7 Ways to Help a Client Boost Adherence

Once a client has decided to make nutritional changes to support weight loss, you can play a key role in developing an action plan that is most likely to support those changes and contribute to long-term adherence.

Following are seven strategies that can be used to support adherence to a particular diet, or rather “eating plan” or “lifestyle change.”

  1. Keep a food journal. Have the client keep a food log for 3 days, including 2 typical weekdays and 1 weekend day, prior to starting a diet. This will help the client identify baseline eating habits. Advise the client to measure portions and read nutrition labels. Help him find an app or a food tracker (a good quality, free one is www.supertracker .usda.gov) to input the recorded information for a summary of calories, carbohydrates, protein and fat. Then, once on the diet, the client can periodically check in and compare current eating habits wit hteh diet’s suggested regimen.
  2. Be realistic. Help the client identify areas of change needed to adhere to the eating plan. If the changes feel too drastic, or the client has low confidence that she will be able to adhere to them, consider coaching her to identify the most realistic opportunities for change.
  3. Assess the home environment. For a client to adhere to an eating plan, the home environment has to support the plan. Help the client clean out foods that are inconsistent with the eating plan, and load up on healthier, nutrient-dense options. To support him in eating less, suggest reducing quantities and using smaller plates and utensils.
  4. Incorporate a doable physical activity program. A “doable” program is likely not only to provide results but also to be something the client actually enjoys and finds relatively easy to incorporate into her daily routine. The American College of Sports Medicine recommends 150–250 minutes per week of moderate-intensity activity for improved health and to prevent weight gain (Donnelly et al. 2009). This is equivalent to about three 10-minute activity bouts per day.
  5. Garner support. Social support is recognized as a very important predictor of weight loss success. Social circles also predict health behaviors. Help the client strengthen relationships with people who are like-minded and are practicing healthy behaviors. If those relationships do not currently exist, direct the client to appropriate social programs and groups. Encourage family involvement to the highest extent possible.
  6. Self-monitor weight. By keeping tabs on his weight, the client can see when regain begins and make the necessary adjustments to stop it. In fact, studies suggest this is a key behavior of people who lose weight and keep it off (Coughlin et al. 2013).
  7. Check in with a weight loss coach monthly. The Weight Loss Maintenance Trial found that the individuals most likely to maintain their weight loss had monthly personal counseling sessions incorporating nutrition and physical activity for at least 2 years. The sessions were brief and took place by phone (Svetky et al. 2008).

To read more about this subject, please see “What’s the Best Diet for Me?” in the online IDEA Library or in the March 2015 print issue of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at (800) 999-4332, ext. 7.

Natalie Digate Muth, MD, MPH, RD

Natalie Digate Muth, MD, MPH, RD

"Natalie Digate Muth, MD, MPH, RDN, FAAP, is a board-certified pediatrician and obesity medicine physician, registered dietitian and health coach. She practices general pediatrics with a focus on healthy family routines, nutrition, physical activity and behavior change in North County, San Diego. She also serves as the senior advisor for healthcare solutions at the American Council on Exercise. Natalie is the author of five books and is committed to helping every child and family thrive. She is a strong advocate for systems and communities that support prevention and wellness across the lifespan, beginning at 9 months of age."

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