THE DIETITIANS PHILOSOPHY AND PRACTICE IN MULTIDISCIPLINARY WEIGHT MANAGEMENT

Dietitians are developing a philosophy and a practice protocol of weig ht management. A professional philosophy of weight management addresse s questions about the social, psychological, and biological spectra of weight management: Should overweight be considered in terms of size a cceptance or gluttony and sloth? How should emotional overeating and o bsessive restriction be managed? Should obesity be considered a chroni c disease, or should the idea that health at every size is possible be espoused? A professional practice protocol addresses another set of q uestions: Is obesity to be viewed as a short-term and long-term health challenge? Regarding the spectrum of antiobesity agents and antidieti ng approaches of weight management, what professional position and ind ividual practice will be adopted? Should professional contact with pat ients be continuous or aimed toward self-care? What measures of succes sful outcomes will be used: weight change or life quality improvement? How should professional responsibility be balanced with personal conc erns about eating and health behaviors that affect body weight? What a re examples of closing the gap between the vision and the reality of t he roles and goals of the dietitian on a weight management team? Dieti tians are translating philosophy into practice. Because dietary contro l alone has a record of limited success in weight loss and less succes s in maintaining weight loss, the dietitian's expanded role includes h elping patients manage weight with coping skills, motivation technique s, physical activity, and food behavior change. The challenge is integ rating functional components of practice with dietitians' unique food and nutrition skills that include selection of alternative foods, port ion control, and preparing acceptable, tasty foods for lifelong weight management.