Canadian Dietitians’ Approaches to Counseling Adult Clients Seeking Weight-Management Advice

This study describes Canadian dietitians’ approaches to counseling adults seeking weight-management advice. Fifteen focus groups were conducted at seven sites across Canada. The participants, most of whom worked in clinical or private practice, discussed their approach to specific weight-management counseling scenarios, including women clients with and without associated risk factors (impaired glucose tolerance, hypertension, family history of cardiovascular disease) and long histories of dieting. Results indicate that participants used a lifestyle approach for weight-management counseling, where the main goal was improved client health through healthful eating and increased physical activity. In contrast to clients’ perceived weight loss goals, participants rarely included weight loss as a goal for clients with no additional chronic disease risk factors. For clients with risk factors, some participants advocated moderate weight loss, while others aimed for health at any size. Participants also discussed the importance of clients’ psychological well-being, particularly in relation to feelings about food and body image. Individualized approaches to setting goals, gathering information, and giving advice/educating were identified as key counseling strategies. Further research to evaluate the effectiveness of dietitians’ weight-management approaches and additional counseling training for dietitians will enhance practitioners’ skills and confidence in this area.