In my cozy corner office tucked between the pharmacy and the frozen foods section, I listened to customers explain their health and diet histories while providing nutritional counseling as a supermarket dietitian. I often braced myself during these conversations — my shoulders tense, my heart racing, my palms sweaty. I saw their faces across the desk from me, framed by the warm, orange-colored leaf decals and inspirational health quotes stuck to the wall, and I wondered: “Am I doing this right?”
Some people were straightforward and to the point. Others took their time and went off on tangents, providing in-depth descriptions of doctor’s appointments or family dinners. All the while, I was counting the minutes, hoping that I would have enough time to educate them. I thought it was so important to show that I was a nutrition expert. I jumped into scientific explanations and sent them off with a pile of handouts, only to feel confused when the message didn’t seem to click, or the person didn’t book a follow-up appointment.
I felt like I was missing something, so I reached out to a preceptor from my internship. On our phone call, I explained my feelings of inadequacy during my counseling sessions. I was baffled at her response: “The first session, you’re just getting to know the person. You won’t have much time to give them a lot of information, so if they want that, they should set up another time to come back.”
This approach was a 180° turn from how I thought I should be counseling. Wasn’t that the whole point — to be providing medical nutrition therapy? How were they supposed to change if they didn’t have the information to do so?
Despite my resistance to the idea, I implemented this advice. Instead of pressuring myself to tell someone everything I knew about fiber or sodium, I listened. I got to know the person sitting across the desk from me. I gave the information that I could in the time frame that I had. Most of the time, no one left saying, “You didn’t explain enough science to me!” The people who were ready to make changes came back for more information, and those who weren’t ready didn’t. The world didn’t crumble. No one called me out as a fraud.
Since that first job, I’ve worked in intellectual and developmental disabilities, autism, behavioral health, eating disorders, and now dialysis. I have continued to struggle with the idea of “just getting to know someone” throughout all of these experiences.
I’d be lying if I didn’t admit that I’ve felt guilty and frustrated when patients don’t change. I’ve often felt like I’ve somehow failed or simply not tried hard enough. It brought me back to that phone conversation I had with my preceptor, which reminded me of a lesson I learned in my college speech class.
My speech professor taught our class that ethos (likability and trust) is the most important and influential form of persuasion. If an audience or person does not like you or trust you, they will not want to listen to you.
For those who need a refresher, the three pillars of persuasion are as follows:
- Ethos = credibility, likability, trust (thus, persuading someone because they like you and trust you)
- Pathos = emotion (thus, persuading someone by appealing to their feelings)
- Logos = logic (thus, persuading someone with a logical explanation)
This lesson is a truth that’s been staring me in the face during my entire journey thus far as a dietitian, yet I haven’t quite accepted it until recently.
From the beginning, I’ve approached most conversations about nutrition with the mindset that logos would be the most effective avenue for persuading people to make nutrition and health changes. All along, I was using ethos without realizing it; however, I always rushed past that part of the process and thought it was most important to give people information.
The truth of the matter is that most of the people I’ve encountered didn’t care about the scientific details behind nutrition recommendations. They didn’t care that blueberries are good for your heart because they contain anthocyanins. They didn’t care about the difference between soluble and insoluble fiber. They didn’t care that oats and barley have more beta-glucans than other grains. They didn’t care about what a probiotic is; they just ate yogurt because they liked it.
The realization that hurts the most is that most people didn’t care about the difference between a “nutritionist” and a “dietitian.” Most people didn’t care that I earned a bachelor’s of science, that I underwent 1200 hours of supervised practice, and that I had to sit for a tricky exam to have those “RDN” letters behind my name.
I’ve learned this through the blank stares, the no-shows to counseling sessions, and the patients who never seem to want to change no matter how much science I spew at them. I’ve also learned it through the people who have thanked me for helping them reach their health goals. They usually don’t thank me for teaching them about the optimal omega-3 to omega-6 ratio or the biochemistry behind gluconeogenesis. They’ve thanked me for my empathy, my support, and my patience. I learned about their jobs, families, triumphs, and struggles. I related to their passion for sports, baking, music, or running. They trusted me, and because of that, they felt seen and heard. As a result, they felt more comfortable in making changes. Knowing more about them also helped me tailor my education and interventions.
To be a dietitian is so much more than to be rooted in nutritional science. I am a speaker of truth. I am a dispeller of myths. I am an educator. I am a listener. I am a counselor. I speak to people about food and how it relates to their lives. In those conversations, I do so much more than telling them what to eat. I’m listening, empathizing, and helping them understand how to eat.
I’ve had to slow down and realize that my expectations for this career are very different from reality. In school, I was steeped in research and ready to go out and prove to the world that I was the nutrition expert. I learned the hard way that most people don’t care as much about sound nutrition science as dietitians do.
To any dietitian reading this, please know that you don’t need to prove you are the nutrition expert. That’s already a given, so put it on the back burner. Before any conversation you have with someone about nutrition, whether it’s professionally at your job or in a casual conversation outside of work, the ethos needs to come before the logos. Take a deep breath, slow down, and get to know the person in front of you.
This is a concept that I’m still working on incorporating into my practice, but I can attest to the fact that when I do, I feel more at ease. Don’t get me wrong — logos and pathos are both still useful persuasion techniques. A lot of people do care about sound nutritional science and my dietitian credentials. However, when I reflect on it, I realize my most effective interactions were based on a foundation of trust and connection.