A review of one-to-one dietetic obesity management in adults

Abstract

This review outlines the evidence and proposed professional consensus on one-to-one dietetic weight management for UK adults. New opportunities and challenges are arising for dietitians as the status afforded to obesity management increases. It is timely therefore to reflect on dietetic practice and consider the associated evidence. Despite a long standing history of working in obesity, little is known about the specific nature of UK dietetic practice, making it difficult to determine whether services are evolving and meeting recommended guidelines. It is essential that an evaluation of dietetic practice is undertaken and, importantly, that findings are published and disseminated to the profession. Assessment is the foundation of good weight management. However, given the complexity of obesity, the practice of completing both an assessment and instigating treatment during a brief consultation may not be feasible. The practitioner's interpersonal skills are central to treatment outcomes and merit regular review and comprehensive training. The ability to express empathy is a key skill, which is particularly important given the widespread weight bias in healthcare. Evidence supports multicomponent interventions combining diet, physical activity and behaviour modification. Following stabilisation of eating, as well as improvements to diet quality, the evidence supports the 600-kcal deficit, meal replacements and, in carefully selected individuals, very low energy diets. A weight maintenance component to management is linked with reduced weight regain, although the optimal frequency, duration and content of sessions are unclear. For many services, this higher intensity provision will likely require a multidisciplinary, multi-agency approach.

Improving Glucose Tolerance by Reducing Weight Gain in a Polygenic Obese Mouse Model: Use of a High Protein Diet

“…Given the co-morbidities associated with overweight and obesity, interventions that reduce weight gain will provide significant health benefits. The most common and readily available intervention to reduce body weight is dietary manipulation [9][10][11]. This typically requires an individual to reduce the total amount of energy intake, which usually involves a reduction in the amount of fat and carbohydrate ingested [12][13][14].…”

Intervenção nutricional pautada na estratégia de oficinas em um serviço de promoção da saúde de Belo Horizonte, Minas Gerais

“…Esse tempo foi considerado devido às evidências de que somente após três meses as mudanças de comportamento são efetivadas 11 . O questionário abordava as seguintes questões: "Você considera que mudou algum há-bito alimentar após a participação nas oficinas?…”

Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

“…Traditionally, the first step of standard obesity management is a combined treatment consisting of calorie-restricting diet, physical activity, and behavioural modifications [13, 14]. Due to the strong dependency of diets on individual particularities, personal dietetic management was recommended for this weight loss strategy [14].…”

“…Due to the strong dependency of diets on individual particularities, personal dietetic management was recommended for this weight loss strategy [14]. For the purposes of effective counseling, objective weight loss predictors for individuals on specific dietary plans are under exploration [15].…”