“We should be as kind to ourselves as we are to others”

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This week we chat to Tabitha Hume, a registered clinical dietitian in private practice, to find out why she became a dietitian, what she enjoys most about the work she does and what the challenges are:

Why did you become a Registered Dietitian?

I danced very seriously when I was at high school (ballet) and fell prey to the eating disorder monster. When I went to UCT, I started out studying BSc with an aim to genetic engineering, but then someone mentioned that dietetics was offered as a post-grad honours degree and my interest was piqued. I changed my BSc subjects to physiology and psychology and then was equipped for dietetics. I had a very strong interest in the physiological development of metabolic problems and so when I started my honours thesis on the hyper-metabolic response of paediatric burns patients, I was in heaven! Then after honours, my huge thirst for knowledge blessed me with a research and lecturing post at Wits Physiology Department, doing my thesis on carbohydrate and insulin metabolism, which was incredible. I knew I was in the right career when I started private practice and saw how rewarding it was, helping people with disordered eating and eating disorders completely lose their fear and anxiety of carbohydrates and remain skinny whilst eating a LOT.

So, it was really an evolution into dietetics, but a perfect fit!

What do you enjoy most about the work you do? What are the most satisfying moments?

I love interacting with people. I see myself as a bit of a teacher. Watching as the penny drops with people is very rewarding. Seeing previously restrictive people turning into satisfied eaters with a genuine passion for eating, and losing weight or stabilising muscle mass makes me feel like I’ve helped both body and mind, and made a positive difference. My most satisfying moments are probably seeing my past anorexic and bulimic patients enjoy food, socialising, eating with their families, and moving on to inspire other eating disorder sufferers with lecturing, blogging and mentoring. That’s paying it forward and I feel blessed that I am able to be part of that journey.

What has been your career highlight?

I think this answer has two parts: The first was the success of my first three books. Then, the second highlight has been slow: working my way back up from complete financial and emotional ruin after being accused of malpractice in 2001. However, the exoneration and my ongoing passion for helping people recover has put me back in the practice seat and made me stronger in the process. I’m proud of that.

What are the most challenging aspects of your career?

There are 3 main challenges, which hit me every day.

  • The fact that everyone and anyone dishes out conflicting and pseudoscientific dietetic advice and that the public is not protected against this. More disease and death is being caused by confusion, yo-yo dieting, eating disorders and orthorexia arising directly from ‘diet gurus’ who have little or no physiological or medical background. Because the public sees these ‘diet gurus’ and registered dietitians as equal authorities and equally qualified to dispense dietetic advice, I sometimes feel angered that I am forced to highlight the vast difference in qualifications there are. It’s crazy that we are forced to ‘convince’ patients that we are the experts. After all, someone with a rotator-cuff injury would not question a physiotherapist on what advice she received from her personal trainer!
  • Apropos the above: I also find it very challenging that medical aids still don’t see the massive value in dietetic therapy. This hinders the patient from obtaining the full scope of care that they actually need from a dietitian, and this incomplete process leaves the full lifestyle change open to failure, further exacerbating lost faith in dietetics.
  • With the plethora of rubbish advice available to people, much of the limited time in consultation is spent trying to teach complicated physiological concepts so that they can understand and thus ‘trust’ the advice we give, because it is often so contrasting to what is fashionable and the latest fear-mongering fad. Patients so often say, “I need to spend a whole day listening and understanding because only with understanding it ALL can my enormous fear of food be undone.” We, as dietitians, shouldn’t have to do this. We should be able to guide, direct and heal. Not have to spend patients’ valuable time convincing them that eating normal food is OK.

How do you cope after a day of nutrition disaster and bad eating choices?

I speak to myself kindly, as I would to a child who made mistakes. We all do things for a reason, and I show myself WHY I made those mistakes, and rapidly make small adjustments to address that problem for the future. As soon as I let guilt in, my tendencies to be mean to myself start, and this simply starts a complicated restrict/defiance pattern in my eating which is not healthy. We should be as kind to ourselves as we are to others.

What are the three things that you think people should stop saying when they meet a dietitian?

  • “Are you sure? Everyone else seems to be saying that blah blah blah (insert pseudoscientific rubbish)”.
  • “I know what I should be doing I just can’t seem to have the discipline”. …..Um, no! If you don’t have the discipline, it’s probably because you are doing it wrong!
  • I won’t need much time with you… just give me a diet sheet of what I can and can’t eat”.

What should clients look out for when deciding which dietitian to work with?

I think this is a very difficult one to answer, seeing as most dietitians have equal qualifications. I’d say that because patients usually require a lifestyle change (and that is a fairly personal process), finding a dietitian with whom the patient ‘clicks’ on a personality level is very important to motivation and trust.

What is your favourite dish and your favourite treat food?

Undoubtedly a hot lentil curry with chutney and tons of fresh coriander!

My favourite treat food would be warm apple pie! (Vegan of course!)