Weight Management Counseling Using a Targeted Lifestyle Patterns Approach

Because overweight and obesity typically coexist with type 2 diabetes, weight management counseling is an integral function of diabetes clinicians. However, the task can be daunting with the limited time and resources available and with patients who vary in their attitudes, abilities, and cultural backgrounds. Furthermore, diabetes clinicians differ in their skill sets and competency regarding delivery of obesity care. The cornerstone of treatment for overweight and obesity is lifestyle intervention, which involves counseling on diet, physical activity, and behavior.1 Although some clinicians may lack confidence in their diet and nutrition background, others may feel challenged giving exercise advice, and others still may not know what to do when stress interferes with their patients' weight loss efforts. To improve confidence in counseling skills, clinicians would benefit from using an efficient, targeted approach that is easy to understand and follow, is comprehensive, covers the three aspects of lifestyle modification, and addresses each patient's individual needs. A new weight management counseling method that accomplishes these goals is the Lifestyle Patterns Approach. Pattern recognition, also known as heuristics or intuitive thinking, is an innovative approach to counseling.2 Pattern recognition is familiar to diabetes clinicians when reviewing the relationship between a patient's blood glucose, meals, and medication administration. Adjustments in meals and medications are made after reviewing a patient's blood glucose patterns. For obesity care, diet, physical activity, and behavioral counseling are adjusted based on a patient's lifestyle patterns. This is the basic premise underlying this new counseling method. Figure 1 depicts a lifestyle patterns organizational chart showing the seven lifestyle patterns in each of these three dimensions.3 These 21 patterns were developed intuitively after treating thousands of overweight patients during the past 25 years. By taking a previously validated 50-item questionnaire, patients find out, for example, if their eating pattern …