Medical nutrition therapy for the treatment of obesity

Most physicians do not have the benefit of in-house registered dietitians to facilitate patient evaluation and create treatment plans. Fortunately, with the new tools that are available to physicians and patients, energy balance can be evaluated. Then, a balanced deficit diet can be encouraged to achieve a weight management goal while maintaining healthy food intake patterns. Patients should also be counseled regarding weight maintenance diets to prevent weight gain. A low-fat diet is preferred because the patient will benefit from improved cardiac risk as a result of weight loss and a restricted saturated fat content is healthier. Other diets and approaches are acceptable if they are hypocaloric and do not negatively impact the patient's health (eg, some high-protein, high-fat diets can increase lipid levels; high-carbohydrate diets can increase triglycerides in patients who have type 2 diabetes). As patients lose weight, further increases in physical activity and exercise should be emphasized to help maintain lost weight. It is also helpful from a behavioral perspective to encourage patients to monitor their weight, food intake, and physical activity. Medical offices can support patients by providing weekly or biweekly weigh-ins to track progress and provide ongoing feedback. Patients should be reminded that the ultimate goal of any weight management program is gradual, incremental weight losses that are maintained over time. Sustainable and enjoyable changes in eating practices and physical activity patterns must be made along with a lifelong commitment to health.