Weight management has been thought of as only weight loss by many. Weight management covers all aspects of attaining and maintaining optimum weight for a healthy lifestyle. Health professionals now realize that prevention of weight gain as well as weight loss and improving health status are important goals. These goals must be individualized for success.
At the outset of treatment, the patient and health care provider should discuss and agree upon goals. The goals must take into account the food habits, exercise behaviors, psychological outlook and support systems of the individual. Realistic expectations, short- and long-term, may be promoted by a discussion of a healthy weight versus an ideal body weight. Features of weight management interventions may include behavior modification, dietary principles, energy balance components, and a sound food plan.
In order to create a behavior modification plan that will be successful for the individual, identifying cues, responses and consequences of eating behaviors is necessary. Control of eating behavior, physical activity, emotional, social, and psychological health must all be analyzed and interventions applied. Behaviors related to problems with intake and expenditure of energy must be specifically defined. Recording and analyzing eating and exercise behaviors to develop strategies aimed at learning new behaviors are essential.
Dietetic practice in weight management is complex and challenging. Assessment of weight and health should guide weight management goals and outcomes. The weight and dieting history should include age of onset of weight problems, number and types of diets, exercise history, possible triggers to weight gains and losses, and an appropriate range of weight change. The Body Mass Index (BMI) is considered the standard measurement for weight status. The BMI is estimated by weight (kg) divided by height (m2). A BMI of 25 – 29 is considered overweight and some weight loss is recommended. There is debate surrounding how much weight loss should be attained.
In considering a weight management plan, it is necessary to incorporate each of the following:
• realistic goals (weight loss average of ½ to 1 pound per week);
• energy intake limits related to the energy output of the individual (the Basal Metabolic Rate (BMR) + activity level should be used to determine range of intake (see Table 1));
• a nutritionally adequate diet; (A balance of carbohydrates, fats, and proteins with variety and appealing foods is needed for successful weight management. Foods should be similar to those individual is used to eating to encourage permanent behavior changes.) and
• energy intake adjustments when the weight goal is reached in order to maintain optimal weight.
A negative energy balance is the goal for weight loss. For weight loss, the BMR, caloric intake, and caloric expenditure...