Patsy Catsos: Dietetics Leader Reflects on the Missteps and Lessons from Her Career

When Patsy Catsos graduated college in the mid-1980s, she was the first person hired to work on a new diet and breast cancer research study funded by the National Institute of Health. She was excited. A position like this would give her an outsized ability to influence the project, a rare opportunity for an entry-level dietician. She even helped hire her boss for the project. 

Her task was to create a database on the nutrient content of foods—think MyFitnessPal—without any of the fancy word processing that exists today. 

“Everything had to be created from scratch,” Patsy recalled.  Despite the daunting task, she worked closely with computer programmers to develop a user-friendly interface for the database. She didn’t know it then, but her computer skills would be the golden ticket to beginning her dietetics practice many years later.

Finding Her Field 

Today, Patsy is a Registered Dietitian Nutritionist and a respected leader in her field. Her career has been oriented around FODMAPs, a term describing “certain sugars and certain fibers that are widely distributed in food that cause digestive distress.” She counsels patients with gastrointestinal problems, including irritable bowel syndrome (IBS), which causes abdominal pain and altered bowel habits over a long period.

FODMAPs are the favorite foods of the bacteria that live in the human gut. When you eat lots of FODMAPs, these bacteria ferment them, creating gas. Eating FODMAPs can also pull excess fluid into the intestines through osmosis. Patsy describes it “like making peach pie: juice doesn’t form until you sprinkle sugar on them, then the juice flows out. In your intestines, extra water flows in.” 

Patsy first learned about FODMAPs by reading a paper by researchers at Monash University. She recognized the potential to help patients with IBS by altering FODMAP consumption. This inspired her to develop a tangible guide for consumers to identify foods that cause distress. In 2009, she self-published her book IBS—Free at Last!, selling over 65,000 copies and helping to make the FODMAP elimination diet a widely accepted treatment protocol. It detailed her step-by-step process to eliminate FODMAPs, then reintroduce them one sub-type at a time to determine which ones cause the most distress. She then advises patients to customize their diet to eat a variety of foods while avoiding those that trigger symptoms. Since then, she has continued to counsel patients, consult with industry clients, travel widely to give talks, publish IBS-friendly cookbooks, and even received the Academy of Nutrition and Dietetics Excellence in Clinical Practice Award.

Mistakes and Lessons

Between her first job out of college and her accomplished career, Patsy faced numerous challenges. She took a break from the workforce to focus on raising her three children, moved to a different state, and even pursued her passion for art through ceramics and painting.

“At one point, I made a very bad decision to let my credentials go,” she told me, thinking that she wouldn’t pursue her career in nutrition again. “Practically a day after that happened, I realized, ‘Oh Crap!’ I have to pay for three college educations!” It had been 20 years since she graduated when she decided to return to the field. 

There was a problem, though: her Registered Dietitian Nutritionist credential had expired. This meant she needed to retake the grueling national licensing exam before developing her own practice.

“Believe me, those Krebs cycle and other biochemistry concepts don’t stick with you that long,” she told me. She described diving back into her textbooks and spending three months studying like it was her job. It was a big deal, and it paid off when she passed it on the first try. 

With her credentials under her belt and a thorough understanding of herself, her skills, and her strengths, Patsy intuited she wanted to work one-on-one with clients. However, the stepping stones to this goal were unclear since she had no direct experience, and counseling is one of the most advanced aspects of the profession. 

She contacted a local Dietetics Practice​​ but received the all-too-familiar statement to entry-level job seekers: “We’re not looking to hire anybody” with an unspoken yet implicit “without experience” tacked onto the end. 

Opportunities Come from Unexpected Places

During this time, Patsy managed a girl’s choir program, handling all the marketing and business aspects of the five-chorus organization. One day at rehearsal, she talked to one of the parents of the girls' choir, who mentioned, ‘That woman you talked to at the Dietetics Practice is my best friend. I’ll put in a good word for you.’ Networking doesn’t always come from the places you expect!

Patsy soon received a phone call from the practice. “My friend said I’d be making a big mistake if I didn’t at least talk to you,” the woman on the other line asserted. Patsy described offering a “horse trade.” The woman explained that she wasn’t very good with technology and needed to modernize the practice, and Patsy possessed the computer and marketing skills that the practice required. “If you help me with all that, the mailing lists and the marketing, I will mentor you and help you get started as a dietician.”

At the time, Patsy wasn’t the most excited about this proposal; she wasn’t eager to manage an office again. But looking back, she is grateful that she took that opportunity. 

As time passed, she started doing more clinical work and less office work. That experience offered her the clinical experience that helped her eventually grow into an expert and leader in the field. “Sometimes you have to pay your dues doing something you’re not crazy about to get your foot in the door, " she said. “And if you have a credential, never let it go!”