Outcomes

The areas selected for Monitoring and Evaluation should reflect the patient's goals as well as the overall long-term goal of changes in weight and BMI. Progress can sometimes be measured in a single session, as the patient's goals may have changed during the consultation. For example, their knowledge at the beginning of the session may not have included the energy content of specific foods; but they have acquired this knowledge by the end of the session. Likewise, during the consultation there may have been a shift in the patient's readiness to change.
If after three months of active management the patient has not lost weight, the practitioner needs to reappraise their lifestyle, behaviors and other possible explanations. Depending on the degree of overweight and comorbidities, the practitioner needs to be conscious of focused and intensive interventions, such as pharmacotherapy or bariatric surgery for weight reduction, as an alternative to nutrition intervention^(1,2)