Why Adherence is a Challenge for Both Weight Loss Patients and Dietiti - Rational Foods
Why Adherence is a Challenge for Both Weight Loss Patients and Dietitians

Why Adherence is a Challenge for Both Weight Loss Patients and Dietitians

October 30, 2018

We often think of the role of the registered dietitian in the post-surgical context. However, initial pre-op consultations are also important, as they lay the groundwork for optimal outcomes.

Looking to make the most of your initial consultations with your own bariatric patients? Read on for four tips aimed at helping you make the most of these meetings.

1. Use the consultation as an opportunity for understanding.

Every bariatric patient is different, with different goals and needs. A rule of thumb shared by bariatric dietitian Renee Cooper, RD, LD with Today’s Dietitian: “As a clinician, you must ask yourself if the patient is going to be successful after surgery. If not, what can you do to help them be successful?”

Determining a patient’s readiness for change is an important part of this process. “Some patients may not have even considered making changes to their food habits; some may have just started to think about it, while others have already started making significant changes,” says dietitian Kristen Smith, MS, RD, CDN.

The better able you are to identify where patients fall on the continuum, the more appropriately you can target the session to meet their unique circumstances.

2. Reinforce the importance of good nutrition.

Bariatric surgery isn’t a magic bullet for weight loss, nor is it a magic bullet for health and wellness. In order to get the best post-op results, patients must have functional knowledge of nutrition as well as an actionable understanding of good eating habits.

Keep in mind that many patients may not even know the basics. Says Jody Halouska, RD: “Some of the clients we see have been dieting their whole life and understand what they should be eating but haven’t been able to translate that knowledge into their lifestyle. Others may have no clue about basic nutrition, how to cook, or how to make good choices with regard to eating.”

The takeaway: Rather than jumping right into more complex concepts which can be intimidating to pre-op patients, keep bariatric nutrition counseling simple.

“I focus on basic healthful eating and encourage patients to start making gradual changes, such as eating more fruits and vegetables, drinking less sugary drinks, or eating less fried food,” continues Smith.

3. Focus on personal accountability and responsibility.

According to Today’s Dietitian: “Bariatric surgery is anything but a quick fix for morbid obesity. In fact, surgery is little more than a tool that works best in conjunction with specific diet and lifestyle changes to facilitate weight loss and improved health. From drastically reduced portion sizes, unpredictable food intolerances, or the necessity of regular exercise, dietitians can use preoperative counseling to give their clients a realistic outlook of the postoperative experience.”

In other words, bariatric patients are likely to falter if they sit back and expect the surgery to do all the work for them. Rather, patients should be prepared to take on active roles when it comes to postoperative diet and lifestyle.

How can you best support patients in being responsible and accountable? By arming them with their best weapon: Information.

“We provide a two-hour preoperative class in which patients receive in-depth instruction of all the postoperative nutrition recommendations and a binder to reference when they go home,” says Halouska. “If they follow the instructions and guidelines presented in the class and binder and come back in for follow-up counseling and support from our staff, they will very likely be successful with surgery. If they don’t, they probably won’t be successful,”

In some cases, a patient may require additional bariatric nutrition counseling prior to surgery. As a dietitian, you can boost a client’s chances of success by following up to ensure they have access to all of the information they need to adhere to the bariatric diet and achieve their weight loss goals.

4. Address barriers to success.

While nutrition is a major part of the bariatric weight loss puzzle, it’s far from the only factor. Everything from financial constraints to eating habits to lack of a support system at home can also come into play. Dietitians who acknowledge and address these issues can help patients devise proactive strategies for overcoming them.

For example, perhaps a patient is a busy mom who doesn’t have time to cook bariatric-friendly meals every night while simultaneously feeding an on-the-go family. Going over meal planning and preparation tips can be a useful preventative step. Or, if a client’s job requires him to frequently dine out, sharing tips for making healthy menu selections can help him enjoy eating out without sabotaging his weight loss goals.

One last thing to keep in mind: Bariatric surgery is as much an emotional journey as it is a physical one. In addition to providing invaluable bariatric nutrition counseling, dietitians can also provide essential emotional support by treating patients with dignity, respect, and understanding during consultations.