Setting achievable goals for weight loss

These cases reflect the need for dietetics professionals to be flexible when helping patients manage their weight and to acknowledge that not every eating problem can be solved, no matter how many visits are available. Small, specific goals can help lead to small successes, and small successes lead to big successes. As Reeves and colleagues (2) suggest, there are five guiding principles in helping patients change eating habits:. • Flexibility on the clinician's part; • Assessment of health status and weight loss effect on health status; • Improvement of nutritional status; • Keeping the big picture criteria for success "on the table"; and • Producing weight loss. In order to do that, we have to consider JB's future. Although her reimbursement opportunities are limited the clinician gives her a letter to send to her insurance company to appeal for more visits. The clinician also gives JB a list of programs and Web sites that may be viable alternatives for the support she needs to continue losing weight. Self-help programs such as Overeaters Anonymous and Take Off Pounds Sensibly, Web sites such as SlimFast, Web programs such as ediets, or group meetings such as Weight Watchers may be helpful on a limited budget. Finally, the local department of health offers free aerobic classes in a park near her home, which may also give her an opportunity to increase her calorie expenditure. No matter what scenario, JB has left the dietetics professional's office feeling successful. She has lost weight, improved her blood pressure to normal range, reduced her serum cholesterol by 20 points (not far enough, but a good start), and improved her nutritional picture. If clinicians expect more than that in the short-term, it may be unrealistic. The long-term clinical challenge is to establish a link with JB so she feels safe to return when, not if, life gets in the way and she regains some weight. Keeping the door open in a nonjudgmental fashion may be among the best things we can do for our patients. Copyright © 2005 by the American Dietetic Association.