RD/RDN-qualified practitioners educate their clients about weight loss as one element of a healthy and active lifestyle. The quality of dietary advice will generally depend on the experience level of the practitioner, so when engaging dietitians, check for those crucial letters after their name: RD or RDN.
Are Nutritional Therapists Covered By Health Insurance Or Medicare?
There are more than 900 health insurance companies in the United States, each providing different levels and types of coverage.10 Some insurers now cover nutrition-based treatments as preventative measures, but before seeking advice from dietitians and nutritionists, it’s best to check the details of your individual policy.
Medicare patients can be referred to a dietitian by their doctor, but will be covered for Medical Nutrition Therapy (MNT) only as part of treatment for diabetes or kidney-related issues.11
How Might A Dietitian Or Nutritionist Help Improve Your Health Through Dietary Changes?
After an assessment of your eating habits, dietitians are able to recommend changes intended to achieve your health goals. These could include:
- Providing advice on calorie intake, food choices, and portion size
- Focusing on a reduction of fat and sugar in your diet
- Promoting lean protein, fiber, and micronutrients as dietary elements
- Linking your diet to an exercise program
- Advising you to join a gym, a group, or an online forum
With the plethora of nutrition advice available online and in a multitude of eye-catching books, it’s vital that we understand where this advice comes from. Checking the qualifications of an author or practitioner is a great way to insulate ourselves against pseudoscience, and to make sure the food and nutrition advice we receive is properly peer-reviewed and authoritative.