1. Educational preparation and training.
The main difference between a Registered Dietitian Nutritionist, a Health Coach, and a Nutritionist is education and organizations regulating their scope of practice and credentials.
A Registered Dietitian Nutritionist (RDN) has a Bachelor of Science degree from an accredited university and must also complete a postgraduate Internship consisting of at least 1200 hours of supervised practice, as well as additional coursework. Once they have completed their internship, they must then pass a rigorous credentialing exam, similar to nurses and medical doctors once they complete their education and supervised experience. There is one organized body that regulates the education and credentials of Registered Dietitian Nutritionists called the Commission on Dietetic Registration. A Registered Dietitian Nutritionist has a wider scope of practice to make dietary and supplement recommendations based on your health needs and medical conditions. Registered Dietitian Nutritionists do not diagnose any diseases or chronic conditions. Working with a Registered Dietitian Nutritionist may mean you can use your health insurance to cover the cost of services.
Health coaches do not have any mandatory licensure or training requirement that must be achieved to call themselves a health coach. A Health Coach may have a degree from a 4-year university or may be a licensed medical professional with additional training or certifications. There are several reputable and stringent Health Coaching certificates, but there is no organized bod
y regulating their credentials and education. What is most important is that the Health Coach be aware of their own ‘scope of practice’ based on what certifications they may have, and the legal and ethical limitations to giving medical advice or making medical recommendations for health-related matters. Health Coaches are a great option for a lot of people, depending on their goals. Assuring that the Health Coach has a certificate from a reputable organization is important.
Similarly, to Health Coaches, “Nutritionists” have no mandatory licensure or training. A Nutritionist may have PhD in Nutrition and work in research or a clinic setting but chose not to complete an internship to earn RDN credentials. Often, someone who works at a supplement store will call themselves a Nutritionist to appear as an expert to make supplement recommendations. Asking what type of education a Nutritionist has is important to assure they are qualified to support you in your health and wellness goals.
2. Specialty Focus.
Registered Dietitians, Health Coaches, or Nutritionists are not one-size-fits-all and many chose to focus on one area such as weight loss, nutrition, exercise and fitness, chronic disease management, and so on. Some are holistic in their approach and incorporate mind-body practices like yoga, T’ai Chi and meditation, or have Personal Training certificates to help support physical activity. Some may also support cooking skill development through one on one or group classes. Ample research has shown clinical benefits of these practices in helping to achieve greater focus, reduce anxiety, lower blood pressure, and even lose weight. Ask the individual what their primary interests are and how they can bridge the gaps to provide a more holistic wellness experience.
3. Method and style of coaching.
At the end of the day, individual health and wellness support is about empowering individuals to identify personal challenges, set goals, become accountable, and work toward lasting foundational change. Most reputable Health Coach and Nutritionist certifications, and Registered Dietitian Nutritionist degrees, include courses or information on, and provide practice of, counseling and coaching techniques to support behavior change. A practitioner should be able to describe their own professional methods for exploring sensitive issues while also understanding when psychotherapy or additional counseling may be needed to facilitate changes in a safe and healthy way.
It's also important for you to be honest in what you are looking to accomplish and any challenges or setbacks you’ve faced in the past. Health and wellness partnerships can only be beneficial when both parties are forthright about their needs, expectations, and capabilities. Fully describe what you’re looking to gain through health coaching. Ask about fees and packages so that you’re prepared to make the investment for what will likely take multiple visits and time. If you choose to work with a Registered Dietitian Nutritionist, ask if they take health insurance, can provide a SuperBill (for out-of-network reimbursement), or can take HSA or Flexible Spending payments. Be honest about the time you can commit to working with a professional and ask about technologies such as videoconferencing that may help simplify the scheduling and make follow up more accessible and convenient for you.
4. Referral process for issues that require medical care.
It is very important to remember ‘scope of practice’ and that a Nutritionist and Health Coach is not medically trained or licensed to diagnose and treat medical concerns. Even a Registered Dietitian Nutritionist cannot diagnose medical conditions or prescribe medications or supplements. An RDN is limited to recommending supplements and diet patterns. Having experience working with individuals who have different diseases does not infer qualification to advise, recommend or treat them medically. If you don’t have a health care provider, it is advised you also find a medical provider to support your health and wellness goals. Having a health care provider in place will allow the nutrition and wellness practitioner to seamlessly refer you when a workup or medical exam and evaluation is needed. The nutrition and wellness practitioner should keep records (an RDN is obligated to), allowing for a team-based approach and more comprehensive care should you decide to consent.
5. Required products to be purchased.
Only a Registered Dietitian Nutritionist’s scope of practice allows for recommendations of supplements or eating plans. This is especially important for clients who have diagnosed medical conditions. A reputable practitioner, regardless of scope of practice, will not require specific products to be purchased and/or sell them in conjunction with their services. An RDN may recommend specific micronutrients to supplement and suggest available brands based on their knowledge and experience. They should inform you if they receive any kind of incentive for recommending certain products. A Registered Dietitian Nutritionist may also recommend specific dietary patterns, and they may include a Meal Plan as a part of their paid services. A Health Coach or Nutritionist may not recommend supplements and should not sell you specific products. It is not in their scope of practice to write diet plans or recommend dietary patterns.