The number of people with overweight in North America is constantly increasing. The risk of possible diseases resulting from obesity has encouraged people to focus on prevention and management. But at the same time others argue that fitness influences our long-term health more than obesity. Still others suggest that efforts to prevent obesity can increase food obsession and reduce self-esteem. Such different opinions concerning weight-management approaches parallel differing philosophies concerning the problem of obesity.
The number of people with overweight in North America is constantly increasing. The risk of possible diseases resulting from obesity has encouraged people to focus on prevention and management. But at the same time others argue that fitness influences our long-term health more than obesity. Still others suggest that efforts to prevent obesity can increase food obsession and reduce self-esteem. Such different opinions concerning weight-management approaches parallel differing philosophies concerning the problem of obesity.
This context of differing philosophies has created diversity of practice among dietetics professionals. However, dietetics professionals’ current practices in this area and understanding of the nature of obesity have not been confirmed by research. A recent article described Canadian dietitians’ approaches to counseling adults looking for weight management advice, including how dietitians’ approaches differ between people with and without associated risk factors and long histories of dieting. 104 registered were included in this research. 15 focus groups represented all major regions in Canada. Each group was helped by 2 dietitians. The dietitians discussed their approach to specific weight management counseling scenarios, including women clients with and without associated risk factors (impaired glucose tolerance, hypertension, and family history of CVD) and long histories of dieting.
It appeared that the main goal for clients looking for weight-management counseling was “being healthy” or “healthy living”. The three subcategories of this goal: behavioral changes, physical outcomes, and psychological well-being; were all perceived as necessary for health, but their relative importance varied. Participants rarely included weight loss as a goal for clients with no additional chronic disease risk factors, in contrast to clients’ perceived weight loss goals. However, for clients with risk factors, some registered dietitians (RDs) supported moderate weight loss, while others aimed for health at any size. Psychological well-being, particularly in relation to feelings about food and body image, appeared to be also relevant factors in the counseling.
Key counseling strategies were: individualized attitudes to setting objectives, gathering information, and giving advice/education. According to research, while participants were conformable with their role as nutrition education when dealing with weight management, many were uncomfortable with the role of nutrition counseling. Further study to assess the effectiveness of dietitians’ weight-management approaches and additional counseling training for dietitians will improve practitioners’ skills and confidence in this area.
