Is Being a Dietitian a Job for Wives?

How dietetics & the patriarchy go hand in hand.

Photo by Alvin Mahmudov on Unsplash

I would not have become a dietitian without the financial support of my husband.¹ I hate this fact, but it is true. You need resources to get through years of education and an unpaid 1,200-hour internship (that you have to pay for). It is much easier to "follow your dreams" into a field where the median salary is $61,650 — about half of what a nurse practitioner or physician's assistant earns — if you have a partner to help with housing, food, and childcare costs.

I am not the only dietitian to notice and lament this. Heather Caplan of

No One Talks About

, in her podcast conversation with dietitian Alissa Rumsey about money, success, and business fails, brings up the privilege of being able to go into a field knowing that you likely won't make a lot of money, and links that to the cultural norms of the mainly white, economically secure women who populate dietetics. 

Alissa agrees, and specifically ties it to the economic security of having a partner:

This is something I get point-blank asked a lot. I've heard this. I remember when I was kind of thinking about leaving my job and starting my business, and everybody at that time — this was eight to ten years ago — everybody that I knew who had their own business had a partner who made money, and they were on their health insurance. So they could do part time, and that would be fine, or take time to build it up.²

Some dietitians don't see a problem with their privilege. When I spoke with a Black dietetic intern about her experience as a nutrition student (linked below), she told me about an adjunct professor in her program who worked in community nutrition, a notoriously underpaid space, yet constantly talked about how she couldn't survive without her nanny taking her children to afterschool activities, a lifestyle that was apparently funded by her husband's earnings. In class, she told students that in order to be a dietitian, you needed resources either from family or "a rich spouse."

"It kind of discouraged me," the intern told me. Understandably!

What Is It Like to Be a Black Dietetics Student?

But it goes deeper than a problematic professional pathway that requires access to either generational wealth or a rich partner to survive. I had a light-bulb moment in 2019 at an unlikely location: the Pentagon Barracks in Baton Rouge, Louisiana, in the offices of the lieutenant governor. I was there as a dietetic intern with a group of Louisiana dietitians, advocating for increased Medicaid reimbursement for nutrition-related care. We were a group of mostly young women talking to a group of older, mostly white, conservative, male legislators. Some legislators appeared to be there mainly for the free breakfast, but others were interested in speaking with us. I chatted with an affable man who told me, "I love dietitians! My brother's wife was a dietitian."

Zap! Suddenly it all made sense. Why this whole event felt vaguely patronizing, like we were being patted on the head. Why the pay for dietitians in Louisiana is punishingly low. Why so many entry-level clinical job openings I saw were part-time PRN positions that did not provide enough hours to make a livable income. For these men in power, being a dietitian was a job for wives. We were there as women asking for more pocket money, not working professionals asking for fair compensation.

Modern dietetics is an offshoot of home economics, born in the late 1800s as an acceptable avenue for the education and career aspirations of economically secure white women, who most of the time did not need to financially support themselves or their children, because they either had husbands or were supported by their families. That legacy is still alive and well, clearly, even if it is not as explicit as it was in 1906 or even in the 1960s, when former president of the Academy of Nutrition and Dietetics, Evelyn Crayton, was in college. According to U.S. News & World Report:

Crayton, who attended Grambling State University in the 1960s, excelled in her science classes, and one of her professors wanted to give her some advice. He suggested that, instead of becoming a professor, she should consider home economics because men wanted their women to cook, clean and have children. She wasn't offended. "This was the '60s," Crayton laughs. "We hadn't become liberated women yet."³

And we still haven't. Instead of pushing back against the patriarchy, which devalues a profession in which over 90% of practitioners are women, dietetics reinforces its norms and values. Dietetics puts scientific knowledge on a pedestal, without acknowledging the limitations and biases of nutrition research, in which white men have historically been the people both creating and participating in studies, and whose bodies are considered the default. (See the essay on the Mediterranean Diet below for more on that.) Cultural food and nutrition knowledge, often held and communicated through generations of women, is not valued, and is instead often questioned, undermined, or even ridiculed.

The Mediterranean Diet Is a Whitewashed Fantasy

The fatphobia of our field is another way dietitians uphold patriarchal values, as Lucy Aphramor and Jacqui Gingras explain in their chapter of The Fat Studies Reader. "Why do dietitians concern themselves with regulating fatness?" they ask, and:

Why are we averse to engaging with feminist understandings of physicality and fatness? Is it because we are a relatively young and largely female profession still intent on proving the patriarchal worth of our ideological passport?

They go on to describe an advertisement from the Dietitians of Canada, which touts dietitians as "an essential part of a balanced eating plan" and, in smaller print, promises that you can trust their advice because of their university education.

Underpinned by a coercive appeal to the authoritative status of (a biased) science—and shored up by reassurances of explicitly male-identified academic expertise and a corollary ghost line that is inherently disempowering insofar as it seeds insecurity by casting suspicion on the value of existing forms of women’s nutritional know-how—the message is that the untutored reader-eater should proceed to their next bite with caution.

Traditional dietetics education teaches that dietitians should impose control on women's bodies, especially fat women's bodies, through meal plans and metrics. We should not trust women's appetites or instincts. We know better, because science. It is important that women who are not dietitians also believe this, because in this belief lies power.

Where does the attenuated power of white women express itself in dietetics? Mikahelia Wellington, a Black dietitian, describes it in a series of vignettes in her paper "Karens: Examining White Female Power Dynamics in Dietetics." The Karens described will be familiar to any nutrition student or intern, particularly if you are BIPOC; there is gate-keeping, irrational rage at being questioned by a subordinate, and the assumption that the student or intern brings no useful skills or knowledge.

Because of Karen’s need to be heard and obeyed, she is both fragile and dangerous. For POC, and particularly if you are Black, the consequences of not obeying a Karen can be the difference between freedom vs. incarceration or life vs. death. In dietetics, it would be the difference between receiving a good grade and a poor one, obtaining a placement or not, having your Integrated Competencies for Dietetic Education and Practice (ICDEP) signed off or not, or being hired or fired or not “the right fit for the organization.”⁴

If the patriarchy allows a woman some small amount of power, sometimes she feels she must wield it like a weapon, or it will be taken away.

Sometimes she thinks the power she has been allowed means she is somehow better than those denied it.

These practices and beliefs are deeply rooted in the culture of dietetics — from its very origins. Can we change it? It starts with talking about our complicity with patriarchy.

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1. The culture of dietetics is shaped primarily by cis, white, heteronormative values. In the US, our most recent demographic survey only allowed respondents to choose between the gender categories of female and male. We have a lot of work to do to make the field more inclusive.

2. For the record, Alissa did not have a partner to fall back on when launching her business. Also, I recommend the podcast episode if you, like me, love hearing people talk openly and honestly about money.

3. It should be noted that Crayton is Black, and the history of funneling women into this field is not exclusive to white people. It should also be noted that according to this profile in Today's Dietitian, Crayton was married when she completed graduate school and her dietetic internship. So relying on a partner during your dietetics education and internship is also not exclusive to white people.

4. Wellington, M. (2021). Karens: Examining white female power dynamics in dietetics. Critical Dietetics, 6(1). Read the full paper here.