Nhs vs private dietitan

Anoneemoose

Hi,

I recently posted mentioning I had been referred to an NHS dietitian regarding weight management help with the ailments I suffer. This came about because I contacted a private dietitian and she needed a referral from my gp, which he was reluctant to give because he didn't know who she was - fair enough - sort of (I explained I found her on the BDA website).

Anyway, the doctor said he would refer me to the NHS one at our local hospital. Although I was sceptical (as I once had an appt with a dietitian through my previous gp who basically showed me the eatwell plate and was overweight herself), I was happy to go with an open mind.

Well, my appt was today and to say I am disappointed is an understatement. I am frustrated yet again. I got shown the eatwell plate again. Admittedly, I was given some decent advice in relation to managing my IBS however, all of this info completely contradicted that in the healthy eating leaflet I was given.

And no follow up! Total waste of time! So, now I am wondering whether to go and see the private dietitian anyway (although that will involve asking for a referral from my gp again and having to uncomfortably explain how carp the nhs one was). Has anyone seen a private dietitian and if so, was it any good. Or does anyone have any experience of them to see whether they would actually do anything different from the NHS one?

Thanks in advance.

Anoneemoose

I see I have spelled dietitian wrong in the title - sorry - not sure how to change it!

pmduk

My experience of NHS dietitians mirrors yours - I've seen a dietitian privately, she was working with a private surgeon who operated on me. There was a world of experience, she was familiar with my condition and had a great deal of useful advice.

I've no doubt similar people exist within the NHS, the problem is finding one. If you're under the care of a consultant it'd be worth asking if s/he knows of a dietitian with expertise in the area.

chocolatelover93

I went to see a NHS dietition a few years ago and didn't think much to her, she wasn't very sympathetic and basically told me to eat fruit and veg which everyone knows!!
However my new GP told me that as I don't have a medical condition that requires me to see a dietition (I have IBS so I thought that would mean I would be able to) as the waiting list is very long. He reffered me to the Heath Trainer Service, I see a man once a month for 6 months and he is amazing, he has really helped me and doesn't just say "well eat healhty" he tells me what is good and what is bad and we look at my food diary and see what can be changed and as a result of this my eating habbits have started to change and I am loosing weight and I don't feel like I am "dieting" I live in Norfolk so I am not sure if they do this everywhere as I know different places offer different things. But I would definately recommend talking to your GP about seeing a health trainer as it has really helped me

Businessgirl

Can I suggest that if you are going to go private, research a really decently trained Nutritional Therapist. They don't ask for referrals and you're likely to get a lot better information than from a dietician...the trick is however that you want to BANT registered with a DipION. This is quite important as legally anyone can call themselves a nutritional therapist. The DipION programme is the most intensive and best programme in the UK, and to be honest, these guys come out better able to support weight management coupled with health issues than anyone else. So if you go the private route, I'd personally go that route as they can often give amazing advice on managing your IBS and finding the root causes of it.

Anoneemoose

Thanks for all of the replies here. Sorry I have taken so long to come back to the post. It has given me some things to think about.

It is just so frustrating. I am still doing myfitnesspal on 1600 cals per day with a variety of foods and occasional treats. However, as discussed with dietitian the other day, foods with fibre tend to make my ibs bad. Certain fruit and veg and wholegrain breads (not that I eat much bread!!). Like I said, the stuff you're told to eat for weight management is the total opposite of managing IBS and chronic fatigue!!!

One of my issues is I usually get a major energy slump after lunch towards school run time....this happens whether I eat slow release foods for lunch or not. Also happens when I am properly hydrated as well. The dietitian suggested a small glass of fruit juice to give me a boost of energy!! I though fruit juice was a baddy now. 😳

theoretica

Anoneemoose wrote: »

I though fruit juice was a baddy now. 😳

The way I look at is that people and all the microbes in our guts are complicated, and different. There is the basic sensible advice which does work for most people. And then there is what works for you - however odd that may seem to other people. Hopefully you can find someone who will work with you to find what suits you - rather than the general good and bad foods you can get from the internet or books.

FBaby

My best friend had a similar experience to yours. She was referred to a dietician some years ago and said it was a complete waste of time. She then paid to see a private dietician, which did help for the time she saw her, but she couldn't continue to pay and within 6 months of stopping, she'd put all the weight back and more. She convinced herself she couldn't lose weight.

She then went to see her GP as her back was hurting more and more and he said that it would only get worse unless she lost the weight. He referred her not to a dietician alone, but to a weight management multi-disciplinary team. That meant 2 appointments with a consultant who reviewed her conditions (she also had IBS problems), and 6 appointments with both dietician and psychologist. She said that the psychologist really helped her because for the first time in her life, she admitted that she was eating healthy as she was convinced. She did eat healthy food at regular meal times, she just ate much too large portions (she was persuaded they were not) and did cook many cakes and other deserts, which she would also have in between meals. She said that the psychologist helped her with coming to term with the fact that she was responsible for her weight, not her condition or her bad genes, and the dietician helped her with meals that suited her.

She lost 3 stones in 5 months and 2 years on continue to lose some slowly but regularly. She is currently training to run her first half-marathon.

I think research as shown that multi-discplinary weight loss clinics are definitely the most successful for weight loss. Maybe you can ask your GP if there is one he could refer you to?

DUTR

I have the opposing view, the dieticians can help but ultimately the last card is with the patient.
The eat well plate is a good start, I found the eat well forums for 6 weeks more useful than the 121 meetings as the meetings just seem like they are telling the patient off. Overall conclusion is that cut way back on processed convenience foods and you are well on the way.
A couple of years back I had an Op on the NHS and someone else had the same OP private, guess what? It was the same surgeon that performed the operation.

Anoneemoose

FBaby wrote: »

My best friend had a similar experience to yours. She was referred to a dietician some years ago and said it was a complete waste of time. She then paid to see a private dietician, which did help for the time she saw her, but she couldn't continue to pay and within 6 months of stopping, she'd put all the weight back and more. She convinced herself she couldn't lose weight.

She then went to see her GP as her back was hurting more and more and he said that it would only get worse unless she lost the weight. He referred her not to a dietician alone, but to a weight management multi-disciplinary team. That meant 2 appointments with a consultant who reviewed her conditions (she also had IBS problems), and 6 appointments with both dietician and psychologist. She said that the psychologist really helped her because for the first time in her life, she admitted that she was eating healthy as she was convinced. She did eat healthy food at regular meal times, she just ate much too large portions (she was persuaded they were not) and did cook many cakes and other deserts, which she would also have in between meals. She said that the psychologist helped her with coming to term with the fact that she was responsible for her weight, not her condition or her bad genes, and the dietician helped her with meals that suited her.

She lost 3 stones in 5 months and 2 years on continue to lose some slowly but regularly. She is currently training to run her first half-marathon.

I think research as shown that multi-discplinary weight loss clinics are definitely the most successful for weight loss. Maybe you can ask your GP if there is one he could refer you to?

This sounds like a really good approach. I admit I eat emotionally from time to time and that is mainly fuelled by frustration.

The issue I see is with my GP. Last time I spoke to him, when he referred me to the dietitian, he said and I quote "I can refer you on to the dietitian because there is nothing more I can do for you"!!!

So not sure that option would be available for me! Will research it though as I may be able to organise a similar thing privately.

Anoneemoose

DUTR wrote: »

I have the opposing view, the dieticians can help but ultimately the last card is with the patient.
The eat well plate is a good start, I found the eat well forums for 6 weeks more useful than the 121 meetings as the meetings just seem like they are telling the patient off. Overall conclusion is that cut way back on processed convenience foods and you are well on the way.
A couple of years back I had an Op on the NHS and someone else had the same OP private, guess what? It was the same surgeon that performed the operation.

You're right in your opinion that "the last card is with the patient" but what about people like me who have limitations - as I said the issues I get with my IBS mean I struggle with a lot of the wholegrain, whole fruits and veggies for example (very simply put). I have cut out most of the processed stuff with the exception of an ocassional treat. But still I am the same weight even though I am under my allocated calories!

Go figure!