Katie Gilder, RDN, LD

About

  • Pronouns: She/Her

  • Occupation and Specialty: Dietitian

  • Location (Clinic/hospital): Cultivate Counseling and Wellness

  • Location (City): Northeast Minneapolis

  • Offers Telehealth: Yes

  • Contact Information: cultivatecounselingmn.com

  • Bio: I provide MNT and nutrition support in a variety of ways including meal support as needed. I have worked for the last 10 years in multiple settings, and have experience with adolescents and families as well as adults. I have specialized in helping adolescents and young adults with eating disorders for the past 7 years, and have extensive training and experience in supporting families with FBT(TAY) and believes in individualizing care for clients and families. I work to help people find the food philosophy that works for them and improve their relationship with food through a Health At Every Size lens. I love to bust those diet-culture myths, help clients develop media-literacy around the diet and exercise industry.

Approach to care

  • What does it look like for you to provide care to patients in larger bodies? How is, or isn’t, your approach different from how you care for patients in smaller bodies? If you work with children, how is or isn’t your approach different when working with children?

    I practice from a weight inclusive, fat positive lens. I treat clients with eating disorder and disordered eating and try to provide information to all clients about the interaction of weight stigma and diet culture in the development and sustaining of an eating disorder. For clients in larger bodies I try to give space for them specifically to talk about the way in which society contributes to their eating disorder by reinforcing it and try to help them find providers, especially medical providers who can help clients to address other medical conditions and/or complications from the eating disorder.

  • What is your perspective on how weight is or is not related to health?

    I believe that most concerns attributed to weight are very likely mostly unrelated to a persons body weight alone. As a firm believer in health at every size, I think there is more than ample evidence to show that weight is likely correlated with some health conditions, but more likely then not is not causal. I believe that at best weight might be one small independent factor that still can not be controlled, just as some people have a genetic predisposition to high cholesterol, there are people who are genetically set up to live in larger bodies and that even if that is something that might influence some health conditions, it is out of there control, we can not change our genetics and the medical system focusing on only changing weight to address health concerns is incredibly harmful on a multitude of levels, including significant harm to patients mental health and missing often leading to many clients not having very real concerns addressed or treated because of weight bias.

  • Finish this sentence: “Fat people are…” 

    People, who like all people deserved to be treated respectfully and listened to and treated with the same respect and care as all people deserve to be, but sadly are often not because of bias in our healthcare system.

  • How do you, your clinic, and the healthcare system you work in use BMI (i.e BMI cutoffs for accessing certain services, BMI on charts and printouts, etc)? Is this flexible?

    We do not use BMI. For clients who have lost weight related to eating disorder symptoms, we use growth charts for adolescents and set goal weight ranges to return them to their previous normal regardless of where that was from the 5th percentile to the 95th percentile, and do not give ranges only a bottom so that we can then track how normal eating impacts weight/growth development etc. For adults who have had changes in weight we also assess for what has been a typical and then work with clients to find where there body wants to be when there is a decrease in sx use, a healthy relationship with movement and they are able to eat to nourish their body and enjoy food, again we would not give a range but a bottom number recommendation possibly and then see where weight trends with stabilization of symptoms and assess for other bio-markers as needed.

  • If a patient declines to be weighed, how do you and/or your staff proceed?

    No patient has to be weighed, if a client is actively working on needing weight restoration as part of their care (which many clients need who are not in under weight bodies) there would be discussions around how we can monitor for this in a way that would make them more comfortable; weights at dr and we have ROI, weight in our office less often, etc. Many clients chose to be weighed and never know the weight as well.

  • If a patient declines to discuss weight loss, nutrition, and/or exercise, how do you proceed?

    As a dietitian discussing weight history, nutrition and exercise is a big part of what I work on with clients, but if someone is not wanting to discuss any of that with me, I would provide education on why I am asking some of the things I ask about related to nutrition, relationship with exercise, weight trends etc and then ask them if there is something I could do that would make it feel safe for them to discuss any of that, or if not what they think would be more important things for us to be focusing on, talking about.

  • What does the physical accessibility of your office space look like? What kinds of accommodations are present for people in larger bodies? Are there things you wish were in place that are currently not? 

    We are intentional in our furniture to not have arms and to be accessible for people in larger bodies, but unfortunately could not guarantee it for people over 400 pounds which is something we want to be able to do. We do have an elevator in our building and ramp on our floor that allows for more accessibility for anyone who needs a mobility aid. The bathrooms however are not anymore accommodating then the average bathroom in public building and it is not likely we will have much success in changing this for a while.

  • What do you do to allow fat people to feel comfortable and welcome in your office? 

    We have art in our lobby and offices that advocates/promotes diversity, including size diversity. We try to offer seating arrangements in the lobby and offices that are accommodating.

  • If you’d like to use this space to talk about any identities (gender, race, size, sexuality, etc.) you hold and how this relates to your care, please do so. 

    I am a white, cis, hetero, straight sized person who holds all of those layers of privilege. I do try to take that into account when talking with someone in a larger or fat body (or who has other marginalized identities) and make space for them to be hesitant to trust me because of this and or feel like they can name that even if I am someone who tries to be unbiased and intentional in how I support people in all bodies sizes, I will never be able to know what it feels like to not have those privileges.