Weight Reduction for Obesity

Kaitlin Allan, Chloe Kuet, Natalie Rusu, & Stephania Tilton

Client - Theresa Sunday
- 41 yo female
- BMI: 34.8 (Obese)
- Weight: 209
- Sedentary lifestyle, sits at a desk all day (secretary)
- Lives alone
- High levels of cholesterol, LDL, triglycerides, fasting blood glucose (FBG)
- Low HDL levels
- Diet high in processed foods, fat, sugar, and sodium
- Low vegetable and fruit intake
Social Cognitive Theory (SCT)
- Structured around aspects that influence one’s behaviors including dietary
habits
- Environmental
- Individual
- Behavioral
- Environment, individual, and behavior influences can affect each other
Social Influences on Theresa
- Lives alone
- Opinionated family member
- Work environment
- Her physician
- Diet pills or gastric bypass surgery that she had read about on the internet
Motivational Interviewing
- Strategy that provides the client motivation and confidence to perform dietary
changes
- Based on the following principles:
- Motivational interviewing spirit
- Motivational interviewing principles
- Change talk
- OARS: Open ended questions, Affirmations, Reflections, Summaries
Article on Motivational Interviewing
- Randomized, controlled, clinical trial in which participants all received an 18-
month treatment
- individual sessions of motivational interviewing or attention control to the
weight control program
- Focus of motivational interviewing
● change talk and commitment language
● engaging in discussions of what motivated change
● shifting landscape of ambivalence about changing eating and exercise habits
● how behavioral changes might be congruent with the individual's visions for
the future and personal values
- Motivational interviewing can be a beneficial adjunct to behavioral obesity
treatment for women with type 2 diabetes
Skit
24 Hour Recall
Breakfast: Mid-afternoon Snack:

1 C. coffee with 1 T sugar and 1 tsp half and half 1 C. 2 % milk and 1 sugar cookie

1 C. orange juice
Dinner:
1 Jimmy Dean breakfast sandwich

5 oz beef, pork, or poultry

Lunch:
1⁄2 C of pasta with 1⁄2 C marinara sauce
1 roast beef/turkey sandwich with 1 T each mustard and
mayonnaise 1 slice each tomato and onion 3⁄4 C mashed potato with 1⁄4 C. gravy

1 med coke 1⁄2 cooked vegetable with 1 tsp. butter

1 bag of baked potato chips 1 - 2”x3” frosted cake

Evening snack:
Structured Meal Plan
- Many different types
- Prepackaged foods or dinners
- Grocery lists & recipes
- Jenny Craig
- Hello Fresh
- Portion meals
- Typically have certain percentages of fat, protein, carbohydrates
Article on Structured Meal Plan
- Randomized Clinical Trial of Portioned-Controlled Prepackaged Foods to
Promote Weight Loss
- The participants were divided into three groups
1. Prepackaged entrees
2. Prepackaged entrees with >25% energy from protein
3. Meal plan based on self-selected foods
- All participants went through nutritional counseling
- Group with the regular prepackaged entrees had the highest mean percent
weight loss
Skit
Skill Development
- Development of skills can provide a healthier diet
- 6 Steps
- Skill development can include
1. Nutrition label reading
2. Healthy cooking
3. Planning balanced meals
4. Efficient grocery shopping
5. Meal prep
Skit
Conclusion
- Motivational interviewing, structured meal plan, and skill development will work
well with Theresa
- However, SCT is not the best fit for Theresa
- Cognitive Behavior Theory
- Health Belief Model
Quiz
1. T/F Social Cognitive Theory only focuses on individual and behavior changes.
2. OARS is used in what counseling strategy?
a. Structured Meal Planning
b. Motivational Interviewing
c. Skill Development
3. T/F Structured meal plan only uses pre-packaged entrees.
4. Learning to correctly read nutrition labels is an example of the
________ ________ Strategy
References
1. Rock CL, Flatt SW, Pakiz B, Barkai H-S, Heath DD, Krumhar KC. Randomized clinical trial of portion-
controlled prepackaged foods to promote weight loss. Obesity. 2016;24(6):1230-1237.
doi:10.1002/oby.21481.
2. Nutrition Counseling and Education Skill Development, 3rd edition; Authors, Kathleen D. Bauer,
Doreen Liou,. (2016) Brooks Cole Co
3. Delia, Smith West, et al. "Motivational Interviewing Improves Weight Loss in Women with Type 2
Diabetes." Diabetes care 30.5 (2007): 1081-7. ProQuest. Web. 27 Oct. 2016.
4. DiLillo V, West DS. Motivational interviewing for weight loss. The Psychiatric clinics of North America.
2011;34:861.
5. Academy of Nutrition and Dietetics Evidence Analysis Library. "AWM: Nutriton Education 2006
Accessed 10 October 2016:
http://www.andeal.org/topic.cfm?cat=2887&highlight=nutrition%20education%202006&home=1
Questions?