Building a Bariatric Dietitian Business: Lessons from a Clinician, Entrepreneur & Mom
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[00:00:00] If you're looking to grow your business as a registered dietitian, you've come to the right place. If you're not sure what to do or what steps to take next so that you can create flexibility and freedom in your life, then you're gonna learn a lot from tuning into our podcast here at dietitian Boss.
I'm Libby Rothchild, the founder of dietitian Boss, a fellow registered dietitian and business owner, and in our podcast, I share. The highs and the lows, and I talk all about how to grow your business, get it started, and I interview our clients. To date, we've had over 200 interviews from clients who share their journey on our podcast, dietitian Boss.
Libby: Hello and welcome. I'm so happy to be here with you today. Is a registered dietitian specializing in bariatrics, and she has worked in the clinical and higher education spaces and is now building her private practice. She's passionate about simplifying nutrition information for everyone to understand.
You can find Makeda on Instagram [00:01:00] @Makeda_weightlossnutritionist, and her website is weightlossnutritionservices.com. Welcome to today's podcast episode.
Makeda: Thank you. Happy to be here.
Libby: So excited to have you on and share your story. I love that your bio was short and to the point.
Is there anything that you want the listeners to know about you before we dive in that you wanna add from that quick intro?
Makeda: I think that I live in Syracuse. Okay. So if anyone's in the Syracuse
Libby: area. Great. And I will also add that you're a mom, right? So you've got two kids, a dog, a husband, so those are some fun facts as well.
And I know we're gonna talk a little bit about that today when we discuss balancing motherhood and business. Does that sound like something that you're okay discussing?
Makeda: A hundred percent, yes.
Libby: Excited to have you on, I love your specialty. I love that you've leaned into bariatrics. I think it's such an important space to help and to really provide services, medical nutrition, therapy for the community.
So what led you to specialize [00:02:00] in Bariatrics nutrition, and how did you know it was the right niche for you? Can you take us back? Like how long ago was that? Walk us through some stories.
Makeda: Yeah. Okay. So honestly I stumbled on it. My husband is in the military, so we're moving and right before we had moved back to the states we were living in Japan which is when I did my higher education dabbling. And I had our first child out there and I knew I wanted to get back into dietetics. So when we moved back to the states, she was six months. And I started looking into jobs, trying to figure out what I wanted to do when I was ready to get back and so I just got on indeed or Google and just looked up jobs in my area for dietitians, and I came across a bariatric dietitian position at a hospital. I applied for it, but because of funding it took so long and I was like, you know what? Maybe I look for another job. And then I feel like it was fate because then another bariatric dietitian job presented itself and I was like.
[00:03:00] okay, sure, I'll apply. And then I got both jobs, which was really interesting. But, so ultimately I just did a Google search for jobs in the area, stumble upon bariatrics, and I knew I wanted to work one-on-one with patients and counseling, but I didn't know how I wanted that to look in my first month. I was given a lot of different responsibilities. Long story short, that first month being so overwhelmed there, I knew it was where I was meant to be forever. I got to hear patients talk about how they never thought that they would weigh how much they weigh or they never thought that this healthy lifestyle would be theirs to have and to live.
And then I just knew okay, I want to be a part of that. From the beginning all the way to there's no end for it because you're constantly working on your lifestyle. But I wanted to be right there alongside them. And I felt as a dietitian, I had the tools to help them with something that they desperately needed help with and [00:04:00] ultimately wanted.
I know there are a lot of dietitians out there in the clinical space that feel like you might be educating someone who isn't necessarily ready to accept your information, but in bariatrics, your patients or your clients, they want to be there. And I was addicted to that feeling.
Libby: It is really nice when someone is interested in change. So in that model of behavior change, when you have people in the action stage, in the maintenance stage, if that's at all what you're pointing at.
Makeda: Exactly what I'm pointing at. Yeah. I remember in clinicals educating someone who had just gotten like a triple bypass and I was telling them how to eat healthy and Libby, I will never forget this. I was so defeated after this. But the patient literally said, listen, this isn't my first time here. I'm probably gonna come back for another bypass. I don't want your information.
I'm good. Nothing's changing. And I haven't heard comments like that in bariatrics.
Libby: I hear you. And yeah, that can happen and that's would be a great new podcast episode. Or we can talk about resistant [00:05:00] clients and dealing with that.
But thank you for sharing that story because I think we can all relate to that. Yeah. And especially as a trained dietitian, we want to help our clients and we wanna feel like we're making an impact. And it's really incredible that you were able to find a space by having this opportunity and with living a lifestyle of moving around a lot, with your family, which has to be challenging given what we do and what you do and licensure and all of that. With Bariatrics, did you have any other experience with similar, let's say diabetes or anything like that earlier along and you also liked it or were you just neutral early on in internship, et cetera, and then this just felt good?
Makeda: That's a great question. No, I really enjoyed specifically working with diabetic patients. Yeah. Or people with diabetes. In my internship as to become a dietitian, I did rotate through several different areas and clinics and the diabetes clinics were always the ones that stood out to me.
Because you are working again, one-on-one, I feel like if I had opened my eyes a little bit more, [00:06:00] I would've seen all of the interests that I had along the way. But yeah, definitely helping patients make even small changes in their diet and a huge impact in their life.
And I got that same feeling in diabetes education.
Libby: Yeah. And I wonder if that's like a chronic disease pattern, I know that didn't work for that situation with heart, right? The trouble bypass, but I do wonder if that is something that I don't know. I'm asking the question if maybe clients.
there's parallels between motivation to change in certain conditions, I have heard that people after heart attacks are more likely to make nutrition changes, but I know that's not always true.
Makeda: Yeah, no, I think you're right too. I think with diabetes, I feel like we all want like instant gratification and with heart disease.
I feel like it takes a little bit of time before you see your levels come down or you see the changes in your lab work. But with diabetes, I think the longest we look at something is three months for their A1C. But you can see like your fasting blood glucose levels can change based on what you ate [00:07:00] the meal before.
And I think little reminders like that make patients more willing to change because they can see it.
Libby: I agree with you. Coupled with, glucose monitors and things like, the technology's incredible to really help patients learn how to read their their levels and then also work with clinicians and teams to find out if their blood sugars within normal range and what it should hitting their target 70% of the time.
All of those standards within the diabetic framework. I do agree with you. I think that's. That's an interesting observation. And what would you say, given your work in bariatrics, what are some misconceptions about working with these clients that you wish dietitians understood? You already learned some insights about heart disease in that story, but what about misconceptions in the bariatric space?
Makeda: I love this question so much and I really thought about this for a little bit. I wish more dietitians and more practitioners really understood that a bariatric patient's attitude in a session or whatever you see [00:08:00] them, 99% of the time, it is not directed towards you. So if they come in and they're feeling a little bit like they come off short or hence or rude, 99% of the time, it has nothing to do with you.
And it has mostly to do with the fact that they feel not only. Treated horribly by the healthcare system or other practitioners in the past, but that they're so insecure in that moment. Like it is a very vulnerable time that one-on-one session that I have with my clients, I'm asking you to tell me everything about the way that you eat, what you eat, what you know about food, and it can make someone feel embarrassed. So then I know that when I'm feeling defensive, I come off a certain way and it's not very friendly, and I just wish that people understood that, because if you do a little bit more digging with your client or your patient, you'll know it's not about you, and that they are just so [00:09:00] insecure in that moment and I just wish more people knew that.
Libby: That's such a powerful reflection. Thank you. It's so mature. Thank you for sharing that. What helped you come to that realization? Was it a certain amount of patients? Was it practicing motivational interviewing? Like how did you realize that?
Makeda: It was a certain amount of patients for sure.
Like it just kept happening over and over again. And I'll admit like the first few appointments I was like, I am doing something wrong. But it was also like debriefing with my coworkers after an appointment and they would talk about how the appointment went from their perspective.
And I was like, oh, I didn't get that. Like we talked a little bit further. And I do have the luxury of having more time with a patient so we can get deep. Whereas maybe like the surgeon or the pa, they only get 15 minutes so they're not getting deep. So I did have that working for me.
And then, there's like a specific instance that I remember where I asked someone straight up, I was like, are you having a bad day? Because I feel like I can't get through to you. Do you wanna tell me what's going on? And he just came out and [00:10:00] was like, it's not you.
I'm so sorry. I am pissed off. Like I'm really angry and then he listed so many things and none of them had to do with me. And it was all about his insecurities too. Anyway.
Libby: Really powerful reflections, and I think that's really helpful for the listeners, no matter what stage you're in, whether you're just, starting or you've been in it for a while, we tend to internalize things as practitioners.
And, I love what you're saying you have, you understand you have more time than the other clinical staff. You also have some. Peers, some colleagues to lean on. And then you can also ask poignant questions to your clients and patients to, assess the scene and see how you can support them better.
It sounds like you were able to tick those three boxes to really identify and get underneath what the issue was.
Makeda: Yeah, absolutely.
Libby: And that's your toolkit, your clinical toolbox. Your clinical toolkit is full of resources for how to handle difficult situations, which will happen no matter what.
It's just the volume right After every 10 or 15 patients or clients. In any situation, you're gonna have to have those skills to deal with difficult scenarios and learn how to [00:11:00] not internalize it.
Makeda: Yeah, absolutely. Yeah.
Libby: So we know that you like bariatric, you became a specialist in bariatric.
You've talked about some of the challenges you wish dietitians would know and accept, which is to not take things personally. How did you refine your message to attract the right clients in lieu of your practice?
Makeda: I am still working on this. And as you taught me like that's okay. Refining your message is something that's ongoing.
And ultimately it came from my time working. In the weight loss clinics that I worked in or currently work in I would listen really closely to what my patients were or sometimes weren't saying. And when you meet with your patient after they've experienced that initial wave of bariatric success, whether it's pre-op or post-op, what they were saying to me was very key in refining my messaging.
So it was always something like. I can go up the stairs without feeling winded or I fit into my old clothes and I kept them back in my closet all these years. Or I'm off my [00:12:00] CPA machine, blood pressure medication, whatever it was. And you'll notice like none of those achievements have anything to do with a number on the scale.
And while yes, they do have those goals, that wasn't really what my patients were like focusing on a lot of the time. It was usually like their dreams, like something that they wanted to do or feel that they'd been missing out on. And so that's what I wanted my messaging to focus on. I wanna focus on if you wanna reach these dreams, here's how to do it, versus if you wanna be this weight, here's how you do it.
Libby: So what it sounds like you did from strategic standpoint is you reflected on your experience with clients who are bariatric patients, and identified the words they were using that were frustrations and what they wanted, hopes and dreams that weren't just as simple as certain amount of pounds, but really the behaviors that support that journey.
And you were able to consolidate that and that helped you fine tune the messaging and then later. Maybe put that into your content strategy for [00:13:00] social media. Is that what I'm hearing?
Makeda: Yes, that's exactly right.
Libby: And was that process harder than you thought? Share a story or two about resistance from that because clearly that's what I teach, but it's not easy for a lot of dietitians to do that.
Makeda: Yes, it was very hard because, it's in the name like weight loss surgery, so I could not get out of my mind to not focus on weight. Because some of my patients are like, yeah, I'm still obese, but this is the healthiest I've ever been.
And in my head I'm like, no that's not what they want, but that's what they're telling me. Then it also took like trial and error so like putting out a message and then seeing the kind of feedback that came from that or seeing who interacted with a particular message. And then asking like my audience what is it that you guys are struggling with and or what is it that you are looking to do?
And it was almost always like I want to play with my kids at the park. I want to go to Disneyland, but I can't do it 'cause I [00:14:00] can't walk the seven miles because my knee hurts because of the weight. And so it does always come back to weight. But the final goal isn't. Always necessarily weight.
Libby: So powerful.
And you've done some really powerful deep work and I'm just like, it's so cool to hear you talk about it and how clear you are. A lot of dietitians do struggle with what you're describing, and I hope that they can get some inspiration and pull out a lot of ideas from what you're sharing with your journey because it's ongoing right to learn.
Absolutely what saying and what their final dreams and hopes are, which is not just the weight loss, it's why. Yeah. To improve your quality of life. How does that specifically look? And so you're drawing these parallels, hearing it from them, and then using that in your marketing to further help and support through email marketing, through social media and through conversations.
Right?
Makeda: Absolutely. Yeah. And I'll give you a little bit of a plug. I feel like almost every session that you and I had in our private coaching. I don't think there was one session where you didn't say, go back to your ideal client list. What do they want? And so then that kind of, that habit stuck with me.
Go back to [00:15:00] who are you doing this for? Go back to like your clients, like what do they want? So I will say you definitely helped me remind myself to keep going back to that population and what they want.
Libby: Glad to hear that and I'm happy to hear that. It feels like it's connecting because if you stick with it, it is a powerful journey.
Marketing is as simple as, learning to really showcase what people want, but the hard parts part is parsing out what it is that they say versus what they mean. It just takes a little bit of work and strategy and psychology, but that's really powerful stuff. So what would you say if you had to start over, what would you do differently in building your brand, specifically in the bariatric space?
Makeda: I wish I would've written down every single positive thing a patient has ever said in our sessions. Whether it was about their own success or about how helpful I was personally. It's helpful to have all of that written down so you can refine your messaging, but also to have testimonials to show future.
I know that when I'm considering purchasing either a service or a product, I [00:16:00] look through the reviews. Like I wanna know what people have said about this, and I wish I had written down more of those things before. And why do you think you
Libby: didn't?
Makeda: If I'm being completely honest, I thought I would just remember it.
I was like, oh, I'll remember that, like that comment. Felt so good in my heart when I heard it, so of course I'll remember it. So there was that, and I think I didn't do it because I didn't, maybe deep down I didn't think that I would ever do have a bariatric practice. I didn't realize how important it was to have testimonials.
Yeah. I don't know, something to be a little bit more reflective on,
Libby: and I think that's really common. And for a lot of dietitians, they're just overwhelmed. They hear feedback and in the moment you're like, oh, that's cool that, that's good. That's in a good direction. But then you gotta, you're pulled 'cause you gotta go do something else and then, oh, if not work.
You got kids at home. Exactly. Can be a lot going on. It can be hard to know what is it I should stop and document and earmark to come back to in the midst of learning and growing. So sometimes as a clinician it can be challenging to juggle doing a great job and then also earmarking what's important for [00:17:00] marketing.
It just takes a little bit of time and patience to put it all together.
Makeda: Yeah. And I also don't think I knew the impact of marketing back then, sure. Even if I was planning to open up a bariatric practice back then, I guess I didn't realize how heavily I would be dependent on marketing.
Libby: Yeah. And that's a really fair reflection as well. So I think that's powerful. What would you say some of the biggest challenges were that you faced in your first year of business specifically, and do you remember overcoming them?
Makeda: Oh God. Confidence and imposter syndrome. And I don't do it as much anymore, but I would always second guess myself before posting something or like publishing a newsletter.
But something that helped me is a while back I had a little passion project that I was working on and a while back I heard someone say, if you ever feel like your service or your product isn't needed or you feel like there are so many people already doing what you're doing, just go walk down the bread aisle at the grocery store and it makes so much sense.
There are several different [00:18:00] brands of bread and there's still on the shelf, which means that someone is still buying that product. So like just to tie that back. To me and my challenges, I felt what am I doing? Like somebody out there is doing it better than me and I should just stop.
So that was really difficult to overcome in the first year, and I feel like that's where a lot of people's practice dies. Just all that self-doubt.
Libby: I love the bread metaphor. I think that's fantastic. And it's so true. There's also, 3000 or something dietitians, depending on your state, like for every person or whatever.
There's some stat about that I spoke of a while ago. There's certain amount of people per dietitian, meaning there's an abundance of resources. Like we can help so many people. As a dietitian, it's just in the moment it feel limiting. So I can appreciate that reflection.
Yeah. And moving on, you've shared about imposter syndrome, which is all relatable and how you have seen the importance in marketing now. How would you say that motherhood, you've got two kids and a dog, how has that influenced the way that you [00:19:00] run your business and work with clients and a husband?
Husband, two kids and a dog?
Makeda: Yes. I would say all of them need my attention all the time. It has made me more efficient. My time is very valuable and it's very limited. I don't wanna waste it. And likewise, I don't wanna waste anyone else's time either. So I think that's why I sometimes second guess myself because it's is this valuable or not?
Because if it's not, I'm not putting it out there. I'm not doing it. But it's also helped me like further buckle down on trying to get my business off the ground and thriving because there is a certain lifestyle that I wanna live with my family at the center of it. I don't want tell someone telling me like, no, you can't drop cupcakes off for your kid's birthday because you have this going on.
I know like motherhood is I wanna be a certain type of mother, a certain type of wife, and a certain type of dog mom, and a certain type of dietitian all at the same time. And I think that has really changed how I approach my business.
Libby: Yeah. And so gimme a specific [00:20:00] example. You mentioned being efficient.
Makeda: Absolutely. It's time blocking. So at the end of every day, I'll make a to-do list for the following day.
And then something that you and I talked about was not only creating goals, but then stretch goals. And so if I get those three goals done and then there's more time to do the stretch goals, great. But if there isn't, I'm not gonna worry about that because now I'm like encroaching on the other part of my life that I want to respect.
So that time blocking and boundary setting that has been. So my top two strategies so important
Libby: and so important in business. I love that. I love that reflection. And yes, stretch goals are great. So for listeners, for example, you might have three priorities in a day, and then you might have one additional that's important, but it didn't quite make the top three.
You could call that a stretch goal. So that might be making an appointment for your dog who has manual physical, but you have a couple weeks wiggle room. So it's a stretch goal to do it, but it might roll over to the next day or the next week, just as an example.
Makeda: Exactly.
Libby: Okay. By the way, that's my stretch goal right now. So in [00:21:00] wrapping up, I just have a couple more questions left. It's been also just such a pleasure to talk to you, hear your perspective. I love your reflections about not only being a clinician, but being a businesswoman and being a mother and tying it all together is what this business, dietitian boss is all about.
And so I love hearing your perspective about each aspect of who you are, right. And how that ties into your role and contributions. So when it comes to strategies that have helped you balance, you talked about time blocking, tell me a little bit more about boundaries. Can you gimme one or two examples of what that might look like?
What's specifically helped you? You talked about the to-do list. Do you have any work boundaries with hours of business or can you share one or two tips about how that's helped you?
Makeda: Yes. How that's helped me or like examples of it.
Libby: Either way. Whatever you wanna go with is helpful.
Makeda: Okay.
I would never want my kids in an appointment with me making noise when I'm with a client, right? Because that's not fair to my client. And likewise, I would never want to bring a [00:22:00] client into playtime with my kids, right?
So I do try to, set office hours, so I'll reserve maybe like an hour after the kids are like, after they've taken their bath and they're playing. If I need to check in on my phone and like on my platform and answer anything, I can do it right then, or I can do it in the morning.
But I set those time boundaries and then I'm not gonna be rude to my client and I'm also not gonna be rude to my kids or my husband. So meaning, just as important it is to keep my kids out of the room during a client call. It's important to keep my clients out of the room during playtime or, even if they're just like, mommy, watch this.
Yeah. Okay. I'm gonna watch that because it's me and you right now, kiddo. And there is time set aside for you to respond to your patients without them feeling like you're neglecting them. And more importantly, my kids feel like, okay, like Mommy's [00:23:00] gonna watch us, mommy's playing with us right now.
And yeah, they're not like mommy's busy doing work. We need to respect her. No, but they understand okay, mommy's gonna do this for 10 minutes. And then I'll be right back or whatever. So it helps them feel secure. I wanna say I hope that they know that like I'm present with them when it matters.
Libby: So thanks for sharing that. It takes discipline to do that. It can be really hard to not blur those lines. And so you articulated that very well. Really good role modeling for the listeners and it's gonna makes you a great business person.
Because all of that translates really well over into all facets of business, as right? Making sure you're being fair, keeping your sanity while also maintaining profitability. Like it, the list goes on and on. One last question I wanna ask as we wrap up today. By the way, it's been a pleasure to talk to you.
So thank you for making space to share your story. Absolutely. What advice would you give? It doesn't have to be a new dietitian. Just a dietitian who wants. To start their practice. Maybe they're a mom like you and they're obviously feeling overwhelmed. We all have that imposter syndrome. So what would you say to [00:24:00] them?
Makeda: I would say you do not have to do it all in one day. Starting a business takes time and energy, so give yourself permission to just start somewhere, like literally anywhere. How do you eat an elephant? One bite at a time. So that's exactly the approach I recommend. Even though it's my first official year of business, or technically my second, this seed was planted.
I think, this seven years ago. I've been going through all of your resources for seven years. And then the time just felt right and then I had all of that pre-work done because I just started back then. So it won't take you seven years to start your business, hopefully, but basically every little building bit hounds in your progress.
So just start
Libby: Really beautifully said. Thank you so much for your time today. If you could just remind everybody where to find you on social media, it will be listed on the show notes on our website. A dietitian boss, but just one last plug.
Makeda: Yeah. On Instagram, it's Makeda, M-A-K-E-D-A_weight loss [00:25:00] nutritionist, and my website is weightlossnutritionservices.com.
And on Facebook it is Weight Loss Nutrition Services.
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