As dietitians, the foundation of our work lies in understanding our clients’ unique needs, goals, and challenges.
The initial intake process is more than just gathering basic information—it’s the key to building a strong, trusting relationship and crafting an effective, personalized nutrition plan.
This is especially true when working in nutritional psychology, where the mind-body connection plays a crucial role in overall well-being.
In this post, we’ll explore the essential questions that dietitians should be asking new clients to gain a comprehensive understanding of their health, habits, and lifestyle. By the end, you’ll be equipped with a robust framework to ensure your intake process is thorough, insightful, and tailored to each individual you work with.
Table of Contents
Understanding the Client’s Background
Knowing your client is always important, but the first step is understanding the chronic conditions they have or are worried about in the future. Family history and environment are big factors in this.
Medical History
Ask about:
- Chronic conditions (e.g., diabetes, hypertension, mental health diagnoses).
- Previous surgeries or hospitalizations.
- Current medications and supplements.
Family Health History
Predispositions to conditions like heart disease, diabetes, or mental health disorders are important to understand, though they are not necessarily sentences.
Even clients who are adopted could have insight into learned behaviors that may impact their health.
Social Determinants of Health
Ask about:
- Socioeconomic status, food access (and history of food access), and support systems.
- Ability and willingness to cook.
- Day-to-day activity level.
- Have they had any changes in how they feel?
Sample Questions
- What percentage of your meals are made at home?
- Do you ever worry that you can’t afford food?
- How physically active is your job?
- What physical and mental health conditions are prominent in your family? Have you been diagnosed with any of these?
- What medications have you been prescribed? Are you taking them according to instructions?
- Are you taking any supplements? Which ones? And what for?
- When was the last time you felt well? What caused the change?
Assessing Dietary Habits and Nutritional Intake
Obviously, we need to learn about their current dietary habits, right? But more than just a food frequency questionnaire or a 3 day food recall is necessary.
Current Eating Patterns
- Meal frequency, snacking
- Food preferences/aversions
- Frequently eaten foods
Meal Preparation
- Who prepares the meals in your house?
- Do you have time for meal prepping or planning?
- What do you find difficult about feeding
Special Diets
- Vegetarian, vegan, gluten-free, low FODMAP, religious restrictions, etc
- Food allergies or intolerances.
Previous Nutrition Counseling
- Any past experiences with dietitians or nutritionists and their outcomes.
Past Dieting
History of diet attempts (Atkins, Keto, Weight Watchers, etc)
Sample Questions
- How often do you eat throughout the day?
- Do you snack? If so, what do you choose the most often?
- Have you received nutrition counseling in the past? If so, what was it for? How did it go? Did you learn anything? Did you make any long-term changes?
- What diets have you tried in the past?
- What percentage of your meals were made at home?
- Are you involved in food-related decisions?
- Have you been instructed to follow a specific diet?
- Do you have any dietary preferences, such as vegetarian or gluten-free?
- Does your religious practice involve any dietary restrictions?
- Do you have any food allergies or intolerances? If so, do you avoid these foods?
Evaluating Mental and Emotional Well-being
This is where I think dietitians get hung up sometimes. Sometimes scope of practice feels murky and underdefined. So we don’t step out of the box we were taught in school.
Mood and Stress Levels
- How the client feels on a daily basis; common stressors.
- Do they have a stress management routine?
- Any diagnosed or suspected mental health conditions.
Eating Behaviors
- Relationship with food
- Eating style
- Food “rules”
Lifestyle Factors
- Sleep patterns
- Movement
- Work-Life Balance
- Creative Outlets
- Social Interactions
Sample Questions
- How do you manage stress? Do you feel like you manage stress effectively?
- Describe your relationship with food.
- Do any of these apply to you?: fast eater, binge eater, carb avoider, clean plate club, confused about nutrition advice, juggle nutrition needs and preferences with other family members, etc. (I have a list and asked them to check the ones that apply.)
- How do you express your creativity?
- Do you have any pets?
- What types of movement do you do? Or enjoy? Do you have any medical restrictions on exercise?
- Do you wake up feeling rested?
- How do you feel about your body? (I have a scale from hatred to love; anything lower than neutral causes my form to skip certain questions.)
Exploring Nutritional Goals and Motivations
It’s SUPER important to make sure we don’t push our own thoughts and goals onto our clients.
Client’s Short-Term and Long-Term Goals
- Managing chronic conditions (diabetes, blood pressure, cholesterol)
- Weight management
- Improve energy levels
Motivations and Barriers
- Client’s Short-term and Long-term Goals
- Weight management, energy levels, managing a specific condition, etc.
- Motivations and Barriers
- Reasons for seeking dietary counseling and any perceived challenges.
- Client Expectations
- What the client hopes to achieve and their timeline for results.
Assessing Nutritional Knowledge and Education Needs
- Current Nutritional Knowledge
- Understanding of nutrition basics, common myths or misinformation they believe.
- Education Needs
- Areas where the client may need more guidance (e.g., meal planning, label reading, understanding macronutrients).
Identifying Red Flags and Areas for Further Investigation
- Physical Signs
- Unintended weight changes, digestive issues, fatigue, skin or hair issues.
- Mental Health Concerns
- Signs of depression, anxiety, or other mental health issues that may need a referral to a specialist.
- Eating Disorder Indicators
- Signs that suggest a more in-depth psychological evaluation may be needed.
Conclusion
The intake process is a pivotal moment in your relationship with a client, setting the stage for all the work that follows.
By asking the right questions, you can uncover critical information that informs your approach, identifies potential red flags, and helps you tailor your guidance to meet your client’s unique needs.
Remember, a well-rounded intake isn’t just about collecting data—it’s about understanding the whole person sitting across from you.
As MNT for mental illness continues to evolve, so should our intake methods, ensuring they remain relevant and responsive to the complexities of modern health. I encourage you to revisit your intake questions regularly, adapting them to reflect new insights and research.
Have any questions or insights to share? Do you ask questions that aren’t on this list? I’d love to hear your thoughts in the comments below!
