I remember a specific Tuesday afternoon early in my private practice career. I was sitting across from a client who had been seeing me for six months. She was “compliant.” She brought her logs. She knew the macros. She followed the plan.
And she was miserable.
I could feel the tension in the room like a physical weight. I was frantically flipping through my notes, looking for a handout or, at the very least, a different way to explain insulin resistance. It felt like pushing a boulder up a hill, and I was terrified that if I stopped pushing for even a second, the whole session would roll back over both of us.
I was trapped in the Fixer Mentality. And if you’ve ever left a session feeling “unsettled” despite doing everything “right,” you’re likely trapped there too.
The Education vs. Integration Gap
In our dietetics training, we are taught to be the keepers of the “Right Answer.” We are conditioned to believe that if a client isn’t progressing, it’s a failure of education. So, we provide more education. We give more recipes. Offer another handout. We explain the “why” again.
But after 25 years in this field, I’ve realized that education stops being the issue long before confidence arrives.
Most of our clients don’t need more information; they need a clinician who can sit in the “murky middle” with them without rushing to fix it. They need space to think it out and talk it through. When we show up as fixers, we aren’t just exhausted; we are actually accidentally colluding with the very “hustle” systems (diet culture, healthism, and patriarchy) that our clients are trying to heal from.
The Paradox of the Weight-Inclusive RD
The hardest part of moving toward weight-inclusive care isn’t the science; it’s the paradox.
It’s the moment a client looks you in the eye and says, “I know I should love my body, but I just want to be smaller.” The “Fixer” wants to jump in with a HAES® lecture or a script about body neutrality. But the “Navigator” knows that this moment isn’t a problem to be solved, it’s a tension to be held.
When we try to “fix” that feeling, we move into what I call Clinical Collusion. We start centering the weight (or the resistance to it) instead of the person. We become hard on the individual and easy on the system.
Why the “Fix” Leads to Burnout
Burnout in dietetics rarely comes from having too many clients. It comes from the internal friction of practicing within a system that demands certainty while your values call for nuance.
We turn to Facebook groups and peer forums, sharing “compliance” stats and asking “what am I missing?” because we’ve been taught that if the formula doesn’t work, the clinician (or the client) is broken.
But what if the formula was never the point? What if the goal isn’t to make the body conform, but to make the care respectful, autonomous, and integrated?
Moving Beyond the Script
Moving from “Fixer” to “Navigator” requires a paradigm shift. It requires us to look at:
- Our Cultural Water: Acknowledging the thin, white, cisgender privilege that often dictates our definitions of “health.”
- Our Internalized Bias: Realizing that weight stigma isn’t a moral failure—it’s conditioning we didn’t consent to.
- Our Need for Witness: Understanding that this work is too complex to do in isolation.
We need to be hard on systems and easy on ourselves.
The Invitation
If you’ve been feeling that quiet pull toward something deeper, if you’re tired of the surface-level “how-to” and ready to explore the “how to be”, you are exactly who I’m speaking to.
This work is nuanced. It’s heavy. And it’s incredibly beautiful when you stop holding the boulder by yourself.