Nutritionist for Provo, Utah

Utah County skews young and family-heavy in a way almost nowhere else in the country does. That shapes what people come in with. A great deal of the work here is postpartum — women several months or several years past a birth, being told that exhaustion is just what having small children feels like, when a thyroid or iron picture would say something more specific.

It also shapes the constraints. A protocol that assumes an hour of meal prep and a quiet evening is useless to someone feeding five people at 5:30pm. The programs that hold in Provo are the ones designed around a real household — foods everyone will eat, changes that survive a bad week, and a supplement list short enough to actually take.

The student population adds a second pattern: people in their twenties on a budget, eating badly for four years and assuming their metabolism will absorb it. Sometimes it does. When it doesn't, an early metabolic panel is the cheapest useful thing they will ever do.