What’s the Difference Between a Dietitian and a Nutritionist?
March is National Nutrition Month! If you’re here, you probably realize that nutrition matters for SO many reasons… but not all nutrition information is created equally.
A quick scroll through social media will show you an array of folks selling nutrition services: nutritionists, nutrition coaches, dietitians, macro coaches, health coaches… I’m a Registered Dietitian - but what does that even mean? And how is it different from a nutritionist? Buckle up for the ride!
What is a Dietitian?
Dietitian is a regulated title (like doctor, nurse, or psychologist). Every dietitian has a slightly different education and career pathway, but we all share the same basic requirements. Here are the things all dietitians have to do:
Complete dietetic coursework from specially accredited programs (not every nutrition major at every university qualifies you to become a dietitian; this is how the profession governs educational requirements). Here is a tiny sample of the coursework I had to complete:
Organic chemistry (2 semesters)
Biochemistry
Metabolism (2 semesters)
Psychology
Counseling
Nutrition education
Nutrition assessment (yes, I took an entire course on how to determine someone’s individual nutrition needs)
Management
Food science
Receive a master’s degree. Note that this requirement is new as of 2024 and previously credentialed dietitians were grandfathered in.
Complete a 1000+ hour dietetic internship (comparable to a medical residency). We are required to work in a variety of settings (including clinical, community, and food service, but many internships also include rotations in private practice and sports nutrition).
Pass a national board exam (with a pass rate of 70%).
Depending on location, obtain state licensure.
Maintain ongoing continuing education (minimum of 15 hours per year). This is where we can get really specialized.
Laws vary from state to state, but in most states, the only person who can legally provide individualized nutrition advice to treat a medical condition (including things like anemia, prediabetes, eating disorders, or REDs) is a dietitian. Some states have even stricter laws. In Montana, for example, it is illegal for anyone not licensed as a dietitian in the state to even assess nutrition needs or provide any kind of nutrition counseling - even to people in perfect health.
What is a Nutritionist?
The reality is, the only consistent requirement to be a nutritionist is… to call yourself a nutritionist. Seriously. That’s it. Nutritionist is not a regulated title, so anyone can call themself one - and charge you money for services.
Does this mean that all nutritionists are garbage? Absolutely not! I know some highly educated nutritionists who are great at what they do. But what it does mean is that you don’t really know what you’re getting into when you sign up to work with a nutritionist unless you do some extra digging. Your nutritionist could have a master’s degree in nutrition. Or they could be someone who took a 6 week online course. (As a side note, the Certified Nutrition Specialist is recognized in certain states and becoming a CNS involves completing similar education and training as dietitians.)
What Is a Dietitian Qualified to Treat?
All that education and training actually equips dietitians to work with most people with most health conditions. Like any profession, many dietitians choose to specialize.
As a dietitian who specializes in care for mountain athletes (looking at you, runners, hikers, climbers, skiers, and mountaineers), here is what this looks like for me:
Performance nutrition: How to fuel to support performance, during races and training and throughout day-to-day life.
Management of a health condition as an athlete: Athletes have different nutritional needs than the general population. Whether you have Celiac disease, prediabetes, iron deficiency, or hypothalamic amenorrhea, my specialty in sports nutrition and my training as a dietitian allow me to support you as a whole person - which includes being an athlete.
Disordered eating and eating disorders: Whether you have a diagnosis or not, you deserve to have a healthy relationship with food.
Injury recovery and prevention: Nutrition plays an important role in reducing your risk of injury… and healing from one once you have it.
REDs recovery and prevention: Low energy availability (not eating enough for your activity level) lies at the center of Relative Energy Deficiency in Sport. This may be related to eating disorders or injury but also may not be!
Plant-based diets: Whether you are plant-based or plant-curious, your nutrition needs differ, even from those of other athletes.
Why Should I Work with a Dietitian Over a Nutritionist?
There are situations where a nutritionist may be able to meet your needs perfectly well. But here are 3 reasons to choose a dietitian:
You know what you’re getting! Like any profession, not all dietitians are good at what they do… but the RD credential at least guarantees a base level of competence (probably). If you do end up with a bad apple, there are repercussions if you report harm to the state dietetic governing agency. Since nutritionists are not regulated (the exception being the CNS), there is no consequence if they cause harm.
Dietitians are able to credential with insurance companies, so you may be able to get services for free. (Psst, I am in-network with most Aetna, Cigna, and BCBS plans and some of my clients are getting unlimited visits for FREE. Want to see what your plan covers? Fill out an application to work with me 1:1.)
In many states, a dietitian is the only provider who is legally allowed to provide any individualized nutrition advice - especially if you have an underlying health condition. For example, here is what Montana law states about services that may only be provided by licensed dietitians in the state:
Assessing the nutrition needs of individuals and groups and determining resources and constraints in the practice setting;
Establishing priorities and objectives that meet nutritive needs and are consistent with available resources and constraints;
Providing nutrition counseling for any individual;
Developing, implementing, and managing nutrition care systems; and
Evaluating, adjusting, and maintaining appropriate standards of quality in food and nutrition services.
Essentially, if you are receiving any kind of 1:1 nutrition care in Montana - it must be provided by a dietitian.
The Bottom Line
Ultimately, it is up to you to make an informed choice about who to work with. Just as not all dietitians are great dietitians, not all nutritionists are bad nutritionists. And even the bad nutritionists generally mean well. But that doesn’t mean they are not causing harm. I’ve worked with countless athletes who had previously worked with a nutrition or macro coach with terrifying outcomes. One of my athletes had been encouraged by a coach to cut out entire food groups, contributing to a disordered relationship with food. Another met with a nutritionist who errantly diagnosed an insensitivity to dairy without offering an alternative source of calcium. By the time I met with her, she had developed osteoporosis and was healing from multiple broken bones.
I say this not to scare you but to encourage you to seek out the background of whoever you choose to work with - nutritionist or dietitian - to ensure that they have the knowledge and training to help you reach your goals… and the awareness to refer out if they don’t.
Are you a mountain athlete or outdoor enthusiast ready to learn how nutrition can help you reach your goals? 1:1 Nutrition Support is just for you! Learn more here.
