Communicating with Your Doctor As a Vegan

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About Ashley

Ashley Krautkramer has been a dietitian since 2014. She lives in Wisconsin with her husband and 4 cats.

She went vegan in 2006 after completing her first nutrition research paper in her freshman English class; the subject was ‘health benefits of vegetarian diets.’ She learned some things about how animal products get to our table that made her want to go fully vegan.

She was actually vegetarian for about 4 or 5 years before this (can’t remember exactly). Ashley always wanted to work with bariatric surgery clients, but realized a couple years ago that she could combine her two passions of vegan and bariatric nutrition and created her brand Vegan Bariatric Dietitian.

Ashley is a registered dietitian, but also board certified in obesity and weight management and a certified diabetes care and education specialist. She works for a healthcare system in Wisconsin as a clinical dietitian and diabetes educator but is a wannabe entrepreneur.      

Picture of Ashley Krautkramer

Transcript

Ashely: It’s not always easier.

There are things that are more difficult about it, but most people who went vegan didn’t do it because it was easy, you know, exactly doing it for other reasons that are important, so people are willing to do those things: they just need to know what they are.

Christine: Yeah.

Welcome to the Plant Powered You podcast! This is the resource for all things vegan nutrition. I’m Christine, your host and vegan bestie. And I also happen to be a dietitian.

As a disclaimer, this podcast is just providing education and a bit of entertainment. If you have any questions about your health or diet, talk to your own health care provider. Our full disclaimers will be linked to in the show notes below. Now let’s get to the episode (here).

Hey Ashley, welcome to the podcast!

Ashely: Hello, thank you for having me.

Christine: So I’m so excited to talk to Ashley today! And I’m just gonna read a little bit of her bio for those who aren’t familiar with Ashley.

Ashley Krautkramer has been a vegan since 2006. She is a registered dietitian with a board certified specialty in obesity and weight management. And she’s also a Certified Diabetes Care and Education Specialist.

Ashley works as a clinical dietitian and diabetes educator in Wisconsin but is also a wannabe entrepreneur. She always wanted to work with bariatric surgery clients but realized a couple of years ago that she could combine her two passions of vegan and Bariatric nutrition. So her brand: Vegan Bariatric Dietitian was born!

And so Ashley, I can’t wait to talk about your vegan story, but first, for those who aren’t familiar with bariatric surgery, can you just explain a bit about what that is? And how you got into that area?

Ashely: Sure! So I’ll start with I guess how I got into it, which may sound a little bit strange.

So I decided to become a dietitian, because , while I was studying biology, and I didn’t really know what I was going to do with that…

And I wanted something science based because I like science. And I was paging through the course catalog and found “dietitian” and I was a new vegan and I thought oh, that sounds cool. Right? So then I started doing that.

And then when I was in college, (so I graduated from college in 2010). So you know-those days like the early 2000s, and I remember on TV, seeing the early episodes of “My 600 Pound Life.” And that show I mean, people have varying opinions about it, right?

But I remember thinking that it was such a, I don’t know-interesting population and people that I just wanted to help. And so it was always in the back of my mind that I thought that that was a really interesting career for a dietitian, but not that I could ever necessarily do it like, where would I find a position like that?

But it ended up being that the hospital that I work at now, when I started there, as a dietitian, they needed somebody to work in the bariatric surgery area, and probably nobody else wanted to do it! So you know: me!

(They laugh)

So, I just sort of got inserted in there, which was fine, because I really like it. And it became my favorite thing that I do out of all of the different tasks that I do at work and the different types of people that I work with. So that’s how I got into working with people who are having bariatric surgery.

But what it is, there’s a variety of different types. And if it was something that you were interested in, or you think could help you, the doctor that you work with would help you decide.

Christine: So, you primarily help people after they’re done with the surgery because they have different kinds of dietary needs, correct?

Ashley: Um, I actually help people both before and after surgery. Because before surgery, there’s a lot of learning that goes on, because after surgery, there is a lot of changes that have to be made to the diet.

Sometimes people will say/or I will hear my patients say that they were told that bariatric surgery is the easy way out. That they you know, they took the easy way out to lose weight basically, but it is so not true. There’s so much changes that people have to make to their diet to be successful and not become malnourished after the surgery. You have to take vitamin and mineral supplements.

And so starting those habits before the surgery is something that we work with people on but also there is oftentimes insurance mandated visits that they have to have with a dietitian before the surgery.

So we help them with that. Not that those visits actually are proven to help people, you know, like that need a certain number of visits for us to pay for the bariatric surgery, there’s not evidence that needing those visits actually makes people more successful after surgery.

But the basic educational ones we need to do so that people aren’t totally blindsided, you know, after the surgery by what they have to do.

Christine Sure!

Ashely: Once they do have surgery, we’re seeing them because they go through different diet stages as they heal from the surgery, they have to take vitamin and mineral supplements, like I said, and then people need continued care and health.

Christine: And that is a lot of your focus in your program, by the way, which we kind of mentioned that you have a program called…

Ashley: Oh, the program is called “How to Be Plant Based after Bariatric Surgery.” Because I do offer it to people who are maybe like, interested in eating plant based or eat whatever version of a plant based diet works for them. Because all of these people need support.

So yeah, “How to be Plant Based after Bariatric Surgery.” But my brand is called “Vegan Bariatric Dietitian,” and that’s what my blog is called as well.

Christine: Okay, cool! So that’s a bit about how you got into the area… And, what inspired you to to make this program?

Ashely: I would say, mainly, all of the people that I talked to in the plant based vegan bariatric community, because there are many people. Oh, gosh, you can see my cat over there!

Christine: Wow, really jumped high!

Ashely Yeah, there’s a refrigerator over there! (they laugh)

Anyways, so what inspired me to start the program is all of the people in the bariatric vegan/plant based community that I have talked to/met online. So there are a couple of Facebook groups of people. There’s one really large one that’s not my group, but some other lovely person’s group on Facebook.

And then I also have my own Facebook group that’s got nearly 500 people in it. And while some people do feel well supported by their bariatric surgery program, it’s not unusual for somebody to tell me my bariatric surgery program said: I can’t be vegan, and I have to eat meat.

Christine: Yeah…

Ashley: Which is just silly! Like, we all know that that’s not true. Just kind of like similarly to somebody telling a pregnant person that they have to eat meat (if they don’t want to), like- that’s not true! They don’t have to, there are ways to meet the nutrition needs.

So that is mainly the, I guess- inspiration behind behind my program, but also, just that I really like working with people who have had bariatric surgery.

And while part of the job that I do in the hospital that I work in is that, and I really enjoy it, the other part of it is “other nutrition care” that, yes, is very interesting, but also not my favorite! You know, and I’m at the point in my career where I want to do my favorite thing all the time, and if I can do that for myself, then I’m gonna do that.

Christine: Yeah! And you kind of get to marry your vegan nutrition expertise with those who are interested in staying vegan after (bariatric) surgery, or maybe they’re just interested in being plant based, which I think is awesome, because there’s a lot of health care providers out there who just seem very strongly against a vegan diet.

I think there’s probably a few reasons why. I’m just curious what you think: why do you think that: Maybe you have people in your group who are like: “Oh, my doctor said, I can’t do that.”

Ashley: Sure.

Christine: Why do you think that is?

Ashley: Um, I think part of it might be lack of knowledge is part of it. I think that’s a big part in the bariatric surgery program, because sometimes, I hear from people that it’s not that their doctor said that they couldn’t, but that they don’t know how to help them. Or their dietitian, even: that they don’t know how to help them!

I think that’s a big part.

Like I had a person comment one time that, so- after bariatric surgery, most people end up with a diet stage that is full of like soft, high protein foods basically, or sometimes pureed, high protein foods. And they had said that they were told they couldn’t have any tofu at that time.

Well, clearly that’s coming from a person who doesn’t know what soft tofu is, right?

Christine Yes! (They laugh)

Ashely: So things like that.

Where if you don’t really know about something-you think tofu is only extra firm: So yeah, you shouldn’t have that on a soft diet, but you can have soft tofu.

Or just how to how to make it work and what things you need to… I guess take more into consideration. For example, if you’re eating a fully vegan diet, and you have just had bariatric surgery, and you can only eat like, a quarter of a cup of food at a time, you know, how are you going to get in your protein foods? Because there’s a couple challenges with that:

Number one, the protein needs are higher right after bariatric surgery, because you’re eating so few calories. So we need extra protein to help maintain muscle mass as much as possible, but there’s still going to be some loss. So there’s that.

And then vegan, plant based sources of protein tend to have more volume to them. Right?

Christine: yeah!

Ashley We can get a lot of protein from beans, but how many beans can somebody eat, who’s had bariatric surgery?

Christine: right!

Ashley: Not as many! And then add on top of that, that if you’re eating completely, like vegan protein foods that there, is digestibility differences in those. Now, most people don’t have to really micromanage that too much, because they just eat a “normal” amount of food.

But like when you’re eating like little teeny tiny amount, you do need to worry about that! And we need to make sure that you’re getting the right amount and the right things and all that.

And so I think the ability of most practitioners to understand that is limited.

Christine: Yeah, in general, it seems like there is a lack of understanding about a vegan diet in general. And like you mentioned, maybe it’s because they don’t have the knowledge about it. Also, here in America, I feel like our education does center a lot around animal foods, like you know, the whole “dairy for strong bones campaign,” for example!

So it’s part of education, I feel like!

Ashley: mhm!

Christine: and then yeah, the other thing about like you’re mentioning very specific needs for the bariatric surgery population. So that that brings up a good point: to really find someone who knows about this, and the whole vegan diet in general, specifically, if you’re someone who wants to be plant based.

So plug for Ashley and her program- because she knows all about that being a vegan for let’s see… since 2006? I’m not good at math. How many years?

Ashely: A while! Yeah, many, many years.

Since I was like, 19, and I’m 36 now.

Christine: Yeah, so there you go! Not that a dietitian, who is not vegan wouldn’t know about this stuff, or have the knowledge.

But, you know, the way I think about is that anyone can really look into the research and know about this kind of stuff, but they might not have the experience or know the challenges.

For example, I’m just trying to put myself in their shoes-hearing all this info and thinking: you know, I really care about the animals and- they’re telling me, I need to eat meat. But I don’t want to do that…

But maybe I should eat meat, you know? That kind of stuff. Do you hear about this kind of stuff in your group?

Ashley: Yeah, people don’t want to get sick. Like you didn’t have this surgery to be worse off than you were before. Right? So I totally get that.

And people want to please other doctors, too. It’s really difficult to go to the doctor and say that you didn’t follow their advice. Right?

Or the dietitian too, you know?

Christine: Yeah.

Ashely: And people with obesity have often been judged every time they go to the doctor. So, going against your doctor’s advice and being more…I don’t know what the right word is “vocal” or like “squeaky wheel” is hard for a lot of people who are judged at the doctor all the time.

But yeah, I totally understand why doctors and dietitians feel that they can’t adequately care for somebody who wants to eat a vegan diet, because it’s not always easier.

There are things that are more difficult about it, but most people who went vegan didn’t do it because it was easy, you know, exactly doing it for other reasons that are important.

Christine: Right exactly.

Ashely: So people are willing to do those things. They just need to know what they are.

Ashley: Yeah. There’s certainly nutrition topics that I don’t know how to deal with like…

Christine: Yeah, and I don’t know if I can equate veganism with religion, but let’s just say for example, you’re Muslim. And you know, like, are you going to go to like me who’s not a Muslim, but I’m a dietitian? Or are you going to go to a dietitian who’s a Muslim?

You know who… it’s just it kind of just makes intuitive sense to me to seek someone out who has that experience and that knowledge, if you can!

So now, if somebody comes to you and says, you know: Ashley, my doctor said that I can’t do this as a vegan… what do you tell them? Do you tell them to go to someone else? Do you tell them that talk to them? What would you say to that person?

Ashely: So one thing that we talk about in my group program is how to talk to your doctor, because part of what we do is provide the evidence that you are able to do it so that it’s not a question.

So we do that through food tracking. And obviously, learning about vegan plant based nutrition and Bariatric nutrition and why certain recommendations are the way that they are so that people can understand because most of the time, it’s just “these are what the recommendations are,” and that’s it.

Because probably, health care providers don’t have time to say, well, this is the reason why, and this is where the guidelines come from. And a lot of people aren’t interested in that anyways.

But I think having that understanding helps people who’ve had bariatric surgery know why maybe their doctors making a particular recommendation- they didn’t just like pull it out of the air, right? Or their dietitian: we didn’t just make it up.

But also so that they can understand and have a conversation with their doctor and not just be told stuff, or their dietitian-, not just be told stuff, because I think they almost don’t realize that it’s okay to have a discussion with your doctor or dietitian.

It’s not okay to be disrespectful, but it’s okay to have a discussion and say, “This is what I’m doing. And this is why, and here’s the proof that I’m doing okay.” Right?

Like, these are what your guidelines are, look, I’m meeting them. So like, what’s the problem?

Christine: Yeah. So you kind of empower them to talk to the doctors?

Ashley: Yeah.

Christine: That’s a good thing, because not everybody has the privilege of finding someone else, for example, or maybe it’s just out of reach for them to find someone.

So I really think, you know, if you tell the doctor, you know- why you’re doing this, and they’re still hesitant? Yeah, it would be good to ask them, like- Why? What is the explanation behind that?

And then, at that point, I would hope that the doctor would just refer you out, honestly, if they’re still hesitant, because like I said: it’s kind of like a double standard, but the religion thing, you know, we’re okay with referring out for this. But veganism is still kind of this new, “new thing” that I don’t think everyone recognizes.

I have a story of someone who went to their doctor told them they’re, you know, doing vegan, and they were just like, flat out: I don’t think that’s good at all and that was it.

Ashley: laughs

Christine: And the person, just- they’re intimidated, you know! I’m sure that that happens more often than not-that that’s just where it stops.

Ashley: mhm, yeah: people don’t realize that doctors are human too, and they don’t know everything. But I think because, you know, and I can’t prove this at all. And it’s just a thought that I have: But you know, as a doctor, there’s probably an expectation that you know these things and you don’t want to come across as incompetent either, right? So, you kind of have to act like you do!

I mean, that I come across that in my job too, because I get consults for a variety of different nutrition problems, and I don’t know how to deal with all of them, frankly.

But it’s my job to deal with them, so I have to look it up and deal with it, you know, and do the best that I can for that person, because I’m all they have, !less their hearts! You know, that they have to talk to me about their IBS! I don’t really know much about that! I know the like general level stuff, but like you were saying before, I don’t know all of the like “insider stuff” like I do with bariatric surgery.

Christine: So yeah, back to the empowerment that that’s great that you’re you’re trying to give them those resources, give them encouragement to talk to these doctors.

And then like you said, giving them them some grace as well with the knowledge that they have. In America: It’s almost seems like plant based is something that we’re recognizing more as…can be healthy? Whereas before we would think: or it was just the “thought” that, you know-“you need some animal products in your diet.”

Ashely: Yeah.

Christine: And that’s not to say that, you know, even though you and I are vegans (they laugh), I think we both know that a lot of different kinds of diets can be healthy.

Ashely: Yeah!

Christine: And veganism is more than a diet.

Ashley: Yes!

Christine: And that’s what kind of separates it from other things in general.

I think that’s another important thing that we can do, as you know- vegan dietitians is just to you know, hopefully the vegan diet is the healthiest, that’d be cool!

But, you know, we really can’t say that adding small amounts of animal products, you know, like, fish and yogurt (for example) in an overall healthy diet is the worst for health.

Certainly, there are environmental and ethical considerations, but I think it’s good that we just keep that up front. And that makes us a bit more credible I think in the eyes of other health care professionals.

Ashley: Yeah, I think so too. I, I like… What is her name? The dietitian that has the blog, “The Vegan RD“?, Do you know her?

Christine: Yeah! Oh: Ginny Messina?

Ashley: Yeah! So I really like her message about that: it doesn’t serve the vegan community to just be parading this idea around that the vegan diet is best for everything. Because people don’t stay vegan when they’re disappointed? You know, maybe I’m not saying her message exactly right, But okay, like, vegans get sick, too!

Christine: Yes!

Ashley: Yeah. And it’s not fair to say that the vegan diet cures all because it doesn’t. And then if people are going vegan to try to have that happen, then those are not going to stay vegan, because they’re going to quickly realize that that’s not the case.

Christine: Yeah

Ashley: And even if you eat healthy, you might still have something wrong with you, like our bodies are not perfect.

Christine: True!

Ashley: You know, just like, I think there’s even a misconception in the non-vegan community. Just because veganism is seen as like, more of a healthy diet that-like: why are there people who are vegan who are getting bariatric surgery? Doesn’t veganism just make you lose weight? No!

Christine: Hmm… Interesting.

Ashley: Yeah. There’s more to it than that. Certainly. I think that that can come up in just the dietitian community too.

Christine: Yeah!

Ashley: People feel like they have to look a certain way to be a dietitian. Which is also just ridiculous.

Christine: Yeah, we all come in different shapes and sizes, and so do vegans!

Ashley: Yes. (laughs)

Christine: Yeah, speaking about… I didn’t even ask you at the beginning! But I love to ask all my guests how they came to adopt the vegan philosophy. So what is your story?

Ashley: Yeah. So I was actually vegetarian before I was vegan. When I was like 14 or 15. I can’t really remember. And that was because our family had this cockatiel. And I was thinking about eating chicken nuggets one day, and I was like, huh, chickens are a bird. And this Cockatiel that I love so much is also a bird. Doesn’t seem quite right!

So then I stopped eating meat, but I didn’t go vegan until I was 19, and that was after I was in college, and I was in my English class. We were writing like a science based research paper in English class. And I was doing something about health benefits of vegetarian diets. And I learned about vegan diets in looking things up for that.

And then I thought, hmm, you can’t unlearn those things. So then I decided that that’s what I’m going to do because I don’t feel right about anything else. So it was and still is related to animal rights: which is really important for me. I feel like even if vegan diet is not the healthiest choice, like at this point, I don’t care or if it’s not the best, like, as big of an impact on the environment, I don’t really care. Or if everybody’s nice to the animals on the farm, I don’t care because I don’t want to eat them after they die. You know?

Like all of those things may be. And I think, certainly it is important to have good animal welfare on farms, but I’m still not going to eat them myself. (they laugh)

Christine: Yeah, they still have to die before their time.

Ashely: Yeah, so that said doesn’t interest me.

Christine: So you didn’t watch any of those documentaries? Or you just researched?

Ashely: Um, no! I never did because I was like, that’s just gonna make me sad.

Christine: Yes!

Ashley: And I already know about those things, so why do I need to watch that?

Christine: I agree!

Ashley: I don’t want to!

Christine: I saw the trailer for I think it was Earthlings or something, I said, I cannot: I cannot do that! Like, I know “the things.”

Yeah, I think just almost every guest has said they’ve watched one of those and that was what helped them to… but yeah, I don’t know… I’m just very sensitive soul I guess… I just can’t! The imagery is… yeah.

Ashley: Yeah, no. I would have nightmares just like thinking about it. So I’m not going to watch it.

Christine: Yeah. So you’re not one of the camp that you go to… what are they called… you know: where you go and witness what’s happening at the farms and things like that? And that just… they talk about it like it reminding you of what you’re doing?

Ashley: No, I don’t think I really need a reminder.

Christine: You know through this podcast and other things, that we just get this message out there, that here’s the knowledge.

Ashley: Mhm!

Christine: You decide what you do with it and.. that’s it! Were adults! (they laugh)

We know what pain is, we know how we would feel (probably) in that in that kind of instance, (in place with the animals).

Ashley: Mhm!

Christine: So that’s what’s going on. That’s the reality. And people can do what they want with that information.

Ashely: Right!

Christine: So you don’t need to watch documentary!

Ashley: No!

Christine: You can literally just, you know-find out what is standard practice.

Ashely: Mhm!

Christine: Yeah! I think that we kind of covered all of our points that we’re going to talk about today.

So I have a few ending questions for you: What is your favorite dish at this moment?

And if you could choose any famous vegan: so celebrity, activist, someone in the health space… who would you eat that with?

Ashley: Hmm, okay. So favorite dish at the moment: there’s a like, Thai/Vietnamese restaurant (it’s both)in the town that I live in/the city I live in, and they have this dish. I don’t remember what it’s actually called, but we’re going this weekend so I’m really excited for it!

It’s like a “lettuce wrap thing” and it’s got like, rice and the regular dish has pork, but they have a vegan version with tofu, and so I get that one of course, and some type of seasonings with it, I don’t even know what it is, but like it gets crunchy because it’s like fried and then you put it in the lettuce. It’s really good.

So haven’t had that for a while. So looking forward to that! But otherwise, like regular day: probably a bean burrito, as boring as that sounds!

Christine: Classic! That tofu thing sounds kind of like at PF Changs I don’t know if you had their, like, tofu lettuce wrap thingies, I think it’s an appetizer?

Ashley: No! But I’ve had other things there! Ok, I’ll have to try that sometime because we do have a PF Changs Around here.

Christine: That sounds good. It’s been so long since I’ve been there.

Yeah! Okay, so who are you eating the bean burrito and lettuce tofu thing with! (they laugh)

Ashley: I was trying to think about that, but then I was like struggling because there’s only a few people I know of who are actually vegan, I think?

Because you hear about all these people who are vegan celebrates, but you also hear about them not being vegan anymore?

Christine: Yeah.

Ashley: So, I couldn’t really think of anybody who I would want to who is still vegan? Probably the only one I could probably think of is Joaquin Phoenix? But probably everyone says that? But he’s the only one I know of who’s like, you know… vegan for life right?

Christine: Huh!

Ashley: But otherwise, I don’t know of anyone else, do you?

Christine: Yeah I mean, I would think more about kinda, of the health space? Who I would like to meet i guess?

Ashley Oh!

Christine: Yeah, like we mentioned Ginny Messina, I think that would be really cool to meet her.

Ashley: Oh yah, sure!

Yeah, Ok, I guess on Instagram: have you ever listened to Dr. Danielle Belardo’s podcast?

Christine: Yeah!

Ashely: Yeah, I think she’s really cool. I would eat with her.

Christine: Cool! In closing then, where can people find you and learn about your program?

Ashley: Yeah, so, my website is veganbariatricdietitian.com and on there, up at the top page you can click to the informational page about my group program if you’re interested in that!

Otherwise my email is ashley@veganbariatricdietitian.com or on facebook, I have a facebook group! So if your interested in joining a facebook group with other plant based and vegan bariatric surgery folks with me, it’s called: Vegan Bariatric Nutrition Support Group on facebook.

Christine: Cool, we’ll put the links in the show notes. And then, I think you have a new cohort coming up for your program in February 20? (2023)

Ashely: yeah, that’s when I think the doors are opening for the waitlist. So I think I gave you my link for the waitlist?

Christine: Yes! So I’ll put that in there. (waitlist for Ashley’s program)

Ashely: So If you want to learn more about the program, join the waitlist, cause that’s where I’ll be starting to email about it very soon, and there will be a live event coming up to learn more about it as well.

Christine: Ooo! So they can ask you questions live and stuff like that?

Ashley: Yeah!

Christine: That’d be cool! So check her out and thank you Ashley for coming on, and your service to the vegan community and just to anyone who want’s to eat plant based.

Ashley: Yeah! You’re welcome, thanks for having me!

Christine: Yo, that was an awesome conversation I had with Ashley!

I had a lot of fun chatting with her about how we can empower vegans to talk to their doctors about their unique nutrition needs. Here’s the take aways I got from our conversation:

Some people feel intimated talking to their doctor about their vegan lifestyle, yet-it is important to let your healthcare team know about values and diet, so they help with your unique needs.

If your doctor is hesitant or doesn’t think you should be on a vegan diet, ask why. Hear the answer out! Does this answer have some solid health concern or is it based on personal views or opinion? Ask for an explanation behind their recommendations.

It is my hope that your doctor would be happy to give a referral to a qualified professional who is more knowledgeable about a vegan diet if they your doctor does not have the expertise to help you. 

Did you know that I started Plant Powered You: a nutrition resource for vegans, so that they can become more confident in their knowledge about plant based nutrition? Check it out at plantpoweredyou.com, it’s all free!

If you enjoyed this episode please give us a 5 star review on Apple Podcasts.. This just helps us get out to more people. Until next time!

Did you enjoy that episode and want to hear other totally rad conversations with fellow dietitians who also happen to be vegan, check out our other episodes on the podcast!
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