Who Is The 'Weight Loss Professional'?
As it currently stands, there is no profession that stands out as the specialist in weight loss for the general population. Personal trainers, Dietitians, Nutritionists, or ‘weight loss coaches’ are often the first people that come to mind when it comes to weight loss, but for many people it is the General Practitioner that is the first point-of-contact on their weight loss journey.
There are many experts in a range of fields who do a phenomenal job in working with clients seeking to lose weight. But it is the individual who specialises - not the profession - as they gain expertise applying their profession to help people with achieving weight loss.
This has benefit of practitioners who are passionate about this area being able to apply their knowledge and experience to work with people who seek their expertise.
On the flipside, some practitioners who do not specialise in weight loss are sought for advice when others might be better-suited. This can lead to recommendations that are too general or simply not suited to the individual, even though delivered with best intent.
For example, the Personal Trainer who specialises in strength training might take on a client who wants to lose weight, so the client gets a strength training program to get them there.
Many professionals tag weight loss onto the specialities, even it is not their primary area of expertise. It is very simple to give advice to someone to help them lose weight, but it is a different process to coach the process and adjust the strategy to continue generating client engagement and results.
Meet the experts
Here are some of the experts that most people are likely to come across in their weight loss journey. It can be useful for an individual to see the different contributions each professional can make to their weight loss journey and potentially identify their use, where they might not have considered it before.
General Practitioners (GP)
GPs are often the first point of call in getting people to lose weight. Most people do not specifically seek out GPs for weight loss advice, however, since the usage of GP services is much higher than the other professions listed below, the GP often becomes the first professional to make recommendations for weight loss, be it for a specific medical condition or general health and wellbeing.
GPs get a bad rap from other professionals in the weight loss area, often criticised for a lack of nutrition training and a medicine-led approach to weight loss. This is unfair and often comes from people who do not consider the GPs true role in the client’s journey. GPs are not there to specialise in weight loss, but when 63.4% of the population is overweight or obese, and the health implications are unavoidable, weight loss is going to be a topic that comes up a lot for GPs!
Now let’s think about what initial advice a GP can provide in a consultation - essentially eat less and move more, consider hiring a trainer and/or seeing a Nutritionist/Dietitian. A GP cannot be there to coach you through the process, nor do they necessarily have the tools to develop a strategy to get you there - this is not their area of responsibility - hence why they refer you out.
If you come back six months later, saying you have tried everything - whether you have or have not - of course the usage of a very low calorie diet (VLCD) involving meal replacement shakes becomes increasingly likely. If that does not work, often surgical intervention is the next option.
I personally think that the use of VLCD and surgical interventions often take place not because training and nutrition interventions do not work, but because they were not adhered to. However, whether something does not work because it failed or was not adhered to, there is still a case to proceed to the next viable option.
The complication is that the VLCD may not work either (due to adherence) and even surgical interventions that initially led to weight loss can see the weight come back over time. If someone gets to the stage of weight loss surgery because they have not adhered to training and nutrition alterations, it is almost inevitable that the intervention will fail in the long term due to the lack of lifestyle adjustment.
To be clear, I am not against the use of VLCD and surgical interventions - they are both steps that work very well for some people and can be part of successful weight loss and maintenance. However, they are not perfect solutions and often fail to address the lifestyle modifications required to maintain a healthy body weight.
A GP will give you simple weight loss advice because they are pointing you in the direction of changes you need to make. They cannot be there to make you adhere to it, you need to do that or use their referral to practitioners who specialise in the different components of weight loss.
Fitness Instructor or Group Fitness Leaders
Fitness instructors (FI) or leaders of group fitness classes are commonly sought out by people who want to increase their physical activity in a group environment. There is a level of supervision and accountability that comes with this method of coaching, while remaining cost-effective compared to private coaching options.
Fitness instructors mostly do not advise clients on matters beyond the session they are leading. However, some might offer additional nutrition coaching programs or supplements to be used in conjunction with the classes. The quality of these recommendations will depend on the individual - I know some highly-qualified nutrition experts who also coach group fitness - but it pays to be wary.
Generalised recommendations such as do ‘this diet’ or take ‘this supplement’ is a sign that the recommendations have not been personalised to your goals, experience or lifestyle. Look into qualifications before taking advice. The Certificate Three in Fitness required to be a FI has no component that specialises in personalised nutrition assessment or recommendations.
Personal trainers (PTs) come to mind before group fitness options, however they are engaged by less people than FI. PTs offer private coaching to optimise your training and help you work towards your goals. There is an extra level of attention compared to group fitness options, which allows the trainer to tailor the session to your needs.
PTs specialise in the training component of weight loss, but not necessarily the nutrition side of things. Similar to group fitness instructors, you should be wary of generalised recommendations and diets.
Many personal trainers ‘look the part’, which can increase authority of any nutrition recommendations. While maintaining a healthy body weight sets a good example, this is not always a case of practicing what you preach, but it does not necessarily translate to an ability to coach others, particularly those with different lifestyles to them.
A coach should be someone who preaches what you should practice, helping to design and implement a strategy to get you to your goals. What the coach practices themselves is mostly irrelevant.
Take a look at the personal training board of your local gym and see how many trainers list ‘playing competitive sport my entire life’ as part of their experience. An active lifestyle is excellent, but they are not always the best person to coach someone who hated physical education and avoided sport their whole life, as they need to start from the basics.
An Accredited Practicing Dietitian (APD) has a minimum of a Bachelor's degree, often a Master’s, in Nutrition and Dietetics alongside continuing professional development required to maintain their accreditation. Dietitians have specialised training in the use of nutrition for managing chronic disease and medical conditions, alongside expertise in eating disorders.
I personally feel that Dietitians are an underutilised resource here in Australia. Like any of the profession, you want to work with a Dietitian that specialises in weight loss, and there are some that are better than others in this area.
One of the drawbacks for Dietitian's is the consultation model, which can be expensive. Clients are left to their own devices between consultations which can lead to a lack of adherence, just as it does with any other profession (ie. does anyone ever do their physiotherapist exercises?).
Dietitians are the only people who should be making nutrition recommendations for people with medical conditions. I have personally found them particularly useful for clients who have had conditions such as IBS, require low FODMAP diets, or are vegetarian or vegan.
What is the difference between a Nutritionist and Dietitian?
Anyone can call themselves a Nutritionist, whereas an APD must meet certain qualification requirements and CPD to maintain accreditation
Dietitians have expertise in nutrition for medical conditions
There is often a bit of discourse between some Dietitians and Nutritions. But for the most part, each respect the other and understand their own roles in the health of each person. Talking as Nutritionist, I have clients who I refer to Dietian’s when their needs are outside my scope or expertise. Likewise, I have Dietitians who refer clients for body recomposition and performance strategies.
To clarify the point above, while anyone can call themselves a Nutritionist, to gain insurance to practice in this area you will need to have qualifications such as a degree in Nutrition.
Generally speaking, a Nutritionist should be working with a client who is free of medical conditions and looking to improve their nutrition for health, body composition or performance outcomes.
Remember, anyone can call themselves a Nutritionist. This means that you need to be more critical when engaging a nutritionist - look for qualifications and do your research by reading articles, seeking out reviews and so on.
Exercise Physiologist or Exercise Scientist
Exercise Physiologist (EP) and Exercise Scientists (ES) require the completion of a Bachelor’s or Master's degree in the relevant field.
While there are many similarities between the two, there are some key differences.
EPs are trained to provide exercise to clients for the management of medical conditions and disorders.
ESs specialise in general population clients and/or athletic populations.
EPs tend to work in clinics, often alongside physiotherapists.
ESs tend to work in gyms, often alongside Personal Trainers.
EP are the experts for exercise for/with a medical condition. If you have a condition that requires management, you should start training with an EP before transitioning to Personal Trainer.
EP clinics often have their own gym and provide group classes to clients with specific conditions. This is an excellent use of the expertise and increases client participation, as it is much cheaper than a private consultation.
Most general population clients will encounter an ES working as, or alongside, Personal Trainers in a gym setting. There is truth to the statement that an ES is a glorified Personal Trainer, which as an ES myself, I think is true. Beyond the tertiary qualification and maybe charging a higher rate, the clients tend to be very similar between the two.
Weight Loss Is Multifactorial - No One Has All The Answers
Weight loss has many components, so it is naive to think that seeing one person will solve the entire puzzle. Instead, we need to seek out experts to target certain areas.
If you struggle with exercise, start there. Look into group fitness classes or personal training, or book a consultation with an EP if you have a medical condition.
The best solution will depend on you. Some people like the better value or group fitness classes, while others want the privacy and attention that comes with personal training.
The one you adhere to is the best value. Spending $250/week for three PT session a week over three months (~$3000) that leads to 8kg of weight loss is better value than a $15 a week gym membership ($780/year) if you do not use it and gain weight.
Beyond GPs for general medicine and APDs for nutrition advice, there is a range of qualifications that you can be exposed to with other practitioners. Tertiary qualifications are not the be all and end all, but they should never be discounted. While people do not necessarily learn everything they will ever need at university, completing a degree shows commitment to that area and helps people gain an understanding of the foundations.
More importantly, in my opinion, tertiary education helps professionals develop skills in critical analysis, which goes a long way to determining the validity of information they come across in the future and decreases the likelihood of flip-flopping between approaches in their profession.
There are a lot less ‘everything you have been told about weight loss is wrong’ claims among more-educated professionals. Instead, everyone takes the same foundations and then uses their interpretation, knowledge and experience to develop their own approach (which may well differ from others).
Find A Specialist
Finding a specialist in the area of your needs will give you the best chance of getting advice that is relevant to you. Just because someone is a Dietitian does not mean they are an expert in a particular component of body composition for someone like you. Read their articles, publications or social media; search for reviews from previous clients; do your best to identify their approach and see whether it resonates with you.
In my opinion, a recommendation from a friend is not always the best way to go. While people want to be helpful to others, they also want to help their professional out as well. So they might refer you to their accountant simply because they use them, not because they are the best for them. Definitely use any recommendations as a starting point, but you need to do more research than that.
I cannot emphasise enough how important it is to find a professional that you want to work with. You should understand their approach and it be something that you want to implement.
The Integrated Approach
I want to take a second to outline the approach we take at Integrated Fitness & Nutrition. Beyond the shameless plug, I think it helps people understand the approach and reasoning behind it.
It is easy to think of online coaching as the easy option for the coach because it can be done from anywhere, but there are also a multitude of benefits for the clients compared to other coaching methods.
We have qualifications in Human Nutrition and Exercise Science, alongside previously working alongside an EP. This means we can provide training and nutrition advice to healthy general population clients looking to improve performance and body composition, which is what we specialise in and have five years experience.
Clients outside of this remit are referred to the relevant practitioners, which tend to be APDs and EPs.
One of the main differences we seek to overcome is the consultation model. In many fields, the more qualified the expert, the less time you get with them. But this is not ideal for a coaching service, whereby people are looking to implement lifestyle changes that they have often struggled to do on their own (hence they are looking to be coached).
We use fortnightly or monthly consultations with our clients, which we can offer at cheaper price point due to working remotely and not having the costs associated with running a gym or clinic. The increase consultation frequency also helps clients with adherence, because it is more contact than a typical consultation model.
We also provide ongoing check ins and accountability via email, check-in forms, a training application to record fitness and monitoring food intake using apps as required. This means that we can monitor data whilst you aren’t in the room, so we can make better recommendations when we call.
Just think about how often you have to tell an expert everything you have done, they have to think about and then make their recommendations. We can do this before the consultation to save time and costs.