November 5th

So November has always been a significant time in my life. Not only is my birthday November 7th, but today (November 5th) specifically, is such a significant day for me in so many incredible ways!!

November 5th , 2017: I was matched to my Dietetic Internship with Iowa State University.

November 5th, 2018: I passed my Registered Dietitian Certification Exam.

So in today’s blog post I wanted to discuss my journey into becoming a dietitian: why I chose the path I did, and how I know that God has ordained every, single step that I have taken to this very moment, and how I know He will forever guide my steps to serve His kingdom and bring honor and glory to His mighty name.

So let’s go back in time. Since birth I have had a huge love and fascination with all things food. I was a foodie before being a ‘foodie’ was a thing. I never take for granted the positive relationship I had with food and my body, and that I was privileged to experience that, all the way until I was 18 years old. I never had to give a second thought to what I was eating or how it would affect my ‘image’. Now saying all this, I also realize that this was my own experience, and this is not the experience for everyone. So I want to acknowledge and offer my deepest sympathy to anyone who has ever experienced body shaming: whether through words, thoughts, or actions at an early childhood level. This is not okay. Societal ideals seem to always be changing and body acceptance seems to be greatly challenging for almost all women in today’s society.

Moving forward to November 2010. This is where my interest in health & wellness took a really sharp turn. I had just ended a career in competitive volleyball, which I had played for approximately 10 years (I started at about age 8 and played until I was 18). This probably attributed to my ability to have a higher degree of body acceptance than some. I never had to worry about my body or what I ate because my metabolism was constantly in need of more energy. But upon ending my time as an athlete, I began to trickle into diet books. Why you might ask? Well I was looking for nutrition education, and nutrition education is heavily intermingled with dieting. The dieting industry is a billion dollar industry, while the non-diet/body acceptance industry is only now (2019) gaining popularity. So upon reading some of these dieting books I thought “Wow! I have been taking care of my body all wrong. I was an athlete for the last 10 years, and have been fueling myself in a way that has really hindered my performance. Well I can change things now. I can start to eat ‘healthy’ and therefore change the trajectory of my future self to ‘actually’ take care of myself as a non-athlete in the real world.” Healthy thinking, right? Well kinda. That’s how diet culture works, it convinces you that by engaging in healthier behaviors you’re in turn a ‘better, more acceptable’ person. So this is a self-acceptance problem, not a body acceptance problem. In order to refrain from mentioning triggering behaviors, I’ll say I spiraled, and began losing weight, which made me feel like I was accomplishing what most people want.

Now in August of 2011 I was transitioning into college. I was moving 12 hours to a state where I knew absolutely nobody and was ‘starting over’. This seemed exhilarating and scary all at the same time. Over the next 6-months I spiraled deeper and deeper into a hole of self-loathing, striving to look like the female ‘ideal body’, and I lost a significant amount of weight. I became extremely rule-oriented, schedule-driven, and ultimately secluded myself where I interacted with nobody and had no friends due to the desire to be ‘in control’. I guess I should also mention the fact that I didn’t have a final career thought in mind when I entered into college. All I knew was I had an interest in psychology. Kinda thought I might go into Sports Psychology, due to my past as an athlete. So I thought okay I’ll start with that. In the same time that I was spiraling out of control with dieting, I changed my major from psychology to Dietetics. After reading the end career goal of a Dietetics major was to become a dietitian (aka-finding the ‘perfect’ way to eat), I was sold. It was an easy transition. I kept searching for something within myself to be solved by food, so in the process of discovering that for myself, I thought, when I find it, I’ll eventually be able to give the answer (‘the cure’) to others.

So in November 2011, after months of my mom becoming my closest confidant and strength, she gave me a phone call that changed the trajectory of my life forever. She merely asked if I’d be willing to go see a primary care physician (PCP) when I came home for Christmas break. My heart sank. I knew for months something was wrong, that I wasn’t living the life that God intended for me to be living. I knew I had a purpose in me that was greater than how my life was looking to move towards. So, I said “yes”. When I went home for Christmas break my freshmen year, I saw my PCP and she gave me words I never thought I would here in my life: you are clinically and psychologically diagnosable for an eating disorder, and you have 2 options at this point: (1) go into a residential treatment program and get pulled out of school or (2) start working with an outpatient treatment team (consisting of a dietitian and psychologist). I chose the latter. At the time, I couldn’t fathom getting pulled out of school and having to go into treatment for an eating disorder, I didn’t even truly think that I had. I started my recovery journey though. I met with a therapist back in Texas (virtually), and the dietitian on-campus. I was extremely lucky, again, that I was meeting with an ED therapist that I connected with, from my first session. I was also working with an ED specialized dietitian on-campus. Working with that dietitian actually made me realize my purpose. I wanted to do what she was doing. I was still on the academic track to becoming a dietitian, but within the unforeseen experiences that had brought me to this point, I didn't know whether that was the path I still wanted to walk, but working with this dietitian made me realize my journey can bring hope to others.

Now, not knowing whether the path to becoming a dietitian was ‘right’ for me was a constant theme in my walk into becoming the dietitian I am today. I spent approximately 2 years working with my ED treatment team, and then was told that they felt confident in my recovery that I could navigate my recovery, in the real world, on my own. Honestly at this point I was still extremely uncertain what that looked like, and I was still surrounded and partly immersed in diet culture. It’s honestly hard not to, because that’s exactly what our society promotes as ‘socially acceptable’. I kept navigating the dietitian route, but was losing confidence in my skills the entire way. I was being fed two opposing viewpoints: (1) engage in the multi-billion dollar dieting industry that feeds into a consecutive loop of ever-lasting self-loathing and body hatred; (2) engage in a healthy relationship with food and your body, practice intuitive eating and Health at Every Size (HAES) principles while becoming an ED dietitian, with the ultimate goal of working in private practice. The best advice I can give is that once you are awoken to the world of diet culture, and the lies it spreads to you on a moment-by-moment/daily basis, and how there is another way you can interact with food and your body, through intuitive eating and HAES, you can’t unlearn it. You can refuse to participate, but intuitive eating makes more sense than anything else in terms of eating. We are meant to interact with foods and our bodies’ in a positive way, not be hindered and questioning everything we put into our mouths.

So again, I chose the latter. I knew it would be hard because the entirety of the dietitian stereotype is to tell people what they can/cannot eat, but in order to make any changes in the current world, you have to be willing to challenge the norm. You have to stand firm in your beliefs and equip yourself for battle against those who oppose your thoughts and beliefs.

So the traditional path to becoming a dietitian is 3-fold in checkpoints: (1) complete your dietetics degree (whether a coordinated program which is connected to an internship or a standard 4-year program where you will need to apply to internships, externally through DICAS); (2) Complete the 1250+ hr dietetic internship, which consists of rotations in traditional dietitian roles: clinical, community, and foodservice settings; (3) Pass the CDR (Commission for Dietetic Registration) Examination. And I guess I could even add a fourth point, which would be landing the job. I was constantly asking myself: how do I gear my experiences to land the job that I want? Is that feasible right off the back? Will I have to sacrifice my morals and values to eventually work for myself as an ED practitioner? Within the entirety of your dietetics education, professors, internship directors, and even working dietitians let you know the importance of maintaining the highest GPA possible to get matched to an internship. On top of that your expected to be greatly involved in a variety of volunteer experiences, working within the nutrition field as a student, as well as balance having a good amount of extracurricular activities. Also as a student, you always hear that getting matched to a dietetic internship is more competitive than getting into medical school (there is approximately a 50% acceptance rate). But the reality of it sets in when you go through the process.

Okay, so I was completing my courses to the best of my abilities, but I was finding more and more that the traditional route of becoming a dietitian was not what I wanted to get involved in, but in order to become a dietitian I knew I’d have to go through the grueling process. So, I finished my courses, in my undergrad program, to the best of my abilities, and graduated in May 2016 with a Bachelors of Science in Dietetics and a minor in Psychology, but I wasn’t ready for the internship process yet. Or better yet, I should say that I felt like I wasn’t going to be accepted into a program because of my grades in my undergraduate program. So the next best option to me was start my Master’s degree. That would then give me another couple years to redefine my path, and figure out what I was suppose to do. At this point I really felt like the ‘scare tactics’ that others try to use on people to get out of the field were working on me. But God had a much bigger plan. I just couldn’t see it.

I began my Master’s degree in August 2016, straight out of my undergraduate degree, and was working as a Teaching Assistant during the first year and a half of my program. After my first semester, I was heavily encouraged by many of the peers in my program to apply to dietetic internships, so I decided in the spring of 2017 to apply.

I got denied.

I felt extremely defeated and started to believe that everything I once believed, and that the dream and desires I had in my heart were never going to come to pass, and I would never get to be an ED dietitian. But God granted my mom the spirit of intervention to encourage me to apply again in the fall of 2017. I decided to take the ‘non-traditional route’. I decided to do a ‘distance-based internship’. This meant that all the work that traditionally the internship directors at universities’ would do to set-up rotations and connect you with preceptors for completion of your rotations, now fell upon me.

Daunting, right? Yes. It was. But I did it.

I contacted many, many, many, many people to find my rotations, and was denied an equal amount of times, but within one month of deciding to apply to Iowa State’s program, I solidified my rotations, my preceptors, and submitted my application through DICAS. So if that wasn’t enough, even after doing all the ‘leg work’ you could still get denied to the program. I had already faced rejection before, but this one felt different. I remember in the three months that I was waiting to hear back from the program, just praying fervently, on a daily basis, out to God that as much as I wanted this for my life, and that I felt in the deepest parts of my soul that God wanted to use my story to bring hope to others, that if God’s will was different than mine, I wanted His more. I would constantly lean upon the scripture that said:

“Be anxious in nothing, but in everything, by prayer and supplication, make your requests known to God, and the peace that surpasses all comprehension, will guard your hearts and minds in Christ Jesus.”- Philippians 4:6-7

and then my favorite biblical scripture:

“Trust in the Lord with all your heart and all the plans you’ve made will succeed”- Proverbs 16:3.

Those two verses granted me the most peace in this process. I knew that God had put this desire on my heart for a reason, and that God would bring it unto the day of completion. And on November 5th, 2017, I was matched to my dietetic internship at Iowa State University. It would start in January of 2018 and last 6-months. It was an expedited program meaning that the typical internship program was almost a year in length (approx. 11-months), mine would be done in 6-months! I was beyond exhilarated. I knew this would be the most humbling, challenging, and beautiful experience as a growing dietitian, and boy was it! A common question I got throughout my internship from my preceptors was “What do you want to ultimately do?” My answer was always the same, “I’ve known since very early on in my undergraduate program that I want to be an ED dietitian, with the ultimate goal of working at the Outpatient/Private Practice level.” This was confusing to some, and many would say “WOW! Good for you. I could never work with such a difficult population.” In which I would respond “ Well I think that’s why there is a place for all of us.” Low-and-behold, not many of them knew that I had such a deep empathy for this population because of my own past with an eating disorder. Thank goodness I did mention my desire to be an ED dietitian because by vocalizing my dream I was given incredible opportunities to engage with patients diagnosed with ED’s in the clinical setting, I got to spend time at the Intensive Outpatient (IOP) level in my clinical rotation, and because I chose to do my internship distance, I was allowed to choose any discipline for my option rotation, in which I chose to do mine with a local ED private practice dietitian. God was truly equipping me even further.

So after months and months of continuing to be pruned, learning, and growing as a future dietitian, I was eligible to sit for the exam. So another little known fact about me was that I have pretty bad test anxiety. Ask me to talk about anything, I can go on and on for hours, but ask me to answer questions on a sheet of paper, or on a computer screen, only one word for that—terrified. So after completing my internship, I waited about 10 days and took my RD exam for the first time.

I didn’t pass.

I was distraught, again. How could this happen? But at least I could wait 45 days and take it again. So I decided to study even harder, day in and day out, and then 45 days later I took it again.

Failed. Again. How?

I felt like I knew everything backwards and forwards. I could talk about any of the given topics, but still I didn't pass. At this point I really did question, was all of this for nothing? Was I going to make it to my dream? Was the feeling that I thought God was laying upon my heart real?

Something inside me knew it was.

In this time, I was still continuously praying that if this path wasn’t what God intended for me to please shut the door, and make it known. But I was like “Okay, I’ll try again”. This time my heart felt urged to set November 5th as the test date. This was about 15 days past the minimum 45 days required to re-test, but something about November 5th felt right. So I went in at 8 am November 5th (I have to remind you that this is merely 2 days before my birthday-seems hilarious to me all the time) and I PASSED!!

I remember the screen popping up with my results and I nearly passed out. I FaceTimed my parents in my car, called my best friend, and all my family members, excited beyond belief. Still to this day, let God have all the glory for getting me through that entire process.

Okay so that’s the first 3 steps, but what about the job? How do I jump into private practice?

Well throughout this entire process of my education I was keeping up with the ED therapist that I saw during my recovery. I was letting her know things like when I graduated, that I was going to grad school, that I got into my internship, and finally I let her know that I became an RD. Now, that’s when she mentioned that we should “celebrate” the next time I was in town. So when that day came, around December 2018, approx. 1-month after passing my exam: we met, chatted, caught up, and she offered me an opportunity to join her practice as the only dietitian in the group. Talk about an opportunity of a lifetime. I had always asked God bring me to the need. And I knew this was where I was meant to relocate and plant myself after graduating from my Master’s degree program.

So all the steps were settled. That was my path, easy enough, right?

Wrong.

I spent the six months leading to my big move getting to work alongside that ED private practice dietitian I mentioned earlier, that I got to work with in my internship. I was leading a support group, which only furthered my experience and desire to work in the field at that level. And on May 4th, 2019, I packed up all my stuff and took the 12-hr road trip back to Texas to work as an ED private practice dietitian.

I’m 6-months into that process now, and it has been an immensely humbling experience. I have more passion and drive than ever that the journey I’ve been on can and will provide hope for others, and that my path was set before I even took my first breath. I have so much faith that God is moving in and through me, and that healing individuals’ relationships with food and their bodies’ isn’t the work of my hands, but the work of the Holy Spirit through me.

God I can’t thank-you enough for the story you’re working through me, and that the ways in which you can use me are even vaster than I can comprehend. You’ve taken all the brokenness and pain I’ve felt through my own self- perception and you’re using it to provide hope for others. Allow my heart to become more surrendered to your will. Let how you speak through me and your truth provide the only true healing. Let all the glory and honor forever be in your name. Amen.

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Tess M Patterson MS RD LD