to individual-level characteristics, various social and environmental factors may also influence a client’s ability to implement a specific dietary intervention; practi- tioners should take this information into account. In order to effectively translate dietary interventions for weight management into practice, practitioners should keep the following points in mind:


ƒ Weight management is ideally implemented by a multidisciplinary team.8 Because diet is a fundamental aspect of weight management, the team should include a nutrition expert, such as a registered dietitian nutrition- ist with appropriate training.7


ƒ An energy deficit over a given period of time results in weight loss. An energy deficit can be achieved through various dietary intervention approaches.7,8,16,17


There is no one optimal approach.


ƒ Helping a client make an informed decision about what dietary interven- tion to implement requires considering all potential individual, social, and environmental influences.


– Individual-level influences: These include the client’s health condi- tions and any opportunities for additional health benefits, as well as the client’s preferences, values, medications, nutrition knowl- edge, and food skills (skills needed to purchase, prepare, and cook food to produce nutritious meals).


– Social influences: These may include the client’s socioeconomic status, cultural norms, and family or peer networks, including who is responsible for acquiring, preparing, and cooking food.


– Environmental influences: These may include the client’s access to food or health care services, including transportation options, and the availability of food in the home and community environment.


ƒ The ability of a client to adhere to a dietary intervention is essential for successful weight management.101,102


Thus, patients or clients should be


encouraged to choose a dietary approach that they anticipate being able to follow.103


Summary


To date, an optimal dietary intervention has not been identified for weight loss; we do know, however, that adherence to a dietary intervention is essential for long- term success.101-103


tion to create an energy deficit.8,9


Fundamental to weight loss is the ability of the dietary interven- An energy deficit over a period of time results in


negative energy balance and weight loss. This energy deficit can be achieved through several dietary approaches supported by high-grade evidence,8


but newer approaches are continually being


developed to enhance outcomes. Popular diets and weight loss products can offer additional options, but they need to be critically evaluated by the health care prac- titioner before implementation.


References


1.


Hill J, Levine J, Saris W. Energy expenditure and physical activity. In: Bray G, Bouchard C, eds.Handbook of Obesity. 2nd ed. Marcel Dekker; 2003:631-654.


2. Schwartz MW, Seeley RJ, Zeltser LM, et al. Obesity pathogenesis: an Endocrine Society scientific statement. Endocr Rev. 2017;38(4):267-296. doi:10 . 1210 / er . 2017 - 00111


190 SECTION 3: Interventions for the Treatment of Overweight and Obesity


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