The Dietitians’ Philosophy and Practice in Multidisciplinary Weight Management

Abstract

Dietitians are developing a philosophy and a practice protocol of weight management. A professional philosophy of weight management addresses questions about the social, psychological, and biological spectra of weight management: Should overweight be considered in terms of size acceptance or gluttony and sloth? How should emotional overeating and obsessive restriction be managed? Should obesity be considered a chronic disease, or should the idea that health at every size is possible be espoused? A professional practice protocol addresses another set of questions: Is obesity to be viewed as a short-term and long-term health challenge? Regarding the spectrum of antiobesity agents and antidieting approaches of weight management, what professional position and individual practice will be adopted? Should professional contact with patients be continuous or aimed toward self-care? What measures of successful outcomes will be used: weight change or life quality improvement? How should professional responsibility be balanced with personal concerns about eating and health behaviors that affect body weight? What are examples of closing the gap between the vision and the reality of the roles and goals of the dietitian on a weight management team? Dietitians are translating philosophy into practice. Because dietary control alone has a record of limited success in weight loss and less success in maintaining weight loss, the dietitian's expanded role includes helping patients manage weight with coping skills, motivation techniques, physical activity, and food behavior change. The challenge is integrating functional components of practice with dietitians’ unique food and nutrition skills that include selection of alternative foods, portion control, and preparing acceptable, tasty foods for lifelong weight management. J Am Diet Assoc. 1998;98(suppl 2):S49–S54.