My Road to a Positive Self Image

By: J’Laine Stutsman

Deciding to start college in my mid-thirties was not an easy decision, but thanks to the support of my family I was able to begin my journey to becoming an RD. When I first decided to go back to school I was not exactly sure what it was I wanted to do. It wasn’t until my oldest child was having GI complications and had to see a dietitian that I finally decided. I started this path because my son, but the further along I go the more I realize my own complicated relationship with food.

I came from the generation of having to eat everything off of your dinner plate before you could leave the table.  When dinner was complete I was always the last one at the table, while my family gathered in the living room. This eventually led to an absence of fullness, which led to weight gain overtime. Everything came to crashing down when in 6^th grade I was diagnosed with a reproductive disease called endometriosis. The only treatment was hormone therapy, which caused me to transform from a size 8 to a size 18 over one summer. As you can imagine such a large weight gain can be tough for any child. To make matters worse my mother was always trying to “help” me by trying to change things about me in an effort to make me look better. This lead to a feeling of not ever being good enough the way I was. I can’t blame my mother for everything, my grandmother and uncle helped to aide in my insecurities. You see on my mothers’ side I felt like the one that wasn’t as smart or pretty as my sister and the comments they sometimes only amplified my feelings. I spent every summer with my grandma telling me that I was too fat and needed to loose weight among other things. This only strengthened my feelings of not being good enough. Throughout my entire childhood my only saving grace was my father, but that didn’t completely drown out the insecurities.

After high school I fell into a tailspin of mentally abusive relationships. When the boyfriend I was living with cheated on me, of course it couldn’t have been him- I wasn’t good enough. I stopped eating in an effort to make myself more attractive. When the relationship ended I once again turned to food, but this time it was my comfort. It seemed like everything was back on track when at 22 I got pregnant with my first child and gained 100 pounds. Given my history I didn’t expect much from the man I was seeing who would later become my husband. He would become my second saving grace. No matter how many times I tried to push him away he never budged. He is the one that encouraged me to pursue school and has kept encouraging me with every bump and doubt throughout. My insecurities specifically body image is still something I struggle with. After 17 years of marriage and 3 kids I still sometimes feel uncomfortable when my husband wraps his arms around me. I may never be completely comfortable in my own skin, but I feel stronger every day.

Those that really know me know that I am not the type of person to share such intimate details into my life. I am sharing my story because I think it’s important for us to understand our own personal relationship with food if we are truly to help others with theirs.

Increasing Women’s Market Share at the Top

How do we cultivate ambitious, leadership-oriented dietitians of the future?

By Katharine Rug

Temperatures warm and flowers bloom, there is no doubt that spring has arrived in St. Louis. The change in temperatures and vegetation mark the beginning of a new season, as well as a signal that the dietetic internship is coming to a close. Just as the bees buzz with excitement for spring, many interns dream of entering into a field they love and paying bills with the compensation they receive. Saint Louis University dietetic interns joined with other local internships on March 26th for “career day.” We received instruction on resume development, interviewing, and even some words of wisdom from professionals in the field. Questions were posed, questions were answered, but leaving career day I felt as if one day could not possibly be enough to equip young professionals with the tools to navigate a saturated job market.

Nonetheless I pondered the words of wisdom we received. Words shared included; job satisfaction above compensation,get your foot in the door, be persistent, and my personal favorite “be fearless.” I thought about the term fearless and the related character attributes of confidence, risk taking, and at times a willingness to “fly by the seat of your pants.” Like a good dietetic intern, I took the inspiration of the day and dove into the research. Some of the questions I want to answer through this post include: What does the employment marketplace look like for women, especially at the senior-executive level management sectors? What factors influence women’s aspirations to become leaders? Are there gender differences and or perceived gender differences that add additional challenges for women entering the c-suite? Finally, tying all these factors together, what areas of professional development can the Academy of Nutrition and Dietetics focus on to increase the propensity for dietitians to assume executive leadership roles?

What does the labor marketplace look like for women, especially at the senior and executive management levels?

According to the Center for American Progress women are responsible for earning 60% of undergraduate and master’s degrees, 47% of law degrees and 48% of medical degrees. In totality women compromise 47% of the U.S. labor force and 49% of the college-educated workforce. Though women are now steady stakeholders of the employment and collegiate marketplaces, only 25% of women are executive- or senior-level officials and managers, 20% are board-members, and most importantly only 6% of CEOs are women.

If my fellow interns assigned me a superlative it would state  “person most likely to quote a recent NPR article, show, or podcast and/or person most likely to bring up campaign finance issues in a public setting,” but nevertheless the point is that in a recent NPR series of Freakanomics Radio titled The Secret Life of CEOs, host Stephen Dunbar explored what it takes to be a CEO of a Fortune 500 company. One particular expert titled After the Glass Ceiling, a Glass Cliff examined the phenomenon that occurs when the 5-6% of women actually do become CEOs. This phenomena is referred to as the Glass Cliff, meaning female CEOs are significantly more likely to be given the job if the ship is sinking (After the Glass Ceiling, a Glass Cliff). The episode concluded that women in leadership are subjected to greater critique from shareholders, frequent challenges to their authority, as well as less praise for saving the ship from total destruction. Psychologists and CEOs featured in the episode point to the natural tendency for women to be risk averse, lack self-confidence, and the fact that women are held to significantly higher standards as compared to their male counterparts as reasoning to why women do not rise to the top of the employment pyramid. Several female CEOs, including the likes of Pepsico CEO Indra Nooyi and Ex-CEO for Yahoo, Carol Burtz, also pointed to the “old boys club” infrastructure of middle and upper management and the blockade it often puts in place for the elevation of female leaders.

What factors influence women’s aspirations to become leaders?

A 2017 report by Egon Zehnder titled Leaders & Daughters: Cultivating the Next Generation identified that 74% of young female respondents aspired to reach executive level leadership. Of the greatest influencers for professional development, women ranked mothers as one of the key components of success, as well as the influence and support of fathers and husbands. This relationship between mothers and daughters also appears to be strengthening in the younger generation of respondents. Additionally, this study examined the role of mentorship as a provision of support to women. 55% of women reported having a senior mentor or manager acting as an advocate for their professional growth instilled a sense of confidence. Though providing maternal figures is not currently part of the Academy’s member benefits, providing platforms for mentorship, as well as advocating for work-life balance for women seeking leadership and family-life has the potential to impact current and future dietitians.

Are there gender differences and or perceived gender differences that add additional challenges for women entering the c-suite?

If you weren’t aware, there are significant gender discrepancies in risk taking behaviors, as well as confidence ratings between men and women. Men are significantly more likely to take part in risk-related behaviors in the domains of health/safety, financial, recreational and ethical decision making as compared to females (Harris, Jenkins,& Glaser, 2006). Along with being risk averse, a recent Harvard study demonstrated that women are less confident than men in their ability to answer questions accurately and women are also less likely to provide answers that strongly agree or disagree (Sarsons & Xu, 2015). In this case, acknowledgment is power and helping women to understand these potential challenges (whether innate or socially constructed) can equip women with the tools to propel themselves forward into the executive levels that they desire.

What areas of professional development can the Academy of Nutrition and Dietetics and Dietetic Internships focus on to increase the propensity for dietitians to assume executive leadership roles?

1.       Increase student awareness of the Academy’s mentoring program. The Academy offers students and professionals with the opportunity to network and gain a mentor/mentee relationship by matching individuals based on area of practice, interests, and aspirations.

2.       Utilize the Academy’s Diversity Mentoring Toolkit. Did you know that of the 100,000 RDs/RDNs in the United States, 76% are white, 11% are unreported or prefer not to disclose, and 9% are individuals of color? It’s 2018, increasing racial diversity is good for our profession, it’s great for our patients, and it’s what we need to move forward.

3.       Think outside of clinicals. Though dietetic internships are a combination of community, food service, and clinical rotations the largest emphasis always seems to fall on clinical nutrition. Perhaps it is the allure of the white coat or the fact that we spend a lot of time committing ourselves to clinical practice, but the world of leadership and dietetics is much broader than hospital walls. Providing dietetic interns with the opportunity to see what the profession looks like in executive leadership roles could provide young professionals with inspiration to create a path to the C-suite.

4.       Leadership skills are not developed through PowerPoint presentations. Academia has a propensity to utilize class presentations as a means to develop “leadership skills.” I am a firm believer in the use of such presentations to increase an individual’s comfort in front of an audience, but true leadership skills require the development of critical thinking, confidence, and risk taking behaviors (most often under pressure). Therefore….

5.       Role playing isn’t just for practicing patient interactions. Role playing future employment conversations such as goal setting, self-advocacy for increase responsibility, and salary negotiations are just a few scenarios that could be worked through with dietetic interns or young professionals seeking advancement in their field.

As a final point to ponder, I would like to take a minute to acknowledge that this fight for leadership has been long fought by the women that have come before me. Many women have endured bias, harassment, disrespect, and much more. While the fight continues, I would also like to put a final spotlight on women of color. Women of color share the smallest portion of leadership roles in our employment marketplace, despite numerous studies pointing to the importance and benefits of both gender and racial diversity in the workforce. As we march forward together, let us continue the movement towards the top, making sure to advocate for all women and call out discrimination in all forms. I love this profession and I believe that the capabilities of the women in this field are endless. To that end, I believe that a profession comprised of 95% female members should work tirelessly to insure that women are able to elevate themselves to the level of leadership they desire.

References

EgonZehnder (2017). Leaders & Daughters Global Survey 2017

Jenkins, M., Harris, C., & Glaser, D. (2006). Gender Differences in Risk Assessment: Why do women take fewer risks than men?. Judgement and Decision Making 1(1). 

Sarsons, H.,& Xu, G. (2015) Confidence Men? Gender and Confidence: Evidence among Top Economists.

Infographics & Photos

3 Barriers: Center for Creative Leadership

Breakdown of RDs & RDNs by Race: The Academy of Nutrition and Dietetics Commission of Dietetic Registration

We Can Do It: http://www.alinaanjum.com/2017/08/16/an-inferiority-complex/

Stand Up For Your Profession

By Allison Scherer

It’s match day and you matched. Congrats! The stress is over. You have yourself a celebratory drink with friends as a feeling of extreme pride now washes over you. You beat the competitive 50/50 odds of even being placed and are on your way towards becoming a registered dietitian. This credential is something you’ve been studying for, volunteering for, (maybe) brown-nosing (a bit), and gaining every experience you possibly could for four (or more) straight years.

Fast-forward to your first clinical rotation: Walking through those hospital doors proudly wearing your freshly pressed white lab coat, and your food-themed badge reel on your lapel, you can’t help but exude confidence, especially when people accidentally mistake you for a doctor or speech pathologist or endocrinologist. Feelings of excitement and nervousness make their appearances as you are about to meet your preceptor – and those feelings become even stronger as you now are about to see your first patient. Mid-diabetes education, there’s a knock on the door. In walks the doctor who says: “I’m sure what you have to say is important and all, but I’m going to talk to the patient now”.  Welp. Those feelings of excitement and nervousness and pride turn into shame, embarrassment, and anger. Mind you, this doctor was there to confirm the patient’s discharge – not how to nutritionally manage their type 1 diabetes on their own which is something entirely foreign and extremely important for the newly diagnosed patient who’s yet to have any information on carbohydrate counting, insulin injections, or medications at all.

            Sadly, these encounters happen to dietetic interns and dietitians more often than you think but is a topic that hardly comes into conversation when you begin this RD journey. I entered into this profession knowing the importance nutrition plays in preventing life-debilitating diseases…and assuming everyone else knew that as well and held it to the same importance that I did - or at least could be educated by the influential impact the registered dietitian makes. Now, these situations may not happen to every body but they sure aren’t anything new to those in the clinical nutrition field. And I praise those who have never lost sight of who they are as a dietitian or felt feelings of being lost. However, it truly is discouraging when during your whole undergraduate life, dietitians were respected just the same as every other licensed health professional with some sort of higher level education (just as you) who walks through those hospital halls only to be treated as if your major is laughable compared to that of the MD.

Many rotations have passed since the interaction above however, these feelings of unimportance in the health field have continued from site to site and at one point I even dreaded going back through those hospital doors. I’ve gotten used to the fact that our professional opinions are often dismissed or stepped upon by those with reversed credential from our own – “DR” rather than “RD” – and have let myself succumb to thoughts of changing my major or wishing my internship time was over because only then with those two letters behind my name will I feel better. However, instead of continuing to entertain thoughts of changing my major, I decided to change my outlook.

            We have miles to go in the journey of having the clinical dietitian be welcomed and respected as a member of the healthcare team. And while it may take extra effort on our end today, the reality where dietitians are equal members will be realized tomorrow. Advocating for yourself and your profession is vital not only in the clinical realm but in the community, foodservice, athletics, infectious disease, agriculture, policy - anything and everywhere. RD’s are backed with scientific knowledge and rigorous training in how a variety of wholesome, nutritious foods prevents disease and grants some pretty beneficial rewards: lower morbidity and mortality rates, less incidences of chronic disease, lower risk of cancer, weight management, better quality of life, longevity, reversal of inflammation, just to name a few. WE as dietitians understand this – and RDs truly believe the public knows this about but has a hard time accepting it.

            Entering back into the room of the newly diagnosed diabetes patient when I was so rudely interrupted by the doctor, I wanted to respond with “Why yes, it is very important for his health as he heads on home without your invaluable care there to guide him along the way. Give me two minutes to finish up and I’ll be done. Thanks”. But really responded with, “Not a problem, I can come back in a couple minutes”. Maybe I shouldn’t have walked out. Or maybe I should’ve stayed and continued on as he finished up and taught him a little bit about nutrition as he listened. But don’t get frustrated when the patient is back through those ER doors sporting some awful black and green toes and an amputation on the way because he wasn’t educated on how to manage his carbs.

Registered dietitian, RD, RDN, dietetic intern, doctor of food, the “Real Deal” – whatever you call yourself; keep on keeping on, hold your head high, and your nutrition morals strong, because one day we will be the ones educating those MDs who thought chocolate was a vegetable.

Merging Health and Body Positivity:

The Role of the RDN [and Dietetic Intern]

By Hailey Rausch

We live in a world of extremes and hard lines.

All in or all out.

Left or right.

Yes or no.

Fad diet or eating without a care in the world.

We tend to care too much or care far too little. Like many other problems this world faces, this type of mentality leads to detrimental impacts. Current and future registered dietitians face great difficulty when promoting and educating nutrition while maintaining body positivity – two areas of concern that I believe don’t belong as two separate entities, but ought to be united. So, how do we merge these two concepts?

Shifting the frame from weight to health. Yes, we have heard the facts time and time again regarding weight status, BMI, waist circumference, etc. and its impact on our health – but healthy looks different on everyone and it’s about time we embrace it. I know what you’re thinking, what about the people who are indeed embracing body positivity (as they should) but don’t have a clear understanding of what healthy is. This is where it gets a bit challenging. To combat this, eating nutritious food and being active can be promoted and taught in a way that showcases the myriad of health benefits that accompany them regardless of weight status. By taking a step back from the numbers talk, we can start eliminating the harsh extremes of all or none and start practicing moderation – which I believe will not only make us more approachable to obtain nutrition information from, but also will lead to more people wanting to embrace nutrition.

 Practicing mindfulness. Throughout my internship, I have found that even a little mindfulness can go a long way. Be mindful of the fact that what healthy looks like is going to be different from person to person. It is easy to revert to the “move more, eat less” regime, but this is yet again another extreme oversimplification. Additionally, we have been taught that there are no “bad” foods, but it took me a long time to realize that many less healthful foods are marketed in a way to resemble just that: “sinful brownies”. I even catch myself saying things like “dark chocolate is my guilty pleasure”. But why does eating a brownie, or dark chocolate, or whatever it may be, have to have any guilt attached to it? It doesn’t and that’s where we come in. Recognizing that what and how we promote nutrition and provide nutrition education or even how we talk about our own eating habits, whether it be in the hospital or on social media, greatly impacts not only the way others see our profession, but also the way others see themselves.

“It’s hard to do the hard thing. That’s why they call it the hard thing… Working on my ability to consciously be having a positive effect on myself and also on the people and the world around me is really important and I always want to be driving towards that.”

-         Hank Green

Passion for the emerging field in nutrition and dietetics. The thing is, none of this is easy. Shifting the frame from weight to health is going to take a lot of time and work on our part. And being mindful? Well it takes a heck of a lot more brain power. I do believe we can make this shift and work towards uniting the concepts of nutrition, health and body positivity if we do so together. I think it is safe to say that we are all in this profession because we care about people and we care about nutrition. I encourage all of us to let our passion for nutrition and dietetics to fuel our practice, to learn more, to do better and to be better.