We caught up with Julie Parrott, MS, RD, LDN, clinical dietitian specialist, on topics ranging from why one diet does not fit all, and how she supports patients who might initially fear that she’s the “food police." Parrott has been a registered dietitian for 16 years and a licensed dietitian for 20 years. She joined Penn Medicine's Metabolic and Bariatric Surgery Program in July 2018.
What inspired you to become a registered dietitian? And more specifically, why did you choose to work with bariatrics patients?
I worked at a teen pregnancy clinic at the University of Illinois at Chicago and wanted to learn more, so I decided to pursue my Masters of Science in Nutrition. I first became a Licensed Dietitian (LD) in Illinois (based on practice and then took the RD exam required for state licensure). I realized I was limited working as a licensed dietitian and needed the national registration. So, four years later I pursued my registration as a dietitian.
I enjoy the behavioral aspect of working with bariatric surgery patients. Bariatric surgery involves treating both the body and mind. For example, I get to talk about nutrition and activity with patients AND I get to help patients with the “how” of making lifestyle changes for improved health.
What are some of the most common questions you receive from patients?
I don’t eat hardly anything, why am I gaining (or not losing) weight? Losing or maintaining weight is much more complex than diet alone. But how and what a person eats, in addition to activity, can provide insight into individual “blind spots.” Extra calories can add up quickly when some “healthy” foods (such as nuts, dried fruits, honey, avocados, and whole fat dairy) are part of a person’s daily diet.
This is why tracking amount of foods, beverages and activity by using an app or journal can help identify potential saboteurs to losing or maintaining weight. Additionally, activity can help to moderate food choices and improve mood.
Is there anything you have learned since becoming an RD that you wish everyone knew?
I wish that other healthcare practitioners understood the level of education needed to become an RD and that an RD can provide more to the healthcare team than just “telling patients what to eat.” I think that health care practitioners might understand the passion (working for the love of nutrition) that goes into working as a dietitian if they knew the education and professional practice required to become an RD.
What’s your favorite part about your job?
I love the challenge of working with patients who have complex nutrition-related issues and the opportunity to facilitate groups.
What’s the most challenging part about your role?
I believe that the most challenging aspect of my job is overcoming the patient and professional bias of an RD as the “food police.”
When a patient first comes to meet with you, it’s understandable that he or she might be nervous. What is one piece of advice you can give to put new patients at ease?
I’m here to help support you in your path both before and after weight loss surgery; not to judge you based on your food choices. This involves a mutual discovery of what changes are needed, realistic and achievable over time.
To some, nutrition can seem like an overwhelming and confusing concept — with advice on what’s best coming from many angles. How do you work with your patients to demystify good nutrition?
We discuss basic concepts of healthy eating and activity and the importance of having a “portable” nutrition knowledge base. I firmly believe that the patient needs to be the driver, in control of their decisions.
To follow up on that, what’s one piece of bad (or at least not-so-good) advice you hear regularly and would like your patients to forget?
You need to do the “keto diet,” “no carb”, or “low to no fat diets” in order to lose weight. “One size does not fit all” applies to weight loss. One diet does not work for everyone.
These type of diets, which eliminate or radically decrease a major food group or source of a macronutrient such as, carbohydrates or fat is not sustainable over time. Lifestyle change involves making small changes for long term results. Small changes could be choosing small portions of healthy fats and larger portions of non-starchy vegetables, and increasing non-caloric fluids.
Anything else you think is important for current or future patients to know about you?
I believe that teaching “why” and “how” to do something can be more powerful that telling a person “what” to do.