Question

A 43-year old woman with a long history of obesity and moderate hypertension and impaired glucose tolerance is referred to you by her primary care physician for nutritional counseling. The woman says she is not interested in following a diet and is not willing to commit to long-term counseling. What strategy would be most effective in working with her?

Answer 1

A patient with obesity who is not interested in dieting or counseling can be approached with a strategic focus on small lifestyle changes, emphasizing health benefits such as improved risk factors with a 5 percent weight loss and setting attainable goals.

Step-by-step explanation:

Working with a 43-year-old woman who has a long history of obesity, moderate hypertension, and impaired glucose tolerance, but who is not interested in dieting or long-term counseling, requires a strategic approach. Since behavioral interventions are critical for achieving and maintaining weight loss, it's important to engage her in a discussion about her health concerns and motivations. It may be beneficial to focus on small, incremental lifestyle changes rather than a complete overhaul of her diet. Emphasizing the health benefits of losing even a small percentage of her body weight could be motivating. For instance, as the Food and Drug Administration (FDA) states, a 5 percent weight loss can significantly improve cardiometabolic risk factors. Communicating this information and encouraging self-monitoring, setting attainable physical activity goals, and providing basic nutrition education are steps that could be taken even without her commitment to a structured program.By considering her autonomy and working collaboratively to identify achievable goals, there is potential for the patient to become more receptive to the idea of making healthful changes, which could lead to discussions around more structured nutritional counseling in the future.