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Type of Counseling: in-person, one-to-one

Typical Cost: $500-1,000

Type Program: medically supervised plan, custom menu planning and nutritional counseling

Type of Foods Used: regular grocery store food

At-Home or Direct Mail Plan Available? Not applicable

The easiest way to locate a local RD that can help you design a customized weight loss and nutritional counseling program is to go to the American Dietetic Association’s website: www.eatright.org. You can search by zip code, using the "find a nutrition professional" link. Some RDs are more involved in weight loss than others. A new practice group of the ADA was just formed in June 2003—a specialty in "weight management". There are 2,900 RDs nationwide with that specialization. The consumer can search the listings of RDs that pop up for their zip code and see what specialties they possess, and if they have "weight management" as one of them.

Another practice group is called SCAN ("Sports, Cardiovascular, and Nutritionists"). Today, there are roughly 5,250 national SCAN members, but these members may be less focused on weight management.

The consumer may also call the ADA at their main number: 800-877-1600, or 312-899-0040.

According to figures from the American Dietetic Association, there were 68,847 registered dietitians (RDs) practicing in the United States in late 2002. Conservatively, Marketdata estimates that 29% of them (or 19,965) are either directly or indirectly involved with some type of weight loss program.

Dietitians may offer weight loss counseling services or "compete" with other providers via the following channels or affiliations....

• As individual RDs, or those in group practices, serving their own clients

• Affiliated with a hospital, medical center or clinic

• Working for corporations

• Giving talks or workshops at health clubs, for their members

• Being a speaker or "consultant" that is contracted to give seminars for commercial or medically supervised weight loss programs, or being on the medical advisory board of such a company

• An affiliation with a special eating disorder facility or residential treatment center such as Structure House, Duke University Diet & Fitness Center, etc.

• An affiliation with the luxury residential spas across the nation (approx. 1,800 spas exist)

Every hospital-affiliated program, whether it is a VLCD (very low calorie diet) program or merely a series of nutritional counseling workshops, has at least one RD on staff or working as a "contractor". Furthermore, Marketdata estimates from health club trade associations (IHRSA) that 8,800 U.S. health clubs today run a weight loss program of some type. Each of these usually has an RD that provides nutritional advice.

RDs don’t "sell" anything - they educate. Many consumers want one-stop shopping today, and health club members want programs tailored to their special needs. That’s one advantage of an RD - they have no specific diet company’s plan to push, since the plan is built around the client, not vice versa.

Typical RD counseling costs range from $35-150 per hr., although group sessions are substantially less. Private consultations generally run $65/hr., $35 for one-half hour. An RD program relies on regular grocery store (not diet company) food, and lifestyle changes. Contrary to "nutritionists" (almost anyone can call themselves one), RDs have a 4-year degree and go through a mandatory internship. They also must pass a registration exam and pursue continuing education requirements of the ADA.

With an RD, weight loss or dieting per se may not even be mentioned to clients. Rather, it’s couched in terms of healthy, low fat eating and educating the public to make better food choices.

Most RD programs last for a number of weeks or sessions. Many RDs want to be able to accept insurance. If clients are looking for therapy in addition to nutrition advice, the RD usually refers them to other specialists. Because RDs work in so many environments (hospitals, private practice, health clubs, MD offices, etc.) they all charge different fees. Fees also vary by region. Dietitians range from having a Bachelors degree to those with an MS or PhD, or even dually trained in exercise physiology and nutrition or psychology and nutrition.

BestDietForMe.com analysts performed phone interviews of RDs nationwide, to get an idea of how much they charge for the "average" weight loss client, how many sessions or time is involved, etc. Here’s what we found…

• The amount of time a dietitian serves a weight loss client can vary greatly—from 2-3 months to 2+ years. However, the "typical" patient is treated for about six months.

• The average frequency of visits is about once every two weeks.

• The average amount of time spent in each session is 60-90 minutes for the first "assessment" visit, then 45 minutes per follow-up visit.

• The average fee per session ranges from $75 to $195 for the first consult and $65 for follow-up sessions.

Based on the above information, BestDietForMe.com estimates that the total cost of the "average" dietitian-based weight loss plan is $802 (with a range of $237 to $1,755).

One potential money-saver… if the RD is a member of the American Specialty Health Network, an association whose members include dietitians, chiropractors, massage therapists, etc., their hourly rates can be up to 30% lower. ASK if the RD is a member of this organization.

One nationally known RD, book author and consultant on the West Coast has a program where she actually only sees the patient one time. The patient fills out extensive logs on diet, physical activity, supplements and medications, and their health history. Then, over the next two weeks the RD analyzes and evaluates this information and designs a personalized and specific program, including a detailed menu plan. The patient comes in to the office for a 2-3 hour consultation and receives a short course in nutrition. After this, the RD communicates with the patient by email and phone over the next six weeks, and is available after that to answer brief questions. It is rare for this RD to see the client again, since most people are already working with coaches or personal trainers. The total cost for this type of program is $1,500.

• Body Composition Analysis

• Computerized Dietary Analysis

• Dietary Supplement and Medication Analysis

• Training Analysis

• Lifestyle Analysis

• Evaluation

• Consult and Recommendations

• Personalized Diet and Lifestyle Plan

• Educational Materials

• Appropriate Individualized Materials

• Exchange Lists for Meal Planning

Another RD offers the following...

The RD does a physical assessment of the client, establishes their caloric needs and reviews all medicines taken. An exercise program is suggested and in- person counseling is available. This RD offers meal planning, supermarket tours to help clients distinguish between healthy, acceptable foods and those that are not, as well as pantry renovations where healthy foods are kept and those that are not are disposed of. Most clients continue the program for 6 months to 1 year, seeing the RD every week at first and then every other week, depending on their level of success. The initial hour-long session is $125. All other sessions are 35- 45 minutes, at a cost of $65.

In this example, the RD looks at the total "wellness" status of their client. The purpose of this program is for the client to move up on the "wellness" scale no matter how insignificant the jump. The RD provides menu planning, reviews all medications and provides an exercise program. This RD works with clients on a very individualized program (example: nature lovers may be taken on a walk in the woods as they discuss their program). Most clients work with this RD for 8-12 weeks, seeing the RD once per month. Each session lasts one hour and costs $95.

For yet another RD...

Clients are provided with one to one counseling, healthy habit classes, healthy lifestyle classes, and help with menu planning. An exercise program is also encouraged. This RD usually sees clients for 1 year, once a month. The initial session, which is 1.5 hours long, costs $80 and each 30-60 minute session afterwards is $40.

Another RD...

Prefers to use the non-diet approach to total wellness. This RD’s focus is on prevention. The clients are provided small group education in which healthy eating habits and food education (healthy vs. unhealthy) as well as portion sizes are discussed. This RD is also a qualified personal trainer who incorporates fitness and exercise in the program. The typical client is seen for 1-2 months but occasionally longer. The sessions are held once a week as the RD feels that this enables her to better keep her clients on plan. The sessions usually last 45 minutes to 1 hour at a cost of $75 per hour.

In our final example...

The first thing this RD does is to establish a weight history. The clients must keep food logs and agree to come to weigh-ins. The RD provides nutritional counseling and establishes an exercise program for the clients. They are referred to a specialty doctor (psychiatrist, psychologist) if the RD feels it is needed. Clients are usually seen for 6 months to 1 year. Each monthly session lasts 1 hour, at a cost of $195 per hour.

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