Question 1
Based on all these results, what combination of interventions do you feel would help an individual begin to lose weight? Would you include weight loss medications in your recommendations?
posted by Steph @ 4:41 PM
12 comments
12 Comments:
I definitely feel that a “multi-factorial” approach would helps patients the most. By this I mean discussing several different aspects of a healthy lifestyle such as diet, behavioral changes and physical activity. With diet, I would discuss the principles of balance, variety and moderation. Each diet education and plan must be individualized for the patient; however, I wouldn’t recommend any calorie levels below 1200. I’m not a big fan of meal replacements. I feel like people can lost just as much while still eating real foods if they are taught the right steps to take when choosing and preparing foods, rather than being placed on liquids, etc. With behavioral therapy, I would discuss portion control and give tips on controlling snacking, encourage three meals/day and discuss healthy ways to prepare and enjoys foods. With exercise, I feel that what the article said was correct; patients are much more successful if they have concrete goals to work towards! Helping patients set those goals, even if it’s just a very generic time frame and set number of days/week- it still gives them something to strive for and improve on.
I would first recommend making small changes in diet and exercise. Simply switching from inactivity and poor eating habits to moderate activity 2-3x/week and slight diet improvements will result in modest weight loss. This method is much more feasible compared to drastic lifestyle changes and will increase the chances of long-term maintenance, both in diet/exercise habits and in weight loss maintenance. I would not recommend weight loss medications, especially in the beginning stages of weight loss. Although they may help to enhance weight loss when used in combination with healthy lifestyle changes, I feel they have too many adverse effects and would not feel comfortable promoting such methods of weight loss.
If I was advising someone beginning to lose weight, initially I would advise to modify eating habits and slowly introduce activity. The “dieting” I would emphasize portion size and how often the person is eating. Also emphasize baby steps towards weight loss, with manageable/realistic goals, and explain/educate that the changes should be life long healthy habits. I would combine the “dieting” with the exercise for ultimate intervention. It is important to consider the whole body wellness and concentrate on all the components and include mental wellness with counseling/advice. I would strongly advise against weight loss medication; however, it is ultimately up to the patient.
Weight loss regimens are very individualized. Patients should start slowly by changing one or two things in their diet or exercise regimens and see what kind of results they recieve from this change. By asking someone to completely overhaul their diet and exercise regimens is unreasonable and may cause the patient to become discouraged and give up. I think that by making small changes in diet and exercise can help to produced wanted results. I would not include weight loss medications due to the fact that weight loss is not achieved by a 'quick fix'. It is something that you have to work for.
Karlie,
I agree that using a multi-factorial approach would be useful for weight loss. Patients will not only have to change one aspect of their life, but several in order to achieve weight loss. Behavioral changes are a large part of losing the weight!
I believe the combination of both diet and exercise is the most beneficial for weight loss. Depending on a patient's energy and motivation, it may be beneficial to start off slow with diet alone and then work up to exercise or vice versa. It also may be beneficial to only implement little changes one by one to allow the patient to ease into a weightloss diet (assuming there will be more than one session). For example, the first visit you could implement avoiding fast food, encouraging home made choices, and avoiding high calorie beverages and then when they come back you can focus on other topics as well.
I would not be one to recommend a weight loss supplement to a patient. I do not think this sends the right message. There are no quick fixes and a weight loss pill makes the statement that you can take it an magically lose weight. There are also complications with possible interventions with medications patients are already taking, as well as side effects when taken improperly. I will continue to leave weight loss medication recommendations to other health professionals because personally I do not agree with them.
Heather-
You are definitely right in focusing on baby steps to bigger changes to achieve weight loss. Slowly altering eating habits THEN introducing (or increasing) physical activity will help ease the patient into these changes so they will not be overwhelmed as the process of weight loss can seem intimidating. I also agree that I would strongly advise against weight loss medications and that, in the end, it is not our decision and is rather a choice to be made by the patient.
I believe that focusing attention in more than one area would be the best weight loss intervention plan. Personally, diet advice and an exercise plan is the healthiest long term weight loss plan if the client is able to stick to the recommendations. In order to make this work to the full potential, you must help you client take baby steps to get to the overall big picture. If you throw a huge diet change and exercise regimen to them and say "just do this," it may see overwhelming to your client. I believe that it is important for them to set goals each week and to make sure that these goals are maintained before moving on to the next one. Many people expect the weight to fall off quickly, but they dont realize that it is much more difficult than just following a stict plan for one week. That is why taking it in steps would be the most beneficial when incorporated with edu lessons on diet advice and exercise tips! I am also a firm believe that medications are not the answer. I believe that these medications are the easy way out and once you discontinue use, your body will begin working back at its normal conditions, eventually leading to weight gain. Also, I believe that many people take pills thinking that they do not have to follow diets or exercise programs because this magic pill does it all for them! This is not the type of healthy lifestyle I would be trying to promote to my clients as the key to my program design would be diet and exercise!
When it comes to giving weight loss advice I feel that you have to focus on an individualized treatment for the person. It is important to discuss what they have tried before, what are their weaknesses, what are their strengths. Then you can devise a program that will focus on boosting strengths and minimizing their weaknesses. No matter what plan is made it is important to focus on continued support. It is also important to show that weight loss and maintenance is a lifestyle change rather then a transient period.
Karlie,
I totally agree with you that a multi-faceted approach is the best way to counsel someone on weight loss and that the plan must be individualized to that specific situation.
I don't think meal replacements are a good substitute either because most people enjoy eating. So to take away that pleasure and replace it with a high calorie liquid beverage is just asking for someone to overeat. Since we often don't eat for hunger reasons. It is more likely that we will miss the "act" of eating and consume food when on meal replacements in addition to those meal replacement drinks.
Lauren~
I agree with you when leaving the weight loss medication recommendation to other health care professionals, if recommended at all. The market for supplementation and weight loss medication is huge. All health care professionals all want what is best for their pts., but it brings up the notion of how many are educated in the benefits, side effects, and know how to properly communicate these to the pt. I understand the article discussed weightloss medication and this is bringing up supplementations, as dietitians we are responsible for understanding them and being able to successfully communicate both of them to the pt.
Heather,
I think you are right. I would not choose to recommend weight loss supplements to patients, but I do think that it is our responsible to stay up to date with new products on the market. This is important in case a patient brings up a new weight loss medication during a session. If you are educated on this medication/supplement then you can relay the pros and cons of using this product to the patient. This way the patient can make a better educated decision on taking a weight loss supplement/medication. At the end of these sessions I would always remind the patient to consult with their doctor before taking any new supplement/medication, stressing the interactions that can occur between medications.
Post a Comment
<< Home