The Difference Between a Dietitian and a Nutritionist

I read an article recently about this very topic, but it was written by a conventionally minded clinician. She put down unlicensed nutritionists and put dietitians on a pedestal. But to be real, there is no clear black-and-white way to categorize one as being better than the other, unless you know which credentials to look for.

I want to start by saying that I contemplated becoming a dietitian myself for many years. I took one university nutrition class, and I enjoyed it, but it just didn't feel right. The mainstream university perspective of nutrition felt watered-down and biased. So I became a psychotherapist instead, later to realize that nutrition is my real passion. I just had to find the right training that felt more wholesome and with the rich, unbiased perspective I desired.

"Nutritionist" is not a regulated term in most states. It is an umbrella term to describe anyone who practices nutrition, including dietitians (similar to how "psychotherapist" is anyone who practices clinical mental health). But for the purposes of this post, let's assume a dietitian is conventionally trained and licensed, and a nutritionist is a certified practitioner.

So here's a rundown on the differences:

Registered Dietitians (RDs) are healthcare workers who have undergone training to provide nutrition services to individuals who are looking for preventative nutrition counseling or medical nutrition therapy. If they are licensed, they have at least a bachelor's degree and do regular continuing education. Note that not all states regulate dietitians because it's not always considered a necessary license. Arizona, for instance, doesn't regulate dietitians at all.

Nutritionist trainings may or may not come from universities and are not typically regulated for curriculum. However, that may be a good thing because it means unaccredited schools can choose their own curriculum according what they feel is best based on newer, unbiased research and traditional wisdom rather than corporate biases. Unaccredited schools may actually be more progressive, but less political.

Some will try to convince you that the licensure requirements for RDs are more rigorous than certificate programs and enforce stricter standards. I don't disagree with that entirely. Compared to the cheapest and easiest nutrition trainings out there, I think this is certainly true. There are many bad ones! But that could be said for university degrees as well. Universities are typically confined to antiquated ideas based on decades-old corporate or political biases.

Dietitians seem to operate from a very numbers-based philosophy as they focus a lot on macronutrients, calories, formulas, and may sometimes allude to quantities of vitamins. But they aren't exactly taught that food is medicine or that some foods help the body heal and some foods cause harm. Instead, they just see the numbers. 

These are the types of clinicians who will say things like, "there's no such thing as junk food" because they don't understand the importance of quality. Their profession is designed to support doctors and the pharmaceutical and processed food industries, so there's a lot of bias in the way they are educated. Western medicine is about managing symptoms rather than addressing the root cause of disease, and dietitians are taught to support this philosophy so they can pass patients off to doctors who can then prescribe another symptom-managing solution.

You might sometimes hear from them that "food is food" and "calories are calories," but if it really doesn't matter what we eat, then doesn't that defeat the purpose of hiring a dietitian? They don't seem to realize that they are delegitimizing themselves. They are also ignoring the fact that American health has greatly declined since highly processed food became normal in the 80's and 90's. Conversely, many people are getting healthier by switching to whole food diets like paleo or ancestral.

So how do you know your dietitian or nutritionist isn’t just coming from a free webinar or biased education? This is where you look for those letters after a name. While I’m personally not a huge fan of them, they are telling. 

My credential is Nutritional Therapy Practitioner (or NTP). This is a trademark and can’t be used by just anybody. Nutritional therapy practitioners undergo a year-long training program with live classes, lectures, textbook readings, discussions, forums, assignments, and practical experience with real clients. In my personal experience with the training, it felt like getting another master's degree in terms of rigor. The curriculum dove deeply into biochemical science, anthropology of nutrition (which is surprisingly very important), anatomy & physiology, supplements, sleep, and stress. The science was even more than I would have liked sometimes. The last half of the program was devoted to a practicum. That meant supervised, clinical experience with real people. This was certainly not the same as some of the other certification programs out there, and I'm glad I chose this one over others. Many of my colleagues who have done expensive courses elsewhere have said the NTP program is top-notch in comparison.

And that’s not all! While there is no legal requirement for it, most NTPs take it upon themselves to pursue continuing education. This is out of a personal passion for the work rather than an obligation imposed by the government. That says something, in my opinion! As a licensed healthcare provider who has to do obligatory continuing education myself, I know what it’s like just to do the training because I have to. I don’t get much from the forced trainings. Like therapists, RDs are obligated to do trainings they aren’t really that interested in and those trainings are most likely perpetuating the bias mentioned before.

So what’s the difference between RDs and nutritionists? I don't want to completely demonize dietitians. It actually depends on the person. Some RDs are very holistic and have a pretty sound approach to their work (you'd have to talk to them to find out). They may have jumped through more hoops to get where they are (but even then, it depends on their state and whether being a dietitian is actually regulated). But nutritionists may have also jumped through a bunch of hoops. It’s hard to tell! If you are not sure who to trust and you know you want a holistic (quality-over-quantity) approach based on unbiased research, look for an NTP or ensure that your RD has proper, holistic training. Although RDs may also have a credential, that says nothing about their philosophy, and they will need additional training to be holistically informed.