Aidan:

Hello and welcome to the Ideal Nutrition podcast. My name is Aidan Muir and I’m here with my co-host Torwen Eerkens, and this is episode 223 where we’re going behind the scenes to talk about how we actually work with clients. The starting place is a bit of background on Ideal Nutrition, because we don’t talk about it much on here. As of recording, we have 15 dietitians. The majority are full time.

We split our time between seeing clients face to face or online, and creating content. Most dietitians have one or two non-client days for content creation, with the rest spent seeing clients. We work with people online or in person. It’s roughly 70% online and 30% in person. We’re Brisbane based. We use a session-by-session, pay-as-you-go model. Financially, clients pay per session and can leave at any time. Service-wise, we blend that with package-style support.

We do work in the consult and outside it as well. If resources would help, we provide them. We also communicate between consults and do weekly written check-ins. I view it as the best of both worlds. I’ll give background on the clients we work with. At Ideal Nutrition, like I said, our dietitians have special interests. In general, we work with body composition goals, weight loss, and women’s health such as PCOS, endometriosis, menopause, and hypothalamic amenorrhoea.

We also work with athletes in endurance, strength, and weight-class sports, gut health and gastrointestinal conditions, and disordered eating or eating disorders. Across the board, it’s about 50–50 athletes and non-athletes. A large percentage of people who see us exercise in some capacity.

I’m happy to work with anybody willing to give it a go. If someone is keen to work on their nutrition, I almost always enjoy working with them. The people I specifically work with fit that 50–50 split of athletes and non-athletes. I lean more towards strength sports like powerlifting, strongman, Olympic weightlifting, and weight-class sports. On the general public side, I do a lot of weight loss and IBS work, and some medical conditions like diabetes.

Many years ago I worked with more complex conditions, largely due to working with an older age group. Most people over a certain age have multiple conditions going on. A large percentage of my clients now are between 20 and 55 years old. They’re less likely to have complex conditions, though many still do. Much of my work is simpler than it used to be, and I enjoy it.

Torwen:

I work with many gut-health clients and gastrointestinal conditions, including CCID, MCAS, enzyme deficiencies, intolerances, and food issues. I also work with athletes and women’s health. Now we’ll talk about how we work with people. I’m keen to give insight into what an initial consult looks like. Once you’ve booked with one of our dietitians, the initial consult runs about 45 to 60 minutes.

It’s a deep dive into what’s going on for you and what your goals are. We look at background and medical conditions. We also discuss things you’ve previously tried and why you want to work with us. After that session, the dietitian will send a tailored meal plan if that’s what you decide together. I think this sets us apart from many dietetics companies. I’m curious about your thoughts on meal plans, Aidan.

Aidan:

For sure. I like your wording. The vast majority of people who work with us get some form of meal plan, which I’ll explain. Everybody should get clear, structured advice. My thoughts on meal plans start with the common criticisms I’ve seen of dietetic services. A common one is people feeling like they didn’t get anything from the session, whether true or perceived. For meal plans, criticisms include being too restrictive, not teaching anything, and lacking variety. Any other criticisms you can think of, meal plans?

Torwen:

The issue is when a plan becomes the only thing the client eats. It can be quite restrictive or harm the relationship with food.

Aidan:

Let’s talk about solving those. First, I like to ensure we give people something tangible. Sometimes a dietitian gives advice, but the person perceives it as being told to keep doing the same thing. Structure avoids that interpretation. Everyone has room to improve. I believe in some form of structure, especially for weight loss.

We can solve restrictiveness and the “only thing they eat” issue by adding systems. It doesn’t have to be my system. Personally, I write that six is fine 80–90% of the time. There are flaws with chasing 100%. In almost 10 years, I’ve never seen anyone stick to 100% and then get good long-term results. I’ve seen people do it for four weeks, but they struggled to follow it consistently after. Eighty to ninety percent works incredibly well. Below 80%, we lose structure and can’t adjust effectively.

If I change something in the plan, inconsistency blunts the effect. The “doesn’t teach you anything” criticism is silly. No single intervention teaches everything. If you used that logic, you could dismiss any intervention. We can have structure and teach at the same time. Do you have other thoughts?

Torwen:

Each dietitian may do meal plans slightly differently. We make them valuable for that person. Personalisation bypasses many problems. We consider time to cook, food prep, tastes, and preferences. The plan becomes a useful tool to guide them at the start.

Aidan:

Going deeper, if someone is doing an acute weight cut for a powerlifting competition, I’ll ask for 100% adherence for that week. If variables move, they might miss weight. In many cases, I write specific weights of foods and provide variations to solve variety. If someone cooks for a family of four and wants progress, I don’t insist on exactly 150 grams.

Batch cook for the family and portion it relatively close. I often put people in at least a 500-calorie deficit. If they consume an extra 100 calories at dinner, they’ll still progress. There’s margin for error.

Torwen:

It’s a foundation we build on as we go. If you aren’t seeing the desired rate of weight loss, we amend. We ask what’s going wrong and whether adherence is the issue or the plan needs review. It’s not a one-off hand-off. We build upon it.

Aidan:

That covers initial consults. We go through background with everyone. We might do education if relevant or if someone wants it. Many people already have great nutrition knowledge. Often it’s more about outside perspective, guidance, and accountability. We might do education initially and ongoing, but the plan is the bigger aspect.

We get background, possibly do some education, and go through the plan. We send the plan within two business days. It’s important to send it quickly so people can start while motivation is highest. And then what do we do after?

Torwen:

I’ll intertwine review consults here, because they matter. Why do clients come back? A big part is rapport. Clients often open up about heavy emotional things, and we’re there for them. It’s more than nutrition. We build longer-term relationships. Diet changes take time. Clients return so we can amend, add information, respond to changing goals, and adapt.

Aidan:

I’m in a position of luxury, so I don’t do one-off consults. The exception is if someone sees me and realises I’m not the right person. If someone asks for a one-off in advance, I don’t do it. The reason is that even if I try to make the first plan perfect, the follow-up plans always improve it. I make the first plan simple so it’s easy to start and make progress.

There are many ways to make it better. If I sent everything at once, it would be overwhelming. Also, I create a structured plan with a calorie target. I often get calories right, but with higher needs the margin for error is bigger. If I’m 10% off, that could be 500 calories. We can quickly assess weight change, hunger, and fatigue, then address it in follow-ups. In one 45- to 60-minute consult, it’s impossible to give all our expertise.

Torwen:

Even outside body composition, I guide people through food trials and reintroductions. It’s not a one-off process. It takes time. With symptom-linked issues, there’s trial and error. We guide you through and we’ll get there, but you need a few returns.

Aidan:

I’m an ethical person, so I’ve thought about this like a physio would. A physio could theoretically give the entire rehab plan in one session, with algorithms for every setback. I don’t think that’s great care. On the other extreme, some drip feed weekly so you must keep coming back. Ethically, that’s a fair criticism. The middle ground is laying out the journey while timing information for best results.

You combine simplicity, outside perspective, and guidance across the journey. It’s not a money grab, nor overwhelming, and you can adjust as you go. With IBS, in the initial consult I often note ten topics to cover later. I don’t give them all at once, not to withhold, but because action is less likely.

The low FODMAP diet alone can be overwhelming. If I add ten more tasks, they might do none. What if one intervention solves everything? Some interventions involve buying supplements. There might be five to seven I’m interested in. If I prescribe seven at once, few people will purchase all. If we go systematically from high-priority and easiest items down, far more gets done.

Torwen:

You’re also building rapport over time. I have a question, Aidan. You’ve seen some clients for years and still provide new information and updates. How have they stayed on so long?

Aidan:

I mentioned this in a neurodivergent podcast with Lea. I haven’t publicly taken on clients or opened my books for over a year, and I’m still fully booked. I occasionally take on an interesting client. If I’m booked out without taking new clients, people are clearly staying long term. About 30% of my clients are neurodivergent. I’m not seeking that out, but outside perspective and consistency help. Helpful reminders keep people on top of things.

Athletes also set new goals. We hit a goal and set another. Some even change sports, which changes our focus. My consult structure is simple. First, a bit of life chat. Ideally, I listen more. I also share a little so they know me. Then we do nutrition, see how things are going, and make changes. Sometimes there’s education on new topics, like supplements. Finally, we leave buffer time to wrap up big items, like competition planning. There’s always more on the horizon.

Torwen:

Let’s cover general philosophies. For me, personalisation is key. It must be feasible, or they won’t come back, especially if overwhelmed early. Personalised and collaborative works best. We look for progress, not perfection. Progress over perfection is the way to go. We give evidence-based information in practical ways.

Aidan:

On collaboration, the life chat builds rapport and informs collaboration later. Also, if you don’t like talking to your hairdresser or barber, you don’t go back. The same goes for us. I’ve wrestled with the balance of prescription versus collaboration. People pay to see us, and motivational interviewing matters. If people feel they came up with the idea, they’re more likely to act. Sometimes telling people what to do makes them want to do it less.

We need structure as well. I know a powerlifting coach who saw a dietitian who only asked what he could do better, without a plan. He said, “What if I asked my lifters how to be better, instead of writing a program?” That’s the balance. We combine structure and our best advice with collaboration. Sometimes I give advice I don’t expect to be followed, like pushing for eight hours of sleep. I’d rather give the right advice. We collaborate when time is the issue.

We can use meal prep, frozen meals, or other options. Some love meal prep, others hate reheated food. We can still solve the problem. I might list options and have them choose. Or I’ll say, “I have my thoughts on this. What do you think?” Some people then say, “Just tell me what to do.” If they say that, I prescribe. If they share ideas, I go with theirs about 80% of the time. Ten to twenty percent of the time, their idea isn’t good, and I’ll say so.

Torwen:

I’m the same. We give advice and the overall picture of the goal. If it doesn’t suit their life, we collaborate to make it fit, so we can achieve the goal.

Aidan:

The last topic is what has changed. Early in my career, I believed in snowballing small changes. It worked for me and others, so it made sense. I tried it first, and it didn’t work well. People are most motivated at the start. One small change wastes that motivation. They also pay money and may feel short-changed by one or two tweaks. Physiologically, small tweaks don’t always create the predicted deficit.

Swap high-fat mince for lean mince, full-cream milk for skim, and cut chocolate, and you might think you’ve removed 500 calories. Hunger often rises when intake drops. Even equal-volume swaps can raise hunger over time. I had clients who swapped chocolate for ice cream. That’s not what I meant. I swung the pendulum.

I started creating the best plan I could, then individualised it. Sometimes I push the threshold of what I think they can do, like cooking most nights. Often they rise to it. Results and retention improved massively. I still use small changes, but after a structured start. Issues always arise, like convenience or taste. Then I snowball improvements.

Torwen:

I’ve worked on this too. At uni it was three strategies and off you go. In public settings, people are often there because they’re told to be there. Our clients want to see us for our advice. I prefer to give more first, then adapt. I ask exactly what they’re here for and aim for an early win so they leave confident.

Aidan:

One last change. Early in my career, many people didn’t want to see a dietitian. Their doctor told them to come. Now, people seek us out, and often seek me specifically. It’s so different and positive. They want to improve performance, health, or how they feel, and they’re bought in.

Torwen:

That’s everything. If you’d like to work with one of our dietitians, get in touch via Instagram or book through our website. We’d appreciate a podcast review as well. Thank you.