Diabetes, overweight, food allergies? See a state-certified dietitian
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What is a dietitian?
The dietitian is a healthcare professional whose title has been strictly protected by French law since January 30, 2007. Inscribed in the Public Health Code (articles L4371-1 to L4371-9), this title can only be held by holders of a BTS in Dietetics or a BUT (University Bachelor of Technology) in Biological Engineering with a dietetics option. Illegal practice of the profession carries a penalty of one year imprisonment and 15,000 euros in fines.
The dietitian is the only paramedical professional specializing in food and nutrition. Their training, centered on nutritional sciences, biochemistry, physiology, and pathology, provides evidence-based nutrition expertise. Unlike the nutritionist whose title is not regulated, the dietitian must hold an ADELI number issued by the Regional Health Agency (ARS), guaranteeing verification of their competencies.
The history of modern dietetics dates back to Hippocrates, who already stated "Let food be thy first medicine." In France, the profession became structured from the 1950s with the creation of the state diploma. The AFDN (French Association of Dietitian Nutritionists), founded in 1954, represents the profession and ensures compliance with professional ethics. Today, nearly 15,000 dietitians practice in France in hospitals, clinics, nursing homes, collective catering, private practice, or teleconsultation.
The dietitian's scope of practice covers nutritional prevention, therapeutic patient education (TPE), development of therapeutic diets adapted to each pathology, and support for dietary behavior change. They work closely with doctors, endocrinologists, gastroenterologists, and psychologists for optimal multidisciplinary patient care.
How does a dietetic consultation work?
The first consultation lasts an average of 45 to 60 minutes. The dietitian begins with a complete dietary assessment: gathering medical and surgical history, current treatments, known allergies and food intolerances. The in-depth dietary survey analyzes your habits over a typical week: number and composition of meals, snacking, beverages, preparation methods, meal location, and associated emotional context.
The dietitian then performs an anthropometric evaluation: weight measurement, height, BMI (Body Mass Index) calculation, and in many practices, body composition analysis using bioelectrical impedance. This non-invasive technique measures the percentage of fat mass, muscle mass, body water, and bone mass, offering a much more precise picture than simple scale weight.
Based on this data, the dietitian develops a personalized dietary plan. This program is not a punitive "diet" but a balanced reorganization of eating, respecting the recommendations of the National Nutrition Health Program (PNNS). The plan considers your tastes, food culture, time and budget constraints. For specific conditions (diabetes, renal insufficiency, allergies), the dietitian implements a precise therapeutic diet in accordance with medical prescriptions.
Follow-up consultations (30 minutes on average) are generally spaced 2 to 4 weeks apart. They allow evaluation of progress, adjustment of the dietary plan, resolution of difficulties encountered, and motivation reinforcement. The dietitian uses educational tools: recipe cards, food equivalences, adapted shopping lists, and nutritional tracking apps. Teleconsultation is increasingly offered, particularly for regular follow-ups.
Diabetes, obesity, eating disorders: proven results of dietetics
Evidence-based dietetics is supported by extensive scientific literature. In type 2 diabetes, structured dietary follow-up reduces glycated hemoglobin (HbA1c) by 1 to 2% on average, equivalent to the effect of an antidiabetic medication. The PREDIMED study (2013) demonstrated that a Mediterranean diet supervised by a dietitian reduces the risk of major cardiovascular events by 30%.
For obesity, dietary management is the first-line treatment recommended by the French National Authority for Health (HAS). Regular follow-up over 12 months allows weight loss of 5 to 10% of initial weight, with significantly better maintenance than commercial diets. The dietitian works on lasting changes to eating habits, not sudden caloric restriction, which explains more enduring results.
In eating disorders (ED) such as anorexia, bulimia, and binge eating disorder, the dietitian plays an essential role within the multidisciplinary team. They help restore a healthy relationship with food, gradually reintroduce "forbidden" foods, and re-establish adequate nutritional intake. Their non-judgmental and caring approach complements psychotherapeutic work.
Kidney diseases (chronic renal insufficiency, dialysis) require precise dietary management of potassium, phosphorus, proteins, and sodium. The hospital dietitian is indispensable in these protocols. Similarly, food allergies (peanut, cow's milk, eggs, gluten) require dietary expertise to ensure complete nutritional intake despite exclusions.
When should you see a dietitian?
The dietitian intervenes across a wide spectrum of clinical and prevention situations. As a first line, weight management (overweight, obesity, malnutrition) represents a significant portion of consultations. The dietitian develops programs adapted to individual metabolic needs, integrating physical activity and psychological aspects of the relationship with food.
Chronic diseases constitute a major area: type 1 and 2 diabetes (carbohydrate counting, glycemic index), cardiovascular diseases (low-sodium diet, lipid management), renal insufficiency (protein restriction, phosphorus and potassium control), liver diseases, gout, and hyperuricemia. In these contexts, the dietitian works in close coordination with the specialist doctor.
Food allergies and intolerances require expert dietary follow-up: celiac disease (strict gluten-free diet), cow's milk protein allergy (CMPA) in children, lactose intolerance, peanut or tree nut allergies. The dietitian ensures nutritional balance despite exclusions and supports patients in label reading and daily management.
Pregnant or breastfeeding women, athletes preparing for competition, elderly people at risk of sarcopenia and malnutrition, overweight children, and adolescents with eating disorders also benefit from the dietitian's expertise. In hospital settings, the dietitian manages enteral and parenteral nutrition, participates in multidisciplinary meetings, and develops therapeutic menus adapted to each ward.
Dietitian training and regulations
Dietitian training takes 2 years after the baccalaureate, through the BTS in Dietetics or the BUT in Biological Engineering with a dietetics option (3 years). The BTS includes approximately 1,400 hours of theoretical courses (biochemistry, physiology, nutrition, pathology, legislation) and 20 weeks of mandatory internships in hospital and collective catering settings. Students gain practical expertise with real patients under supervision.
The decree of May 24, 2024 recently updated the list of diplomas, certificates, and titles allowing practice of the profession. This update confirms the authorities' commitment to maintaining high standards. Registration in the ADELI directory with the ARS is mandatory before any practice, whether employed or self-employed.
The dietitian can work in multiple contexts: hospitals and clinics (therapeutic nutrition, hospital menus), nursing homes, rehabilitation centers, collective catering companies, private practices, health centers, and increasingly in teleconsultation. Continuing education is encouraged, particularly through the AFDN and CPD (Continuing Professional Development) organizations.
To verify that a dietitian is properly qualified, ask for their ADELI number (format: 9 digits starting with the department number). You can also check their registration on the Ameli.fr health directory. On PratiConnect, all dietitians are verified: ADELI number checked, diploma attested, and patient reviews authenticated for complete transparency.
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