Gina Schnathorst (Host): Welcome to the Iowa Specialty Hospitals and Clinics ISH DISH podcast; practical health advice from Iowa Specialty Hospital experts. We want to connect the members of our communities with the latest healthcare information that's understandable, relatable, and useful to your daily life.

We are very happy to welcome with us today Anthony Kinley. Anthony is a Registered Dietician with Iowa Weight Loss Specialists in Des Moines, and we are going to run through some very interesting topics. Just to highlight a few of those how do you avoid feeling overwhelmed by conflicting nutrition recommendations?

The importance of having the right mindset, common misconceptions about nutrition and dieticians, promoting a healthier relationship with food, encouraging people to look at the whole health picture, not just the scale. Not always easy to do. And personalization with nutrition counseling. So welcome to the podcast, Anthony.

Anthony Kinley, RD, LD: Yes, thank you for having me.

Host: Yes, absolutely. So why don't you give us a little rundown of your title, background, and how you came to be with Iowa Weight Loss.

Anthony Kinley, RD, LD: Yeah, so I'm a Registered Dietitian here with Iowa Weight Loss. I work in the Des Moines Clinic, the Bariatric Clinic and Medical Weight Loss Center. My route was a little, I would say unorthodox. So I went to school to become an accountant. And then I quickly transitioned to dietetics because I had this interest in me.

And then I graduated from my undergrad and I became a facility manager for four years. And then I decided to go back to school about two years ago, pursue my Master's and got my Master's in Food and Nutrition, did my Dietetic Internship. And then a short 12 months and two jobs later, I ended up here at Iowa Weight Loss.

Host: Wonderful. We are very happy to have you. So welcome aboard. That's a big jump from accounting to nutrition.

Anthony Kinley, RD, LD: Yes, a very big jump. Yeah, I wasn't a big fan of sitting behind a desk and just crunching numbers all day.

Host: I can attest to this, my mom did the same thing. She was a CPA, and then she went back to school to get her MBA in Nutrition and Food Science. Food Science and Nutrition, so, you're not alone.

Anthony Kinley, RD, LD: Yeah, that's awesome.

Host: Alright, well let's jump into it. We have an interesting program at Iowa Weight Loss Specialists that encompasses the many facets of losing weight. It's not just the dieticians or your provider telling you, you need to go lose weight, which I think happens quite often when people go in to visit their medical doctors, their family practice providers, but they never really tell them how to do it. And I feel like that's what really separates us at Iowa Weight Loss Specialists, is that we have a team that works with the individuals.

They see their practitioner, then they see a mental health counselor, they meet with the Registered Dieticians. We're doing the whole roundabout, looking at the whole person as opposed to just telling them stop eating bad food. Let's just talk about how do you avoid feeling overwhelmed by conflicting nutrition recommendations?

Anthony Kinley, RD, LD: Yeah, you know, that's a really good topic especially in the world we live in right now, right? There's so much information out there and it can be very overwhelming. I mean, even for health professionals, it can be very overwhelming for multiple reasons. And you go on a simple Google search as to is fruit good for me?

You're going to see everything from yes to no to who knows what in between, and how do you navigate that? The best way I usually recommend people is looking for people who are credentialed. And by credentialed I mean that are like actually Registered Dietitians. That's the first step. And then from there, listen to advice that is nuanced.

A lot of times we get one side or the other when it comes to answers. But a lot of times, I mean science isn't perfect. There's no such thing as a solution and there's a lot of trade offs depending on what side of the spectrum you end on, right? So it ultimately comes down to you. What fits in your life? And then how is that going to be sustainable for the rest of your life too? Because I think that's a big thing is a lot of times people can fit stuff into their life, but is it sustainable? And we're not just the short term.

Host: I feel like that word sustainable is a really important one because I've been down this path myself. It's not that hard to lose weight. But it is extremely difficult to sustain that lifestyle that got you to that point.

Anthony Kinley, RD, LD: Yeah much so.

You know, the concepts are few when it comes to weight loss, but the methods are many. And that's kind of the beauty, but also a hard thing to navigate on your own.

Host: When we talk about sustainability, what about having the right mindset helps or hinders that? Like for me, for example, all or nothing mentality, that does not work. So what do you recommend?

Anthony Kinley, RD, LD: A lot of cliche things. So progress over perfection, right? But a lot of times I think these cliche sayings it's kind of similar to science, it doesn't give you the nuance of everything, right? So, when I say progress over perfection, I go into depth about how that also requires patience, that also requires ups and downs. We know that as individuals, but it's also having help throughout the process of it all. And I think that's where Iowa Weight Loss really sets themselves apart from other weight loss clinics is that, like you said, we have that team of nurses, providers, mental health therapists, and dietitians that are all here to be by your side and walk you through that, and to give you ideas of how to maybe plug things into your life that, again, fit well for you and not maybe everyone else.

Host: I like that idea because I don't really want to come in and have you tell me that I'm eating all the bad things and stop eating my favorite foods. Are you going to more than likely recommend that everything in moderation?

Anthony Kinley, RD, LD: Yes and no.

Host: Tell me the truth.

Anthony Kinley, RD, LD: Yeah. I mean, in general, moderation is a good thing to have, right? Moderation is key. That's a common thing you hear. I often like to start my consults off by saying, Hey, I'm going to be the food police, just to like, make people, tighten up a little bit. And then I say, I'm just kidding. I'm just here see what we can do to add to your life. The best way for me to get through to people that come into the mindset that I'm going to just be that food police is to say, we get to certain places because we add, let's say, using weight as an example, a lot of times it's adding a certain habit, adding a certain treat, being reinforced over time, over time.

What I want to do is to add maybe a slightly better habit, a slightly better food, and then reinforce that over time, over time. Maybe the weight will start to, the number on the scale will start to come down with it, but at the same time, we're gaining so many good habits over a year, over two years.

Host: I'm gonna go out on a limb here and say that you probably are not recommending fad diets.

Anthony Kinley, RD, LD: I am not. Something fits in someone's lifestyle, we can talk about it, but odds are I'm going to try and detour them to maybe only doing a little bit of that, but also finding something again that is a key factor into weight loss in the lifestyle.

Host: Right. One of the things that I mentioned earlier in the podcast was that, we have this team and we work mental health and nutrition counseling. I think that's a perfect marriage. Talk to me a little bit about how do you promote a healthier relationship with food? Is that very mindset based? Because, my husband at one point says, you know, I'm not hungry. I don't feel it, but my taste buds are hungry.

Anthony Kinley, RD, LD: Yeah, using that mindset word, I often tell patients that mood follows action. And what I mean by that is doing the thing typically changes your mood and your feelings towards it versus thinking that when I feel good, you're going to start doing it. So a lot of times, whether you have a great mindset or a mindset that we need to talk through and try and get over some hurdles, we just have to start doing something. Now that something looks different for everyone, right? It could be as simple as when you go to the cupboard because you don't, you aren't hungry, but you're usually going at that same time of the night. Maybe we realize that and just step outside and then come back inside. It might not stop you from choosing to eat something at night, but what we're doing is adding detours to your typical route.

Host: That makes a lot of sense. And then when you figure out that you're going to make it, you're going to wake up the next day and it's all going to be okay. That's big because we do, we're so ground in our own habits.

Anthony Kinley, RD, LD: And that's where I also mention though, like, yeah, when you wake up the next day and realize, wow, I feel good. I felt good about that. We either like you to write that down, but pen to paper. Pen to paper is such a powerful tactic. Just realize it, but at the same time, it's probably not going to inhibit you from wanting to do that same thing that night.

Host: Yeah.

Anthony Kinley, RD, LD: It takes a lot of time to break those habits that have been reinforced for who knows how long. We're not just holding your hand and helping you through this process. We're really trying to make you more aware and understanding that we can get to where you want to be, and you can get to where you want to be. But it will be challenging.

Host: Do you then recommend keeping a food journal?

Anthony Kinley, RD, LD: Here and there. So what I like to say is, short. So there's a food journal, where you put pen to paper, is what I usually say, or food tracking, where we can use like a phone application.

Host: Sure.

Anthony Kinley, RD, LD: Whichever route we go, I always recommend that we invest one to two months, four to eight weeks of being as diligent as possible to that. And then after we invest that time, I like to say, just like our checking account, let's audit that. Okay, so once a month, one or two times a month, let's go back and audit and make sure that our portion sizes are still on track. Maybe we added something new to our diet, just so we kind of have a general awareness of what we're actually putting into our bodies. A lot of times, we just aren't aware.

Host: So then how often do you meet with the patients?

Anthony Kinley, RD, LD: So we'll meet with patients anywhere between two weeks to eight weeks, depending on the type of patient. Here at Iowa Weight Loss, if you're a bariatric patient, so if you're going through weight loss surgery, then we'll see you at an incremental timeframe leading up to your surgery and after your surgery.

But if you're on the medical weight loss side, so if you're not going through the surgical process, then we can meet with you, typically with the providers, every four to eight weeks. And then a dietitian can also see you between each appointment. So that's where the two weeks to eight weeks comes in.

Host: Okay. And are you the one then that's setting up like a calorie limit? For example, like I use, one of the fitness and nutrition trackers on my phone. And, you know, it kind of starts you off at here's your daily allotment of calories. Are those really accurate or is that something that you're going to help with to get somebody started?

Anthony Kinley, RD, LD: Yeah, a lot of times those are based on algorithms and calculations, that don't take the full picture into effect. So here we have our own calculations. We also have what we call a metabolic rate. We can even test and get a prediction as to are these calculations that are based on the average going to be accurate for you or not?

And it gives us a good idea as to where that range is best for you. And then we'll work through that with the patient as well. Now I will say, a lot of times we don't start with calorie goals or anything like that. We usually start with like one macronutrient. We really want to focus on protein at the start, or maybe increasing fiber at the start.

And then, you know, our second, third, or fourth appointment down the road, we'll talk about calories a little bit more. But we really like to make this as holistic or full picture as possible. And then we kind of get into the nitty gritty of everything.

Host: I feel like that is a really good point because I think there are so much probably misinformation out on the internet, social media about nutrition. And it's very easy, myself included, to get sucked into these influencers, if you will, even the dieticians online. They're not looking at me. They're just talking you know, in general. And I feel like that's a huge advantage that somebody would have coming to Iowa Weight Loss, is that you're going to treat me based on my needs, my activity, all the things.

Anthony Kinley, RD, LD: Yeah. And that's one of the powerful things also having a team of dieticians and a team of providers is that let's say you come in. And for some reason, you just don't feel that I'm the best dietitian to work with you. Well, I have three other dietitians here that you can meet with the next time, or even one to two virtuals that you can meet with.

We have a whole team that's here to see what fits best with you. And then once we get the plug in, we can start to play, right? Let's find the puzzle pieces that work well for you, and then we can really play around with it.

Host: So if I come into Iowa's Weight Loss and I meet with one of the providers and then I meet with you as the Registered Dietitian. Are you guys sharing information then?

Anthony Kinley, RD, LD: Typically, the provider and dietitian will always be sharing information, to make sure that we're all on the same page and providing similar advice. As far as sharing information with the dieticians, we don't really give out too much unless we know someone's going to see them instead of us. Obviously, they always have access to our notes. Say we run through something we haven't really seen in a while or are familiar with, then we'll, turn around and start talking to each other about what's the best way to move forward with this.

Host: Right. I like the accountability part of that. That you guys are sharing that information and so the left hand knows what the right hand is doing and you guys are using both of those hands to do the best thing for the patient. I want to end today's podcast by giving little a question that you ended here that you gave me and it says, I know what to do, but how would you fill that in?

Anthony Kinley, RD, LD: Yeah, so when it come to I can do this but... We hear everything under the umbrella, right? There's always going to be buts. Most of our patients are adults, and if they have children, what I like to do is, let's sync to your child, right? They start an activity or a sport because they want to, and a week in they think, oh, I don't like this. I want to quit. A lot of times those parents will say you have to see it through right? Now, why is that different for us? When we started this weight loss program that even though there's something that I don't want to do because of X, Y, and Z, I'm too busy, kids, whatever the case is, why does that mean you can do that even though you're asking your children or someone else, or expect that of someone else?

It comes down to practicing what you preach. And I think that gets through to a lot of people. Last thing I'll mention is, I mean, most of us consider weight loss or consider doing something, whether you want to come to Iowa Weight Loss Specialist or not, whether you want to reach out to a dietitian or not, if you're thinking of doing something, just give us a try.

Like I mentioned earlier, mood follows action. There's never going to be a good time. You know, all of us know there's never going to be a good time, but if you can take one small step, one small step, one small crawl, and then see if you can start walking, and then maybe it'll lead to running, and whatever it is, you just gotta start doing it, and hopefully that mood will start to come with it.

Host: Perfect. Great advice. If somebody wants to make an appointment for a consultation to see you, can they do that separately or do they need to be part of the overall program of being either in the medical weight loss or the surgical weight loss program?

Anthony Kinley, RD, LD: The way we have it set up currently is that you do need to see a provider before you're able to follow up with a dietitian. We typically ask that you see a provider once every three months and you can see a dietitian however many times in between there.

Host: Okay, perfect. Well, thank you so much for your time and your talent today. We appreciate it. I could go on and on and ask you a million questions, I'm sure. It's a fascinating subject and one that pretty much affects all of us. So, thank you so much.

Anthony Kinley, RD, LD: You're welcome. Thank you for having me.

Host: If anybody wants to get more information, you could look on the internet at iowaweightloss.com or their number is 515-327-2000. And they also have a health risk assessment on the website at iowaweightloss.com. You could fill out that assessment and see where you fall either under the medical weight loss or surgical or maybe you're doing just fine and that's good free tool to kind of let you know where you are.

Thanks again, Anthony. We appreciate it.

Anthony Kinley, RD, LD: Yeah. Thank you. Have a great rest of your day.

Host: You too. Thank you for listening to Iowa Specialty Hospitals and Clinics ISH DISH Podcast. For more information on the topic we discussed today, visit us on the web at iowaspecialtyhospital.com. There, you can read a transcript of today's episode or previously aired episodes, as well as get the latest news from Iowa Specialty Hospitals and Clinics and explore all of the services that we offer. For the ISH DISH Podcast, I'm Gina. Thanks for tuning in.