IRMC Wellness Lesson

T hose in the Indiana, Pennsylvania, region hoping to lose weight, live healthier or get their nutrition in order after being diagnosed with a health condition such as diabetes or Celiac disease have a resource available at Indiana Regional Medical Center.

Rebecca Williamson, a registered dietitian in the corporate and community wellness department, says IRMC offers several group-based classes. One such class is Journey to Lean, a 12-week weight-management program. Another is Why Weight, a six-week program focused on a low-calorie diet with meal replacements.

IRMC also offers coordination with patients undergoing bariatric surgery.

“With the bariatric surgery, one of the rules with the insurance is that (the patient) does have to follow-up with a registered dietitian and a medical team for six months before they can even qualify for surgery,” Williamson says. “So we get them at the very beginning.”

She says the dietitians follow the patients for a full six months before surgery, as well as afterward.

“It’s a very close-knit group of people, because you develop a close relationship for most of a year with them,” Williamson says. “With bariatric surgery, we primarily focus on the gastric bypass, which has a lot of food restrictions after surgery.”

This includes informing and directing patients on: portion sizes; putting proteins first, as well as making sure they are good, quality proteins; and developing meal plans, so they can continue to be successful after they have surgery.

Along similar lines, Williamson says IRMC also offers individual-based health coaching with one-on-one meetings between a client and a registered dietitian. IRMC also offers one-hour consultations with a dietitian, however, that’s geared more toward disease management.

“We cover things like diabetes, high cholesterol, Celiac disease, morbid obesity — it’s more of a medical-type session,” Williamson says of the dietary consults.

“Generally, for the one-on-one sessions, the patients who go to those want a structured meal plan or maybe a structured exercise plan,” Williamson says. “With the dietary consult, their doctor may give them a referral, saying they need to go see someone because their cholesterol or blood pressure is too high, or they have been diagnosed with something that can be treated through diet.”

For sessions such as those, Williamson says she typically starts by asking the patient to do a “24-hour recall”.

“I have them tell me what they eat during the course of the day, and then I go through the food groups and show them good carbohydrates versus bad carbohydrates — and the role that they play in the body and how they are important,” she says. “Also, the role of protein in the body, and how that is important, and why vegetables and fruits that contain antioxidants are important in fighting diseases.”

In other words, it’s a crash course in nutrition.

For dietary needs, the conversations may be geared toward targeted areas. For example, with diabetes, she says the focus would be on carbohydrates and the timing of one’s meals. For someone with Celiac disease, she would focus on eliminating gluten from the diet.

These sessions help clients create an individualized meal plan and come up with an action plan. If the person who has Celiac disease used to eat toast for breakfast every morning, what is a suitable substitute?

“That’s where I come in, either giving them gluten-free options or other options they can have for breakfast,” Williamson says.

Another situation: The client, who has diabetes, travels a lot — which means he or she is dining out frequently.

“That meal may not be at (a certain hour) all the time,” Williamson says. “So we have to go through packing certain snacks, so they can eat every 3-4 hours, especially if they are taking insulin.”

Meanwhile, for the group classes, Williamson says 30 minutes of exercise is planned into each session.

The sessions also teach the participants how to get the most out of their exercise, and how diet plays into it.

“For someone who is maybe exercising but is still eating fast food, it is showing what they are burning on the treadmill compared to what they are eating at McDonald’s — and how those calories cancel out their workout,” she says. “Anybody can walk, for the most part. But sometimes that is not enough. So, it’s showing them what they can do on the treadmill to make it a better workout. Or, how to use the elliptical and the more calories that are burned on a more difficult machine, compared to an easier machine. Showing them how they can utilize equipment or free weights at home that can burn more calories so they can get more out of that 30- or 60-minute workout than maybe spending an hour-and-a-half walking on a treadmill.”

Williamson says the IRMC Wellness Center also has a full gym that patients use for these classes. Some sign up as members even after the class ends, which can be beneficial as all three of IRMC’s dietitians are there and can continue to offer advice.