Why diets fail so reliably

Every highly restrictive diet works against two major forces. The first one is physical: when you maintain a continuous calorie deficit, your body lowers its basal metabolic rate and increases your feelings of hunger. That is not your imagination, but rather a measurable physiological adaptation.

The second force is practical. A plan that cannot survive invitations, the office canteen, a lack of time, and holidays simply cannot be maintained in the long term. If you rely on lists of forbidden foods, you are constantly relying on willpower. And willpower is a limited resource!

That is why the crucial question is not how much weight you lose in eight weeks, but rather what changes you will still be making in a year's time without even thinking about them.

The difference between nutritional counselling and a diet

In Austria, these are two entirely different things, and the distinction is legally regulated. General nutritional counselling is aimed at healthy people who would like to change unfavourable habits. [1]

Dietetics is something else entirely: a medically prescribed nutritional therapy for individuals who are already ill or suspected of having an illness. Dietitians belong to a legally regulated healthcare profession with specialized training, and they work with nutritional diagnostics rather than just general diet tips. [2]

In practical terms, this means it all starts with a thorough assessment. We will look at your food diary, lab values, pre-existing conditions, medication, daily routine, and working hours. Only then is a plan created, and it is tailored specifically to your week, not some unrealistic ideal.

When nutritional therapy is medically beneficial

There are several situations where a change in diet is a proven part of medical treatment and not just a good resolution:

• Type 2 diabetes and prediabetes. Nutrition and exercise are the fundamental therapy here, not just an afterthought. [3]

• Obesity. Treatment relies on a combination of nutritional, exercise, and behavioural therapies. [4]

• High blood lipids and high blood pressure, where dietary changes can help reduce or complement your medication.

• Coeliac disease, irritable bowel syndrome, and food intolerances, where cutting out foods without a clear strategy often does more harm than good.

• Malnutrition, for example after surgery, in chronic bowel diseases, or in older age.

What it costs

Let's be completely honest: the costs of private nutritional counselling are generally not covered by public social security providers. [1] That is why our dietetic services are offered privately, and they are available to you following a prior medical consultation. This isn't a hurdle, but rather makes perfect medical sense: a tailored nutritional plan is only truly valuable once we clearly understand what is going on.

What actually happens in your first session

Your first session is almost entirely about listening. We will explore what you eat on a normal day, when you eat, the gaps between your meals, how you work, how you sleep, and what you have already tried. We will also look at any pre-existing conditions, medication, and current blood test results from your medical assessment.

Only after this is a plan created, and we deliberately start small! Two or three changes that fit easily into your daily routine are much better than ten changes that you abandon after four weeks. Common first steps might include ensuring a reliable source of protein with every main meal to keep you feeling full longer, setting a fixed breakfast time for fluctuating blood sugar, or finding a realistic way to handle the canteen and dining out rather than banning them altogether.

After about six to eight weeks, we will fine-tune things together. What worked well will stay. What didn't work won't be forced with more discipline, but will be replaced with a better solution.