Health Coach: Skills, Training + Benefits of Working with One

September 13, 2017

As concerns keep growing globally regarding rising levels of obesity and chronic diseases related to poor nutrition, the help of health coaches seems to be needed more than ever. Health coaches — who have similar roles to registered dietitians (RDs) and certified nutritionists, but also some important differences — are valuable because they are said to help “fill a void in the current healthcare system.” (1)

While primary doctors certainly help manage their patients’ symptoms and save lives everyday, many admit that they don’t have much formal training in nutrition. Surveys show that most graduating medical students continue to rate their nutrition preparation as “inadequate.” The majority of medical students are still getting less than 20 hours of nutrition education over four years, and only 37 percent of medical schools include a single course in nutrition. (2)

Doctors and nurses often aren’t comfortable offering their patients diet-related advice or helping them with behavioral change, and many report that they don’t have enough time during office visits to devote to diet-related concerns. This is where health coaches come in: They offer their clients an opportunity to talk through obstacles, accountability and practical advice about how to plan and prepare healthy meals. Some studies have found that care-management programs that include health coaching can help reduce medical costs, hospitalizations and many symptoms associated with poor eating and lifestyle habits. (3)

One of the major benefits of becoming a health coach is that it’s a less-consuming and usually less-expensive process than becoming a registered dietitian. Additionally, health coaches that are trained to have a “holistic” view of health can offer their clients help with common concerns aside from just their diet — like high stress levels, poor sleep, sedentary habits and a lack of time to devote to meal preparation.

What Is a Health Coach?

Most schools that train health coaches consider health coaches to be supportive mentors and wellness authorities who help clients make food and lifestyle changes. Health coaches can go by many names, including: holistic health coaches, certified nutrition coaches, or wellness coaches. A “Health Coach” is not a protected title in many countries, including in the U.S., so definitions differ a bit depending on who you ask.

Definitions of health coaching, such as the one proposed in a 2006 study that appeared in the Journal of Occupational Health Psychology, include “A relatively new behavioral intervention that has gained popularity in public health because of its ability to address multiple behaviors, health risks, and illness self-management.” (5)

How Do Health Coaches Help Their Clients?

So what are the benefits of having a health coach? A 2013 systematic review that was published in the journal Global Advances in Health and Medicine investigated how helpful health coaching/wellness coaching is for improving clients’ eating behaviors. Researchers involved in the review considered health and wellness coaching to be a process that is:

Fully or partially patient-centered
Includes patient-determined goals
Incorporates self-discovery and active learning processes
Encourages accountability for behaviors
And provides some type of education to patients along with using coaching processes (6)

Most health coaching occurs in the context of a consistent, ongoing relationship between a client and a coach who is trained in specific behavior changes, communication and motivational skills. A good deal of the work that health coaches do for their clients focuses on supporting healthy behavioral changes. Health coaches use a variety of strategies to connect with their clients, actively listen to their stories and encourage them to adopt healthier habits.

Some of the behavior change methods/skills that health coaches use include: goal setting, action planning, problem solving, navigating obstacles/barriers to goals, finding resources, self-monitoring and building self-efficacy. Many consider themselves to be “holistically” oriented when it comes to health, focusing on many aspects of their clients’ lives that contribute to well-being, instead of only paying attention to their diet.

Most education programs for health coaches include training that covers a wide range of dietary theories, such as plant-based diets, vegan or vegetarian diets, the Paleo diet, low carb diets, the Mediterranean diet and so on. “Bio-individuality” — the belief that there is not one ideal diet that is best for all people — is considered an important underlying principle for health coaches. Most health coaches keep an open mind when it comes to their clients’ food preferences and needs. Rather than recommending the same type of diet or meal plans to all clients, health coaches tailor their advice to meet their clients’ goals.

Who can benefit most from working with a health coach/wellness coach? Health coaches tend to work with people with one or more of the following health concerns:

Obesity or overweight
Food allergies, intolerances or sensitivities
High stress levels and a busy schedule that contribute to poor habits
Existing medical conditions including diabetes or pre-diabetes, heart problems including high blood pressure, high cholesterol or high cholesterol
In some cases people with a history of eating disorders who are in recovery, including anorexia nervosa, bulimia nervosa or binge eating disorder
Digestive issues including bloating, gas, constipation, acid reflux, symptoms of inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS).
Parents and their children who are trying to follow healthier diets
Women who are pregnant
Adults going through hormone-related changes who are concerned about their symptoms, such as women during menopause

How to Become a Health Coach

There are now a number of health coach training programs available that can be completed online, allowing you to continue working full-time if you choose while you earn your certification. Online programs make health coaching training more accessible to people who have busy schedules and time constraints that stop them from attending classes in person. Depending on which program you choose, health coach certification programs are also usually more affordable than earning a graduate-level degree in nutrition/dietetics, typically costing between several hundred and several thousand dollars.

In order to be qualified to serve as a health coach, most training programs will educate health coaches on behavior change skills, health information, and sometimes business development or specific job training skills. What types of topics can you expect to be trained in when you enroll in a health coach certification program? These include:

Nutrition topics such as macronutrients, micronutrients, recommended daily values, etc.
Various dietary theories
Disease/symptom prevention
Natural remedies such as herbal treatments, supplements and aromatherapy
Weight loss strategies
Help with emotional eating
Bio-individuality
Stress management
Goal-setting, habit formation, behavioral change and tracking progress
Coaching skills
Health coach business development

Health Coach Certification & Programs

What can you expect if you decide to become trained as a health coach? After earning a certification in health coaching newly-trained coaches can choose to follow many different paths. Some decide to try to practice health coaching full-time, while others choose to see clients exclusively online or only part-time due to holding other jobs.

If you’re interested in becoming a health coach, below are some of the top health coach certification programs I’d recommend considering, many of which can be completed online from home:

1. Duke Integrative Medicine — Duke’s Integrative Health Coach Professional Training program combines an online curriculum with onsite face-to-face training. The curriculum focuses on “multiple interconnected dimensions” related to well-being, including physical, mental and spiritual aspects of health. Those who might be interested in becoming integrative coaches include practitioners of massage therapy, acupuncture, yoga therapy and personal training, in addition to people working in ministry, education, business and healthcare marketing.

2. Maryland University of Integrative Health — This program is one of the only master’s degree programs available in health and wellness coaching, making it the highest academic credential in the field. This 30-credit program can be completed in two years, in either online or on campus. The curriculum focuses on four areas of integrative health, interweaving subjects like holistic nutrition, integrative health practices and herbal studies.

3. Institute of Integrative Nutrition — INI offers an online degree in holistic health coaching with a focus on topics such as bio-individuality, dietary theories, traditional diets, counseling skills, superfoods and stress reduction. Modules are completed over the course of about one-year, along with completion of coaching calls and several exams.

4. Emory University— Emory offers a Continuing Education 12-week Health Coach Certificate Program that is approved by the International Consortium for Health & Wellness Coaching (ICHWC). Topics covered in the curriculum include: prevention of diseases such as diabetes, cancer survivorship, healthy habits for older adults, heart health, exercise and movement, healthy eating, mental health, pain management, and work-life balance. Acceptance to the program is based on having a bachelor’s degree and/or healthcare related experience, such as being a registered dietitian/nutritionist, fitness professional or trainer, or recent graduate in the Predictive Health minor program offered at Emory.

Holistic Health Coaches — Health Coaches vs. Nutritionists & Dietitians

What makes a health coach, especially a holistic health coach, different than a registered dietitian or a nutritionist?

Holistic is defined as the belief that “The parts of something are intimately interconnected and explicable only by reference to the whole.” When it comes to holistic health or medicine, this approach is characterized by treatment of the “whole person,” taking into account both mental and social factors. Holistic health also emphasizes disease prevention as well, rather than only treating physical symptoms.

Holistic health coaches believe that being healthy is about far more than just eating a healthy diet and exercising — health is also dependent on supportive relationships, meaningful work, work/life balance, spirituality and more. Holistic health coaches try to keep their eyes on the “big picture” when working with clients, addressing many areas of their life that are contributing to stress and poor health, instead of only preaching the importance of calorie restriction, for example.

Two key concepts that many holistic health coaches emphasize to their clients are: 1) the need to manage stress effectively and 2) the need to practice self-care. Why is avoiding stress so important when it comes to maintaining a healthy diet and lifestyle? Stress isn’t only directly harmful to the body, but it also interferes with many healthy habits and can cause a vicious cycle. For example, stress can contribute to sleep deprivation, which then leads to low energy levels, lack of motivation to exercise, stronger cravings for junk food, and potentially weight gain or disease.

Being proactive about reducing stress and practicing self-care can go a long way in promoting better health. Someone might not realize how much their job, relationships or busy schedule causes them ongoing stress — which then interferes with their ability to stick with a healthy diet — until they work with a health coach who helps to point this out.

There are also significant differences between health coaches, nutritionists and dietitians when it comes to credentials, licensing and qualification:

Health coaches can become certified after completing a series of online or in-person modules for about 6–18 months, then passing one or more exams. Exams to become a health coach are not regulated by major health or government authorities, and internship experience is not usually required.
The biggest difference between health coaches and dietitians lies in the legal restrictions that each title carries. Qualifications for RDs (or RDNs) differ from state to state within the U.S, and also from country to country. In the U.S., most RDs or RDNs are accredited through the Accreditation Council for Education in Nutrition and Dietetics (ACEND).
Dietitians must complete a more formal, rigorous training process to become “registered dietitians” and qualified to practice. Training for dietitians typically includes: completing a minimum of a bachelor’s degree (but usually a graduate-level degree) at an accredited university or college, completing around 1,200 hours of supervised practice through an ACEND accredited Dietetic Internship and passing a national examination administered by the Commission on Dietetic Registration (CDR). (7)
Dietitians commonly work in medical or health-care settings — such as a hospital or doctor’s office — but health coaches do much less often. In order to work at a hospital, someone will almost always need to be officially credentialed as an RD or RDN, rather than a health coach, nutritionist or another type of wellness coach/counselor.
Nutritionists and health coaches have many things in common, especially that both tend to practice a model of holistic-health. “Nutritionist” is not a protected title in most countries, just like “health coach” is not, either. Nutritionists go by many names, such as Certified Nutrition Specialists or Certified Clinical Nutritionists, and their training varies depending on the specific title and program they choose.
There are certain nutritionist training programs that are more rigorous, such as those that lead to a Certified Nutrition Specialist (CNS) credential. These may require completion of a master’s or doctoral degree in a field-related discipline, up to 1,000 hours of supervised practical experience (similar to an internship earned by RDs or RDNs) and completion of one or more certification examinations. (8)

Health Coach Salary & Job Opportunities

Because global rates of preventable chronic diseases keep climbing, more than ever before there’s an increased focus in healthcare on disease prevention and finding strategies that will help improve eating behaviors and associated outcomes. Job opportunities in the fields of public health, disease management, clinical practice and employee wellness are expected to keep steadily increasing.

Where might a certified health coach work? Health coaches can potentially find work in a wide range of settings, including:

In private practice, whether this means working with clients online or in-person
Wellness centers, such as those offering acupuncture, herbal treatment or massage therapy
Corporations and businesses, such as doing employee-wellness talks
Yoga or fitness studios
Chiropractic offices, or offices of other functional integrative doctors
Nursing homes
Potentially schools and doctors offices (depending on specific state requirements)

Health coaches typically earn salaries between $38,000–$51,000 per year, although there’s a lot of variability. The median income for a certified health coach/wellness coach in the U.S. is around $45,000 annually, although some make up to $70,000 and some only about $30,000. (9) A health coach’s salary depends on where exactly they work, if they are a full-time health coach or only part-time, and their specific field. Those working full-time in metropolitan locations, especially in states such as California or New York, tend to earn higher salaries.

Final Thoughts on Health Coaches

A health coach is a supportive mentor and wellness authority who help their clients make healthy food and lifestyle changes. Many health coaches refer to themselves as “holistic health coaches,” which means they help treat the “whole person,” taking into account their client’s mental health, stress levels, schedule, relationships and level of work fulfillment when offering advice.
The benefits of working with a health coach include help with: behavioral changes, goal-setting, weight gain/obesity, existing medical conditions, food allergies and much more.
Becoming a health coach takes about 6–18 months of training, along with completion of an exam and possibly internship experience. Certifications can usually be earned online and are more affordable than earning a graduate degree to become a dietitian.