By BRIAN SODOMA

Virginia Beck likes to think it's all heading in the right direction when it comes to the battle against obesity, even though the numbers tell us differently.

About one-third of the adult population is obese, two-thirds at least overweight and the number of obese children between the ages of 6 and 11 has increased from 7 to 20 percent since 1980. All of this gloom and doom around the subject has many health officials scratching their heads for solutions that, on the surface, seem quite simple.

For Beck, who serves as the Clark County School District assistant director of food service, optimism can be tied to a small but significant step for her department. The school district is hiring a second dietitian (she is a registered dietitian too) to help her plan better meals and get the word out to youngsters about better food choices at home and in the cafeteria line.

"A second dietitian will be really nice. Hopefully, I will be able to get out and speak with kids a lot more," she added.

Beck clearly welcomes the added help. And while there may be no budget boost in sight to add more people to her staff, there are other indicators on a national and regional level that if waistlines keep expanding, so will the need for those who are in the know about diet and exercise.

Diet education

Denise Signorelli, a biology professor at the College of Southern Nevada who has been teaching nutrition classes for more than 10 years, has one word to describe the many students that take her nutrition classes: clueless. She tells the story of one student asking why she couldn't just eat cookies all day and take a multivitamin.

Yet, ironically, while the adult and youth populations, on the surface, turn a deaf ear to the problems associated with obesity, they thirst for more information. Signorelli teaches one nutrition class each semester. But she said there is enough demand from students to teach five each semester.

"If we had the money we could absolutely make a huge impact on health choices," she added.

But while public sector budgets such as schools and social services are being scrutinized, dietitians are still in demand in a lot of other areas like hospitals, doctors' offices and public health agencies.

In 2010, there were about 64,000 dietitian jobs in the United States, according to the U.S. Bureau of Labor Statistics. The agency has predicted 20 percent, or above average, growth in the field until 2020.

There is also 37 percent expected growth in the "health educator" field listed in the BLS's Occupational Handbook. The latter works with government agencies, hospitals and private corporations to implement wellness initiatives. Both require a bachelor's degree and have salaries around $50,000. Fitness trainers have been an exploding field for the past decade, require far less education, but have an average salary of around $30,000, even though that field is expected to still grow 24 percent nationally by 2020 as well.

Beck sees a need for dietitians, particularly with the aging population, and those suffering from diabetes or other obesity-related complications.

"A lot of times doctors are referring them to dietitians so they can review the nutrition education," she added.

Currently, many insurers reimburse dietitians assisting patients with diabetes and kidney disease. But there is talk on a legislative level to mandate insurers to reimburse for obese patients, in general, even if they don't have either of the illnesses. This could help increase demand for dietitians even more.

Dietitians and nutritionists

Karen Wright, a registered nurse and registered dietitian at the Surgical Weight Control Center in Las Vegas, graduated with a master's degree in public health coupled with a dietitian emphasis, a combination program offered at Loma Linda University in California. Battling weight problems her whole life and coming from a long line of diabetics, Wright, herself, even had lap band surgery in 2003.

"I felt like I really had to figure a lot of this (diet) out on my own," she said.

Today, she offers tips to bariatric surgery patients on the lifestyle and diet choices they will need to make after surgery and weight loss. She helps with support groups at the clinic and has been employed there since finishing her extended degree a few years ago.

Like a weight-loss plan itself, the journey to becoming a dietitian is not short or easy. A bachelor's degree or post-degree internship is required. Nationally, only about 50 percent of the intern applicants are placed each year.

After the internship and the passing of a national exam, a state license to operate as a registered dietitian can be given. It's then when the opportunities open up, said Laura Kruskall, a dietitian and director of the nutrition science program at the University of Nevada, Las Vegas, which also has a program with an emphasis in dietetics.

"There are some people who practice without the license but are under the supervision of another dietitian," she said. "It really limits your opportunities, though."

In the most recent legislative session, a bill requiring dietitians in Nevada to be licensed was passed. Because of the new law, those claiming to be nutritionists or nutritional experts, who do not have the registered dietitian credential and in many cases do not possess a four-year degree in a nutrition emphasis, are prohibited from working with patients with diabetes or other diseases.

Kruskall said there is still plenty of questionable practice going on in the state. But in time, enforcement will put a stop to it, she believes.

However, even with the academic rigor tied to the profession, students seeking a degree in dietetics are still on the rise. At UNLV, the dietitian emphasis program was started in 2000 with only a few students. Today it has between 250 and 300 people in it at any given time. But Kruskall also said the heavy science class loads in the program turn some people away.

"This is not just your basic four food groups scenario. When people get in, they realize there's a lot of chemistry and they find maybe it's not for them," she added.

But also of note is the emphasis placed on obesity in the program, Kruskall added. Its complexity and how it ties to other diseases and health conditions makes it the primary topic the professor covers in her nutrition classes.

"It's a huge emphasis for me. It takes me by far the longest to cover of any of the diseases I cover," she said.

Mind matters

Carrie Sheets currently is doing her postdoctorate in psychology work locally. She provides psychiatric evaluations for the Surgical Weight Control Center and also does clinical work at Creative Health Solutions, a medical weight-loss clinic in the valley.

While clinical psychology is the largest employment opportunity in that field, Sheets sees a growing trend of people like her looking at ways to help the obese population, too. Obese people not only change their own personal behaviors but also their relationships with others; it's a shift many say could use the help of a therapist.

"These people are in a place where they are needing to manage so many changes in their environment and life; it really is a growing area for us," she added.

Back to the schools

One of the primary suggestions from a Kaiser Family Foundation report published earlier this year was the need to attack obesity at the school level. For the past several years, cafeteria menus have been scrutinized with mixed results.

In 2006, the Clark County School District approved a wellness regulation program, Beck said. The move helped limit calories from fat and sugary treats. This year, Beck has made the guidelines even stricter.

The district is using 90 percent lean meat for its beef and even the chicken nuggets have gone to lean white meat. The pizza offerings have whole grain crust with low-fat and low-sodium cheese. For the upcoming year, a fresh fruit will be served with each breakfast and an option for fruit at lunch will be made available.

"Our fresh fruit consumption has skyrocketed," Beck added.

But Beck also admits that she can offer more healthful foods, in many cases, but if children choose not to eat them, administrators can make the case for bending the rules on the wellness regulations and instead opt for food students will eat, even if it's junk.

Closer monitoring would require manpower, and the notion of having a dietitian at each school is not lost on some people.

Dr. Andrew Eisen, associate dean for clinical education at Touro University Nevada and also an Assembly District 21 political candidate this year, has been keeping tabs on the obesity epidemic. He said the obesity problem and job growth could be part of a bigger conversation, and getting dietitians like Beck out into schools instead of just fixing menus is key to reversing the problem, too.

Monica Lounsbery, a professor in UNLV's department of kinesiology and nutritional science, said nobody ever poses the question of how this problem could actually be a job creator that brings solutions to longer-term risks such as the potential bankrupting of Medicare and Medicaid.

"We've never really been about prevention. We always seem to wait until we have a big problem on our hands," she added.