Expanding the Arena - January Edition

Matt Stranberg is the lead dietitian and exercise science advisor for the Walden GOALS program. The Walden GOALS program is an athlete specific eating disorder intensive outpatient program. Matt’s main job duties include conducting nutritional and exercise science assessments, individual counseling, hosting educational groups for athletes, coaches and parents, hosting meals and food exposures, and writing and implementing nutrition and training treatment plans.

He is heavily involved in writing the curriculum for the program, treatment collaborations, communicating progress, and and continuing care plans on an ongoing basis to the patient, family, treatment team, referral source, and other individuals involved in the patient’s care.

In addition to these activities, Matt participates in weekly treatment team planning, discharge planning and liaison services with the dietary department. Outside of the GOALS program he conducts workshops, seminars and engages in marketing and prevention efforts in the community.

What is your educational background and how long have you been an RD? Do you have any additional credentials relevant to your position?

I received my Bachelor of Science in Kinesiology with a minor in History and my Master of Science in Applied Exercise Physiology and Nutrition. I have been a registered dietitian for 3 years and a certified strength and conditioning specialist for 7 years. I utilize all of these aforementioned degrees in my daily practice as each athlete requires knowledge of the science and art of training and nutrition in a wide variety of contexts. Although I am not credentialed in the fields of psychology, counseling, and motivational interviewing, I often devote most of my study outside of work to learning more in these areas, as they are critical to understanding and assisting my program’s demographic.

How did you achieve your position/ how did you get started with your current position?

After completing my dietetic internship, I brainstormed an idea to combine my background in strength and conditioning with my love of nutrition, counseling and psychology. I applied for a part time inpatient position at Walden Behavioral Care and pitched the idea for athlete specific eating disorder treatment with my esteemed colleague Paula Quatromoni. Walden’s CEO Stuart Koman was interested, and after a couple months of preparation, we launched the program and began treating athletes from a wide range of backgrounds.

What key areas of knowledge/experiences did you need to have before this job?

It has been critical to be well versed in training and nutrition theory as well as first hand application. Before becoming a registered dietitian, I was a lifetime athlete and coach, and competed seriously in a wide range of sports. In my past life, I trained to be an elite powerlifter and strength and conditioning coach, but a back injury inspired me to diversify my skill set. Without thousands of hours studying in the classroom and applying in the weight room, I would not be able to appropriately understand or assist my athletes. Studying nutrition and training concepts is simply not enough as most of training and nutrition relies heavily on the art of application and the rigorous empirical methods developed over many years of intense work in the trenches. Additionally, past knowledge and application of psychology, counseling, and motivational interviewing has proven absolutely critical in the field since optimal training and nutrition plans cannot be implemented without facilitating behavior change. This is especially true of athletes who struggle with eating disorders and mental illness.

What are the highs and lows of your position?

The highs involve exercising my creativity and knowledge to help create a program that can help athletes overcome mental illness and the opportunity to collaborate with the athlete and the team during their recovery process.

The low of the position is the mountains of paperwork needed for documentation required by insurance. This is standard in the medical field but annoying nonetheless.

What is a typical day for you?

Before athletes arrive for an evening in the GOALS Program, I spend time with my colleagues discussing our educational strategies and individualized athlete care plans. Once program starts, I facilitate an interactive group where athletes gain knowledge on sports nutrition, practice behavioral skills, set personalized goals, and process their experiences with other participants. We share dinner each night at the program, giving athletes an opportunity to plan, prepare, and eat a meal that meets their needs. I also conduct weekly, private counseling sessions with each athlete, helping them process eating disorder struggles and customize a meal plan to meet their specific nutritional needs. An important part of my day involves communicating with parents, coaches, and other providers involved in the athlete’s support network to ensure comprehensive care.

What advice would you share with an RD (or RD2be) that is interested in a similar career path?

Intern, shadow, research, and observe as much as possible before applying for a position. It is critical to understand early on if this work is right for you. Additionally, it is crucial to take an inventory of your own beliefs and habits to determine if working with eating disorders is a good match. Eating disorder dietitian Marci Evans offers a free tool (https://marcird.com/resource/is-eating-disorders-work-a-fit-for-me/) to help you understand strengths and possible areas of growth before considering entering the field. These experiences and the quiz are not meant to discourage but rather, highlight prerequisites that need to be addressed before working in the field or determine if the work is something you actually might enjoy. Internships and volunteer experience are critical to help someone understand what they like and more importantly, what they don’t like. Volunteering in law internships my freshman year of college helped my understand early on as a History major that I did not want to become a lawyer. I shudder to think about what my life might have been if I had ignored these early signs.

What is your greatest strength/weakness as a dietitian?

My greatest strengths are my work ethic, willingness to learn, curiosity, empathy, passion, and flexibility.  My greatest weakness is a need for more overall experience. Although I have worked as a coach and athlete for over 7 years and dietitian for 3 years, I can always benefit from more experience and time refining my skill set.

What are some of your interests outside of work?

I enjoy powerlifting, mixed martial arts, reading books, articles, and research, listening to podcasts, watching movies, playing videogames, trying new restaurants, cooking, baking, and spending time with my girlfriend and friends.

What aspect of sports nutrition (or any other area of dietetics) interested you to pursue it as a career?

As a fledgling high school athlete, I was determined to be the best. I dedicated countless hours to reading journals, books, and articles to help plan my own strength and conditioning programs. This ignited my passion to continue this journey with others throughout college. In an effort to maximize my own training and my athletes’ careers, I devoted the majority of my undergraduate and graduate career to coaching and was heavily involved in the exercise science lab researching walking and running form. This interplay between the acquisition of knowledge and the art and science of applying that knowledge to coaching further cemented my interest in the connection between nutrition and exercise science. During graduate school and my dietetic internship, I developed a love of counseling and an interest in eating disorders, and after I graduated, I decided to create a career which blends all of my interests.

Why have you decided to work with athletes or similar groups?

I enjoy working with athletes with and without eating disorders because I too once struggled with an eating disorder as an athlete. I can understand the mindset and cultures that can produce an eating disorder as well as the factors that facilitate recovery. My patients are also fun and highly motivated, and they often test my knowledge of exercise science, nutrition, psychology, and counseling. Every athlete presents a new challenge and opportunity to learn and grow as a provider and as a supporter.  

How do you deal with the daily stresses presented to you in your career?

I regularly schedule self-care in my day and throughout the week. Self-care includes regularly exercising and eating in a manner that enhances my wellbeing, aiming to obtain sufficient sleep nightly, meditating regularly, seeing a therapist weekly, engaging in a wide variety of hobbies, and dedicating time throughout the week to hang out with my friends and/or girlfriend. Lastly, I have enlisted several coaches and supervisors to provide guidance and counseling with my own training and work.

Prior to getting your credentials, did you have any experience in nutrition (ie. food service, volunteering, etc.)?

Interestingly enough, nutrition was an integral part of my job as a strength and conditioning coach. When I first started, most strength and conditioning coaches and trainers did not have the luxury of working with dietitians, and sports dietitians were rare. As a result, I observed and learned from other coaches who had degrees in nutrition and/or were self-taught. I know this is generally frowned upon in the dietetics community, but many of my best mentors and experiences in nutrition came from self-taught coaches who understood sports nutrition, but more importantly, were top tier experts in the art of applying the concepts with high level athletes. These were my primary experiences before the dietetic internship.

What do you love about your career/job?

I love the opportunity to collaborate with an athlete to facilitate improved training and overall mental and physical growth. The relationship between coach and athlete is extraordinary. It requires trust, patience, countless hours of struggle, and years of work for dreams to come to fruition. Knowing that I play a part in this challenging process is incredibly special. I am also interested in the wide range of topics covered by sports dietetics and eating disorders including nutrition, exercise physiology, psychology, and counseling, and my job always challenges me to learn more every day in a wide variety of fields.  

Is there a course you took in undergrad or grad school that has helped you in your current role?

As someone who now mentors and precepts interns, I find myself reflecting on this question frequently. First and foremost, I would implore all nutrition programs to mandate several classes dedicated to Motivational Interviewing (MI). When working in the field, practitioners soon realize that although knowledge is important, simply providing excellent information will not always result in positive outcomes. To avoid the pitfalls of the “old expert model,” MI is a mindset and tool that helps practitioner collaborate with their clients to navigate ambivalence and take action when they are ready. Additionally, utilizing MI helps keep practitioners mentally healthy, since the goal is not to change people but rather normalize ambivalence, emphasize client autonomy, and help the client explore and increase their own readiness/confidence to change. There is a reason why MI classes were my favorite and are on the rise in the healthcare field; it works.

What are some of the unique nutritional considerations you must consider for the group(s) you work with?

Outside of general sports nutrition principles, I have to consider a wide range of side effects related to eating disorder pathology, psychiatric medications, allergies, intolerances, gut disorders, as well as medical and psychiatric illnesses. These factors often add additional layers of complexity with each athlete and are one of the main reasons why I love my job. I am always interested in a new challenge!