What’s Wrong in Saying ‘Trust a Dietitian’?

White box with influencer crossed out, then registered dietitian centred in capitals, and nutritionist crossed out below.
White box with influencer crossed out, then registered dietitian centred in capitals, and nutritionist crossed out below.

The chairperson of a dietetic association said my blog post condemning weight conversion, aka dieting, was bringing the profession into disrepute and told me to remove it. Or else.

Lots of dietitians, me included, believe that it is the silence, not the speaking up, that brings the profession into disrepute. And more to the point, we put safety, integrity, and liberation before PR.

However, the legacy of poor leadership will be with us for a long while yet. This means we need to train ourselves to notice and reject the ways we have been groomed to support the status quo.

Take the message in the image for instance — people without a dietetic degree cannot be reliable sources of nutrition information. So they should butt out of food conversations and leave commentary to the experts. That’s us. Registered Dietitians. RDs.

Here we are, it says, at the top of the nutrition know-how tree, untouchable with our bona fida credentials. Our allegiance to evidence-based practice apparently clinches the claim.

There’s a few tweaked versions that do the rounds. And now I’ve commented, do you see the arrogance?

Yes, the fact that people qualified only by popularity, not relevant learning, are saying downright dangerous things about eating is a problem that needs addressing.

But creating a homogenous group made of all ‘non-RDs’ and then dismissing everyone in it isn’t a useful response. It’s just lazy scapegoating.

It’s also disrespectful, and doesn’t serve social justice. For sure, wielding establishment expertise like this is part of a broader culture of harm. That doesn’t make us less culpable, it makes us complicit.

The fact that we some of our leaders quash critique and permit harm is an embarrassment and an indictment. It impedes change but it needn’t stop it. Transformation means we need to understand the problem and adopt new, liberatory values. Unpicking the ‘we’re superior’ message is a useful entry point. Here goes.

So yes, we learn things and we work hard to qualify, this much is true. But it doesn’t grant us a group-exclusive capacity for helping people make sense of eating. Creating RDs as unique uses a tactic twinned with white supremacy known as exceptionalism. It also uses binary thinking to create the Other as inferior. These actions are rooted in the colonial drive for control and domination.

Beige background and grey text — Dietitians are the only people who can tell you what to eat to help your medical condition.
Beige background and grey text — Dietitians are the only people who can tell you what to eat to help your medical condition.

At another level, the message fails the test of basic logic. Firstly, the idea that every RD relies on empirically robust advice is ridiculous. For instance, consider the intellectual divide between diet and anti-diet colleagues. Then there’s RDs like me who reject both the diet and the anti-diet paradigm in favour of a health justice approach.

So clearly we don’t agree on what constitutes empirically robust advice. That means some of us are wrong. It could mean we all are.

Now, it’s comforting to cast about for bad apples. But it is disingenuous for us to imagine ‘misconduct’ applies only to colleagues subject to disciplinary action. Again, huge numbers of diet/antidiet RDs believe their colleagues’ diet/antidiet everyday practice is actually malpractice.

Plus a brief scan of dietetic narratives confirms that thousands of highly experienced and legally qualified RDs uncritically reproduce a neoliberal ideology. This touts ‘lifestyle change’ as remedy for power-related diseases like diabetes and heart disease, it ignores trauma, it normalises fat shaming.

The underlying issue is that we remain oblivious to the deep roots of coloniality in our work.

RD’s normalised misconduct isn’t made less harmful when non-RDs share sensationally harmful ideas. The less scandalous and more commonplace of two wrongs is still wrong. We need to name, repair, and prevent more injury, not brush it under the carpet of complacency.

This isn’t the same as saying RDs have nothing of value to offer. But it is saying no-one, RDs included, is made intrinsically trustworthy by virtue of holding a qualification. That’s wishful thinking and scientism, yes? Not honest analysis. We need all of what we say to be credible, caring, considered. That’s how reputation is earned.

The fact that I am an RD is important to many of the people I work with. If you are struggling to make sense of eating, identity, bodyhood, and trauma in a society that teaches you to trust the experts, and schooled you in self-doubt, it can be super reassuring to find someone you hold as an expert who validates your experience and helps you rewrite your story with an understanding of the oppressor. I’m also a poet, and while that shapes how I work as a dietitian, it doesn’t offer the particular sort of social clout, and psychic safety, made possible by my identity and attainments as RD, PhD, British Dietetic Association Roll of Honour Award, and other mainstream accolades.

RDs are the only nutrition professionals regulated by law & governed by an ethical code to ensure highest standards of work
RDs are the only nutrition professionals regulated by law & governed by an ethical code to ensure highest standards of work

As RDs we are high fliers in the medical-capitalist-academic complex’s hierarchy of food workers. So it might be appropriate to invoke RD as professional capital in an advocacy situation. Or to be accountable, say, in an article addressing colleagues like this. We also need to be mindful that pulling rank or listing trophies is rarely the morally robust choice.

The initials RD indicate we got in and we stuck it out. I don’t want to minimise what this entails or devalue what we can offer. I just don’t want us to make false claims or hide structural injustice either. That relies on the idea of a meritocracy, another tactic of white supremacy.

Ideally, the RD certification means we have developed the emotional, spiritual, and intellectual resources suited for a vocation in food work. But it can’t ensure this.

For starters, putting people down strongly suggests we’ve lost our way. As with any seniority, our extra status carries extra responsibility. It’s a toxic mix of supremacist judgement and professional insecurity when we use our position to diminish other people’s contribution.

When we say ‘only trust RDs’ we’re power hoarding. Yet another win for white supremacy. Also, exactly when were we elected adjudicator of whose voice counts in food work? Problematic, yes? There is something deeply flawed with the mindset that teaches so many of us to feel so entitled. This points to a profound moral, philosophical, and ontological failing in our professional socialization. We need to talk about this. Adding a lecture on Cultural Competence is not an adequate response.

Mr Bean (RD) shaking hands with thin woman (Health coach) at the same time as he’s pushing them away.
Mr Bean (RD) shaking hands with thin woman (Health coach) at the same time as he’s pushing them away.
When your friends introduce you because they think you do the same thing

Many of our professional associations encourage us to cite our legal status as a blanket approach to trump non RD food workers. Hijacking gravitas to professional snobbery is an oppressive move. Firstly, it embeds belief in a value-free legal system, a belief which hides structural bias. Second, it’s using the status granted us by the status quo to protect the status quo. Liberatory practice means using the status granted us by the status quo to dismantle the status quo.

In this case, that means refusing to repeat the oversimplified, weaponised messages dreamt up by our own leaders and instead choosing to derail them. So when I’m asked about the difference between an RD and a nutritionist I might begin with:

“In the UK, dietitians hold a degree and have passed professional exams that mean we can call ourselves a dietitian. Dietitian is known as a protected title, so only people who have passed the RD exam can use it. Other titles, like nutritionist, aren’t protected by law. That means someone could do a weekend course and call themselves a nutritionist. There’s also plenty of super-qualified nutritionists who hold nutrition degrees and who chose not to go the dietetics route, or who wanted to but couldn’t even though they’re plenty smart enough. As ever, classism and racism operate with other oppressions to build a white, thin, cis-het dietetic elite.”

It is our role to ensure that competent nutritionists don’t get tarred by the same brush as the charlatans.

This is how we use our legal privileges as RDs to speak up against elitism and scientism and everything these ideologies conceal.

Such as concealing how the belief ‘we’re white, western, and right’ ties us to coloniality, not freedom.

This is how adulation of western science works: In one swoop it writes-off the entire wisdom base of the BIPOC global majority: the healers, mothers, land stewards, indigenous scientists, shamans, and everyone else who contributes to knowledge around food and healing without holding a degree awarded by an education system designed to reproduce white supremacist values and beliefs.

It’s time to stop saying we’re the only group with a credible opinion on eating. Our profession continues to honour norms that have desecrated indigenous people’s earth-honouring ways living and thinking, including eating and harvesting. We reproduce colonialism by teaching western science as if it is value-free and the only valid way of creating knowledge. We tear the heart and soul out of BIPOC people’s foodways by crunching them into materialist frameworks and erase BIPOC joy, creativity, spirituality, excellence, sexualities, kinships and more. We propel narratives of disconnect that reinforce trauma. Re-presented like this, it makes no sense to try and persuade people that they’re onto a winner if they uncritically consume white-approved knowledge from dietitians and discard all other ways of knowing.

Think about it, who gets to graduate with this white-approved knowledge? Who is barred? Dietetics continues to silence and oppress BIPOC colleagues and students. Too often qualifying as an RD is expensive — and out of reach for many marginalised people. On top of this — as you may already know from personal experience — like any other institution operating as part of the medical-capitalist-academic venture, dietetics is ridden with intersecting racism, fat phobia, ableism, classism, all manner of queerphobia, gender stereotypes and other sources of gate-keeping and microaggressions that function to keep it led by thin, white, middle-class, cis-het women. And, in the upper echelons, cis-het men. Who keep the machine running so it produces students who keep the machine running and don’t think twice about ontology or oppression because the machine will never stipulate schooling in revolutionary knowledge.

Some people who have the emotional, spiritual, and intellectual resources that make them exceptionally well suited for a vocation in food work won’t get the RD title because of their caring responsibilities or lack of available internships or failure to grasp enough of the rudiments of complex statistics to pass that exam. It doesn’t mean they/you have less to contribute as food workers than people who hold an RD qualification.

So no, it isn’t true that completing dietetic training developed to meet Eurocentric metrics is sufficient to guarantee trustworthiness. I wish it was, but meanwhile we have to disrupt the hypocrisy that uses western qualifications as mic drop proof of fitness to practice while it screens out privilege and coloniality by leveraging contempt.

Dietetics is rooted in whiteness. White privileged RDs, we need to respond to this legacy with humility and commit to repair.

So, that’s what’s wrong with the meme.

This isn’t a comprehensive summary of All The Points. Instead, I wanted to show how professional norms make us so comfortable with the white supremacist values stitched into the fabric of our narratives that we simply don’t notice them.

And now? What does deep change entail for you personally, and for the profession? For me it means we need to pause, notice, and investigate our thoughts and felts so we act strategically and respectfully for radical social action. We need to recognise and dismantle the hallmarks of white supremacy. We need to listen to BIPOC colleagues and act now for change. Read BIPOC scholars. Get real about respect, rigour, responsibility. Help each other really understand social justice, and importantly, uplift today’s change-makers as leaders.

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Lucy Aphramor is a poetitian — a radical dietitian and performance poet. They developed the health justice approach Well Now. www.lucyaphramor.com

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