Weight Management: A Practitioner's Guide

This 278 page book is a long awaited `must-have' book for all working in the field of weight management, chronic disease and every condition where weight management is a key part of the treatment. It is exactly what it claims to be and more. This is a practitioner's guide, which details every step of the journey one encounters supporting clients/patients in trying to manage their excess body weight. It takes us through all the steps, from setting up services right through to evaluating effectiveness of services/interventions. It considers both one-to-one and group settings. It is intended as a reference for both the acute and community setting.It presents the evidence base for the behavioural approach to weight management, which I peronally believe to be an approach essential to all dietetic care provision and the management of all medical conditions, claiming to be provided in a patient-centred way. Its major strength and value is in the level of detail it provides for the practitioner to put the evidence into practice and deliver structured care. For every aspect of the intervention that needs to be addressed with clients, from the initial assessment, dietary and physical activity advice, individual energy/dietary and activity prescriptions, personal plans, use of skills and strategies of behaviour change, this guide provides explanations, examples of how to have a conversation with clients using helpful empowering language, opportunities for reflection and case studies. References in the form of further reading, texts and video links are recommended throughout the text to support reflective practice.It is clearly laid out with 5 main sections:Section 1 Background Information includes 3 chapters addressing 1) why to treat obesity (facts and causes), 2) health professionals' attitudes towards obesity and the value in reflection on same and the influence of one's attitude on the care delivered 3) the treatment options including diet, activity, the behaviour change approach, drugs and surgery.Section 2 Practical application includes 10 chapters (chapters 4 - 12) providing the `nuts and bolts' of supporting clients on their journey with weight management from preparation to a weight loss period to a weight maintenance period. Through these chapters, a structured approach to weight management is presented which includes: time for an assessment consult, integration of the essentials of the behavioural approach (i.e. addressing preparation for change, planning, goal setting, problem solving, knowledge to be shared, skills to be learnt). These chapters detail behaviour change skills key to this approach including exploration of motivation, self-monitoring, stimulus control, dealing with difficulties, support, rewards, exploring ambivalence, relapse prevention, emotional eating, dealing with hunger, cravings, etc. This section also addresses many of the common challenges experienced by practitioners and how to address same from discussing the causes of obesity with clients to specific challenges regarding diet (e.g. certain foods can burn fat) and activity (e.g. exercise makes me eat more).Section 3 Appendices includes 17 useful references which include guidance on accurate measurements of BMI, tools to assess binge eating, activity levels and energy intake.Section 4 Resources provides 27 references to texts, video links and resources suitable for use with clients.Section 5 Tools provides 14 tools/worksheets ready to use with clients to support development of personal plans for change.In summary, an essential modern text for Dietitians, undergraduate Dietitian students, Practice Nurses, GPs and Consultants to understand the evidence and be guided on practical application. Further training is recommended.Statement on conflict of interest:I have been fortunate to access training in 2005 on obesity management provided by Dympna Pearson and since then completed Behaviour Change training (Levels 1, 2 and 3) and the DOM UK Obesity Journey course. On a personal basis, I have had the opportunity to support facilitation of role plays as part of Level 1 training with Dympna Pearson. I have long awaited this ready-reference where all the information presented and practised as part of these courses can be easily accessed in one reference text. The provision of sample conversations with clients supports us in self-reflection of our own practice and can only serve to help us provide more structured care, increase confidence and effectiveness in dietetic care provision and thus increase job satisfaction in these challenging times! I volunteered to review the text on publication and hope you find it as helpful as I do.Karen Harrington, Dietitian, M.I.N.D.I., Ireland