Medicare, Telehealth & Covid: All you need to know about Dietitian Appointments

With the ever changing climate surrounding COVID-19, we have all been encouraged to get a little creative in regards to how we connect! This includes how we access health care and continue to receive support from Medical and Health Care Professionals. To assist with this the Australian Government has expanded Medicare subsidies for Telehealth services to all Australians.

 

What this means is that all Telehealth appointments (over phone or in video call) will be bulk-billed (no cost to you!) when you see a Dietitian (or other allied health professional). To be eligible, you will require access to a Medicare referral pathway, such as an Enhanced Primary Care Plan, Chronic Disease Management Plan or Eating Disorder Management Plan.

 

Have a Medicare Referral Already? Great!

 

If you already have one of these plans, you can continue to be supported by your respective Dietitian online.

 

Seeking a Medicare Referral to a Dietitian?

 

Good news! GP’s are also bulk billing all telehealth appointments, so you will have quick and easy access if you need a new Dietitian referral.

 

So what does a Telehealth session look like at Glow Group?

 

We are lucky to already offer virtual consults, so we are set up with the equipment we need to support you. We use ZOOM as our preferred platform for video calls as it’s user friendly and easy to follow for those who are a little less tech savvy (like me!).

 

So, to step you through:

 

You can book an appointment with us by phone or email, or book directly online http://glowgroup.co/dev/bookings/ . We are actually expanding bookings to accommodate client preferences as we speak.

 

We will email you before your appointment to set you up with a ZOOM meeting link. Below is a snip of what that might look like

 

 

 

 

 

To attend the meeting, you will just need to click on the link and follow the prompts. If you have any troubles, here’s a video https://support.zoom.us/hc/en-us/articles/201362193-How-Do-I-Join-A-Meeting- on how you can troubleshoot.

 

Once online you can begin your session as normal with your Dietitian.

 

When the appointment is complete, you will not need to make any payments at your end. We can process this for you using your relevant Medicare item codes

 

A few additional benefits:

 

You can speak with us in the comfort of your own home.

 

You don’t need to worry about travelling to the appointment.

 

It allows for some creativity with delivering support, which we are really enjoying as Dietitians!

 

And it keeps you connected with your trusted health care professional in uncertain times.

 

We look forward to connecting soon!

How Self-Care Might Look At The Moment

It’s safe to say we are experiencing surreal feelings at the moment as we continue to work together to find a new normal.

During this time you might be noticing changes to your thoughts and emotions which is expected and completely valid.

Our instincts might be to look out for those around us, especially those most vulnerable. Which while that is so important, in the long-term it will become difficult to do so without taking time to support yourself as well.

This is why I feel the need to bring up self-care.  Below is a list of ideas for self-care and what it could look like during these times:

 

 

  • Allow yourself to be human and acknowledge your changing capacity to handle situations day by day.
  • Allow yourself to acknowledge your needs and boundaries for how much you can tolerate. This may continue to change.
  • Remind yourself that it is OK to not want to engage in social media. One way to get a feel for that is when using social media, invite yourself to increase awareness about what it is providing for you.
  • Encourage self-compassion and kindness towards yourself as we go through a time of change. It is OK not to be OK.
  • Keep a note of support networks you have access to in such a time. If you are concerned about reaching out to others, one helpful tip can be the ask permission to speak to them first. “I am struggling at the moment, do you have capacity for me to talk to you about what’s going on at the moment?”
  • Allow time for yourself to stay nourished. It is expected that the food we have access to is likely to change and that is OK. It is still important to keep your body and brain fuelled to continue your day.
  • Allow time to honour your body with movement however you can.
  • If you feel you can, think about taking time to slow your thoughts and re-connect with yourself. This can be done with mindfulness, meditation, going for a walk and even yoga if that’s your thing.
  • If appropriate, taking opportunities to find humour in situations can help take the edge off. After all we are all in this together.

 

 

There is no right or wrong way. These are thoughts that I’ve had shared with me by my clients and colleagues and I’d like to share them with you as options for self-care.

I invite you to think how they might resonate with you and also how you would like to make some additions to this list to suit your needs.

Q&A: Common Questions Dietitians Get Asked

Almost anywhere I go as a Dietitian, I hear peoples concerns about food and their bodies. There is an overwhelming amount of information out there, and so much of it is misleading.

 

I really hold a lot of compassion when I hear peoples confusion, concern or even fear that has been created by the culture we live in today. It’s such a shame to see it get this way.

 

So I decided to answer a few common questions I get asked. If you like these Q&A’s then let me know, I would be more than happy to continue writing them.

 

Also note that this is general information. It’s best to speak to a trusted Non-Diet Dietitian for more personalised advice or even assistance unpacking some of these thoughts.

 

 

What are the best diets to follow??

There is no such thing as a perfect diet. Only you can really appreciate if your food and lifestyle habits are serving you. Some useful questions to ask are:

How is the way I’m eating impacting my social and emotional health?

Do my meals feel satisfying?

Where are my food beliefs and rules coming from?

 

Intentional efforts to lose weight such as dieting may appear ‘successful’ in the first 6-12 months as weight loss is achieved. However, after this time period and due to no fault of the individual (regardless of whether they continue to follow the diet or not), at least 95 per cent of dieters regain the weight they lost and often more.

 

Such an act of rigid dieting in the name of “health”, especially for people who are chronic dieters (e.g. yo-yo dieters) can often spiral into a range of health problems including slowed metabolism, low energy levels, nutrient deficiencies, gut health concerns, risk of osteoporosis, and increased risk of heart-disease to name a few.

 

  1. What do you recommend instead of following a diet?

Firstly to address why we don’t encourage a diet plan…following a diet usually means following a set of rigid rules decided by someone external. This may be a health professional, your Doctor, Dr. Google, a celebrity, a family member or friend or even a colleague. Following such a rigid way of eating not only is unsafe as mentioned earlier. It is often difficult to maintain (due to life naturally not being so rigid and structured) and takes away autonomy from the individual to determine foods they might enjoy or find satisfying (physically and emotionally).

 

So as an alternative instead of relying on food rules from external sources for the rest of your life. We aim to support you to re-connect with your innate wisdom on how to care for your health and well-being. One practice that Dietitians at Glow Group Health and Wellbeing support clients with is Intuitive Eating. This is a set of of 10 principles developed by Dietitians Evelyn Tribole and Elise Resch designed to empower individuals with skills to build a positive and respectful relationship with food and their body.

 

  1. Can you write me a diet plan?

As Dietitian’s it is probably safe to say that we are the most qualified health care professionals to write a diet plan that adequately addresses your energy and nutrient needs as well as meet your goals and preferences. However, this is not necessarily appropriate or particularly useful for everyone. Diet plans are often rigid and restrictive and do not allow much space for intuition or just general thoughts and feelings associated with changes to the day. These plans also often lead into obsessive thoughts over the foods that do ‘not fit’ in the plan.

 

Instead for those people who crave structure, we collaboratively develop a meal guide that allows for variety, flexibility and ‘fun’ foods whilst also supporting people with their health goals.

 

  1. What are your top foods that I should avoid eating?

Short answer is that there are no top foods to avoid, nor are there specific foods to eat more of. Unless you have an allergy or medical reason for eliminating a particular food, putting certain foods on a forbidden list is unhelpful and unnecessary.

In today’s culture of dieting it is easy to find ourselves commenting on whether a food might be “good” or “bad” for us. We have become accustomed to this black and white way of thinking about food without realising the harm this can have. As a consequence of placing such a moral value on food, we then transfer such values onto ourselves. In other words, food is either good or bad, and we are good or bad based on what we eat. Creating a toxic relationship with food and our self-worth.

It is very common for adults and children to find themselves feeling out of control around those foods that they have decided they are never allowed to eat or have around the house. This is what is known as the ‘forbidden fruit effect’, the more we tell ourselves we can’t have a food, the more we crave it. It’s simply human nature to rebel and defy ‘rules’.

Our roles as Dietitian’s is to help you unpack these beliefs around food and help you understand that nutrition science is not black and white.

 

  1. Are carbs bad for you?

Carbs have a reputation in diet culture for being “bad” which is simply a shame. As discussed above, no food is straight up “bad” for you and in fact carbohydrates play a vital role in our day-to-day survival.

Carbohydrates are digested into sugars for our organs to utilise as energy. These sugars provide our body and brain with its number one and most easily accessible source of energy. Allowing us to nourish our vital organs and muscles and perform our daily physical and mental tasks.

Carbohydrates, particularly in the form of wholegrains and cereals are a rich source of micronutrients, such as B vitamins, magnesium, folate and iron. They also contain a range of fibres that can support healthy blood sugar and cholesterol levels and act as prebiotics which feed those microbes in our large intestine that improve our ability to absorb nutrients and maintain healthy immune and cardiovascular systems, to name a few.

 

Five Ways a Dietitian Can Support You

Glow Group Health and Well Being

Guest piece by Dietitian Pascale Flematti

 

 

When people ask me what I do, I’m often met with the same response: “… What’s a Dietitian?”

In short, Dietitians are tertiary qualified healthcare professionals with the skills to provide evidence-based advice and counselling on food and nutrition. In university we study chemistry, human biology, physiology, biochemistry, food science and nutrition science (and more!). During this time, we develop a comprehensive understanding of how our bodies work, and how food and nutrition can play a role for a range of different bodily and medical needs. We can then translate this scientific information into practical advice on how to improve your health.

 

But what does “improve your health” even mean, and how can a Dietitian help you achieve this? Given that this concept is so broad, I broke this down into what I think are the top 5 things a Dietitian can help with (with particular reference to non-diet Dietitians!).

 

1. Improve your relationship with food

Many people come to a Dietitian thinking they will be told what they should and shouldn’t eat. In reality this is quite the contrary! From my experience, the people who are LEAST likely to tell you to eliminate specific foods are Dietitians. We want to show you that all foods have a place in our lives, and help eliminate ‘good’ and ‘bad’ labels for foods. We want to support you in allowing yourself permission to eat what you feel like, without consequence. Food is meant to be enjoyed! And we want to help you enjoy it.

 

2. Gentle nutrition management of health conditions/chronic disease

Helping individuals to manage health conditions is without a doubt an important part of a Dietitian’s job. We can offer guidance and support for medical nutrition therapy across a range of different health conditions, with different Dietitians generally specialising in different areas. We hope to provide nutrition advice that can help manage symptoms and underlying illnesses in a way that is practical, sustainable and fits within your lifestyle.

 

3. Shift focus away from weight and body image toward health and wellbeing

This one is particularly relevant to the non-diet space. Diet culture has conditioned us to believe that weight is often the most important determinant of health, and many individuals have learned to over-emphasise how we look determines how we feel about ourselves. As non-diet Dietitians we want to break down this notion. All bodies deserve care and respect, and we want to support you in learning to treat yours in this way. We practice in a way that is inclusive of all shapes and sizes, with a focus on developing healthy behaviours, thoughts, feelings and attitudes. We do not use weight as a primary marker of health, as we know health means so much more. It could instead be about feeling less stressed, getting outdoors more, waking up fresh in the morning, or having more energy to do the things you love.

 

4. Identify and work through an individual’s barriers to achieving health (what ever health means to them)

As Dietitians we recognise that health means something different to everyone. On top of this, different people experience different roadblocks on their journey to health, and this journey rarely takes a straight line to its destination. Dietitians will listen to you and provide a space to identify obstacles you might be facing along the way. We take a person-centred approach to help find solutions that work for you.

 

5. Help you make nourishing food and nutrition choices that fit in with your life

Nourishing your body can help improve your overall wellbeing, however there is no simple picture for what that looks like, and no one-size-fits-all meal plan – how boring would that be? We all have different likes, dislikes, schedules, budgets, household dynamics, desires and lifestyles. A Dietitian can work with you to improve your nutritional health by helping discover food choices that are personal to you. Whether it be meals you can have on the go if you leave for work early in the morning, or ways to incorporate different food groups into your cooking that your whole family will enjoy, we will take the time to work out what works for you.

Body Positive Bubbles: How to build safe spaces while healing your relationship with food and body.

Glow Group Health and Well Being

I am so excited to share this with you, as it is one of my favourite tools to use with clients as they work their way through their intuitive eating journeys.

As we begin to explore food through a different lens, it starts to become about taste, social connection, listening to our bodies, and that oh so important satisfaction factor. This is exciting!

However, as with all new adventures, this journey can also be a little challenging – like all activities that push us out of our comfort zones.

So, what do we do when we’re a little nervous but determined to proceed all the same?

We add a little safety net, or perhaps more appropriately, some bubble wrap… as we work our way through this new way of thinking.

 

 

What is a body positive bubble?

 

 

A body positive bubble is a safe space that we create to develop and hone our intuitive eating skills. Whether this is your first time looking at your relationship with food and body, or you have been working away at it for a while, a body positive bubble can support you through the process.

 

 

Inside our bubble

 

 

On the inside of our bubbles we keep the supports and resources that serve us best during this time.

 

 

Which may or may not include for you:

 

 

Supportive Partners, Friends or Family

Body Positive or Body Neutral Media or Books

Mindfulness Tools such as meditation, yoga, or journalling

Supportive Health Care Practitioners: Such as a trusted GP/Psychologist/Dietitian/Other Health Care Professional

Your Goals and Aspirations (Outside of Food, Body and Shape).

 

 

Outside our bubble

 

 

On the outside of our bubbles we place anything that is unhelpful, unsupportive or triggering.

 

 

Again, which may or may not include for you:

 

 

Unhelpful or triggering media or books… such as certain instagram pages, facebook groups or magazines.

Unhelpful or triggering conversations… such as diet talk in the lunch room.

Unsupportive or triggering exercise environments… such as gyms that encourage 12 week “detox” challenges, or trainers who focus solely on weight or shape.

Unhelpful or triggering electronic devices… such as apple watches, and fitbits.

Unsupportive or triggering health professionals… there is NO place for shame or blame.

 

 

Although simple, the body positive bubble allows us to assess our environment, and build a gentle and protective barrier as we explore new and exciting experiences.

 

As always, if you are wondering where to start, reaching out to a Non-Diet Practitioner is a great place to begin or re-kindle your food-body journey.

Working With a Non-Diet Dietitian in Practice: What to Expect

Glow Group Health and Well Being

This piece has been co-written by New Graduate Dietitian Pascale Flematti

 

What to expect when working with a non-diet dietitian in practice.

We appreciate that the idea of a non-diet Dietitian may be quite new to you. To help you understand how we work at Glow Group, we have put together some examples of how we support our clients.

 

At Glow Group, our non-diet Dietitians may:

· Help you understand weight science and the risks of dieting

· Discuss how to build behaviours that will support your health and sense of wellbeing

· Ask you to keep a food journal where you record thoughts, feelings and emotions around mealtimes

· Create meal guides to help you find some structure around eating

· Help promote a sense of freedom to eat a variety of foods (within limitations of food allergies/intolerances/cultural or religious preferences)

· Help you to rebuild trust and awareness of your body’s internal cues such as hunger, fullness and satisfaction

· Support you to build self-compassion and self-care techniques related to food and your body

· Help you reflect on changes in behaviour, emotions, and your relationship with food

· Support you in learning to eat intuitively

· Encourage movement for enjoyment, fitness, strength and wellbeing

 

In line with our philosophies of focusing of health, not shape and creating safe spaces for all bodies, you will not find us:

· Setting weight loss goals

· Recommending calorie tracking

· Prescribing restrictive meal plans

· Encouraging body manipulation

· Discussing food as ‘good’ and ‘bad’

· Making assumptions about health based on weight

 

Bear in mind this list is neither definitive nor exhaustive, but simply provides a snapshot of what it may be like to work with us. For more information about the non-diet approach, we encourage you to head over to our earlier blog piece called ‘What is the non-diet approach?’

Mindful eating: 6 tips to reduce stress around meal times

Glow Group Health and Well Being

Co-written by Serena Hodge 

 

 

 

What is Mindful Eating?

The practise of mindful eating is about being fully present and bringing your attention to your environment, thoughts and feelings when you sit down to eat a meal. In doing this you can remove the anxiety, guilt and distractions surrounding meal times. This allows you to fully enjoy and appreciate every bite of the food on your plate without fear or judgment of yourself.

Below I will share with you 6 ways you can begin to practise eating mindfully based on guidelines set by Eating Disorders Victoria (2016) as well as my own personal experience.

 

 

1. Give yourself permission to enjoy food without guilt. This is one of the most important first steps when learning how to eat mindfully. This is about removing restrictions and giving yourself permission to appreciate the pleasurable experience that food can bring. In doing this, you can shift your focus to eating foods that make you feel good. Remember that this can include eating your favourite foods. So next time you go to snack on your favourite chocolate bar or a dessert, start by telling yourself that it is okay to enjoy the experience.

 

 

2. Consider how you are feeling. Before you sit down to eat your meal, think about how you are feeling in the moment. Are you feeling stressed, or calm and relaxed? Does your body feel tense and uneasy? This is important as your thoughts and the way your body feels can increase your self-awareness and give you a good indication of your attitude towards eating.

 

 

3. Deep breathing. As you sit down in front of your meal, take a moment to take a few slow, deep breaths. You can do this by closing your eyes, breathing in through your nose and out through your mouth. This is a good way to help you relax and bring you into the present moment.

 

 

4. Chew slowly. As you begin to eat your meal, encourage yourself to eat slowly. This can help you slow down and relax while allowing you to savour and appreciate the flavours of the food.

 

 

5. Remove distractions. Many of us are surrounded with a number of distractions during meal times. This can include things such as watching T.V., scrolling through social media, talking on the phone or being on the move and not taking the time to sit down. Next time you are about to eat your meal, take a moment to switch off and focus on the task of eating. Notice if this makes you feel more present and aware of the food you are eating.

 

 

6. Eat with company. Surrounding yourself with the company of your family and friends when you eat can be a great way to shift your focus away from feelings of fear and anxiety when eating meals. When we realise that food and meal times are a time that can be celebrated and enjoyed, we can recognise that we have begun to take the first steps towards creating a positive relationship with food, free of fear and judgement.

 

Remember that this is a guide to support you on your journey to becoming a mindful eater. This is not an absolute must to follow at every meal or snack time as lets be real, life doesn’t always allow for that. But the more we can move towards a more mindful direction and create more presence around our meal occasion, the more positive it will be for our physical and mental health.

 

 

Please note, that mindful eating and intuitive eating may not be appropriate for someone living with an active eating disorder. Please reach out to an Accredited Practising Dietitian to understand if this approach to eating is right for you.