What is Adult Weight Management

What is Adult Weight Management?

Adult weight management addresses health and quality of life concerns by providing “a spectrum of life-long care services available for persons whose goals can be achieved through evidence-based, weight-related interventions and intersects most practice areas of nutrition.”1 Understanding the components of prevention and treatment to ensure a patient-centered approach is the priority of those who provide weight management care.

Weight management is valuable and beneficial for the following reasons:

  • Achieving a healthy body composition can decrease risk factors for several diseases.2-8
  • Quality of life can be improved with a reduction in body fat and health related improvements.9-10
  • Successful health related behavior change helps the client increase their self-confidence, self-esteem, and energy while achieving the quality of life that they desire.1,11

RDNs who work in weight management:

  • Listen to the client to clearly identify their goals and values.
  • Assess an individual’s weight benchmarks in relation to their impact on patient/client identified health and/or quality of life concerns.
  • Assess the client’s nutrition, health status, and disease risk.
  • Assess the client’s health and well-being-related goals, assess their interest and ability to change, and then discuss strategies for behavior change.
  • Help clients who are interested in weight loss determine a healthy weight range
  • Focus on the client’s health-related goals while assessing the foods the client eats and how they fit into an eating plan.
  • Talk with the client about lifestyle changes they might make using behavior change strategies like Motivational Interviewing, coaching, cognitive behavioral therapy, etc.
  • Help the client decide how they want to proceed and what tools the client wants to use to monitor change (which may or may not include weight).
  • Focus on health as the overall goal and help the client find motivators beyond the scale, including self-efficacy, mobility, and quality of life.
  • Help the client understand the long-term nature of health-related behavior change.
  • Provide support and accountability to the client as they make lifestyle changes.
  • Assist the client as they move forward in finding additional support (e.g. healthcare provider, mental health provider, personal trainer) as needed.
  • Collaborate with other treatment or healthcare providers as needed.
  • Encourage regular, enjoyable physical activity and stress reduction.

As the recent Standard of Practice (SOP) states – “The adult weight management Registered Dietitian Nutritionist (RDN) is responsible for providing a psychologically safe, accessible, and respectful setting and empowering care to those seeking nutrition services. This requires the RDN to act as an advocate by proactively seeking to identify personal and external weight biases, understanding the impact of those predispositions, and acknowledging how weight-related prejudices are intricately connected with systems that impact nutrition both inside and outside of health care.1” Addressing the needs and goals of the client should be the foundation of how all RDNs practice. The Weight Management DPG is committed to ensuring this standard is held by its members and providing resources to educate and inform new and current weight management dietitians.

References:

  1. Tewksbury C, Nwankwo R, Peterson J. Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitan Nutritionists (Competent, Proficient, and Expert) in Adult Weight Management. J Acad Nutr Diet. 2022; 122(10): 1940 -1953. doi.org/10.1016/j.jand.2022.06.008
  2. Bray GA, Heisel WE, Afshin A, et al. The Science of Obesity Management: An Endocrine Society Scientific Statement. Endocr Rev. Apr 1 2018;39(2):79-132. doi:10.1210/er.2017-00253
  3. Afshin A, Forouzanfar MH, Reitsma MB, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. Jul 6 2017;377(1):13-27. doi:10.1056/NEJMoa1614362
  4. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. Sep 1994;17(9):961-9. doi:10.2337/diacare.17.9.961
  5. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. Apr 1 1995;122(7):481-6. doi:10.7326/0003-4819-122-7-199504010-00001
  6. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. J Am Med Assoc. 2013;309(1):71-82. doi:10.1001/jama.2012.113905
  7. Magkos F, Fraterrigo G, Yoshino J, et al. Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity. Cell Metab. Apr 12 2016;23(4):591-601. doi:10.1016/j.cmet.2016.02.005
  8. Zheng Y, Manson JE, Yan C, Liang MH, Grodstein F, Stampfer MJ, Willett WC, Hu FB. Associations of weight gain from early to middle adulthood weight major health outcomes later in life. Journal of the American Medical Association. 2017; 318(3):255-269. doi:10.1001/jama.2017.7092
  9. Anderson JW, Konz EC, Frederich RC, Wood CL. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001;74(5):579-584. doi:10.1093/ajcn/74.5.579
  10. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82(1):222S-225S. doi:10.1093/ajcn/82.1.222S
  11. Cardel MI, Newsome FA, Pearl, RL, et al. Patient Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk. J Acad Nutr Diet. 2022; 122(6):1089-1098. https://doi.org/10.1016/j.jand.2022.01.004