If not dieting, now what?
BACKGROUND: Helping patients to achieve and maintain their most healthy weight is a common challenge. Giving a "one size fits all" set of instructions to patients who are over their most healthy weight does not help. OBJECTIVE: This article discusses approaches to assist weight loss in patients while treating each patient as an individual. DISCUSSION: By using less emotive, more supportive and accepting language, we can still talk about reality (for example "a patient being above their most healthy weight") while minimising the risk of negatively impacting on the patient's self esteem. It is important to spend time learning from the patient, factors that have influenced their relationship with their body and weight, and the reasons why that person's weight has become above their most healthy weight range. We need to help patients focus on changes to their thinking, attitude and behaviour with weight loss to come as a result of that. Motivational interviewing is a useful counselling approach. It is also helpful to have a range of options to offer patients. This may include reading resources; a team of health professionals to refer to such as dieticians, counsellors, physiotherapists, and exercise specialists; or appropriate community group programs.