Answering the Age-Old Question “So, What Do You Think About This Diet?”

Since there is no one “best” diet, and since adherence to a new eating and exercise plan is the most important predictor of whether someone will lose weight and keep it off, providing a simple answer to the question “So, what do you think about this diet?” is unlikely to be helpful. With adherence— rather than the number of fat grams or carbohydrates—being the most crucial factor, the objective changes from providing a client with information about which diet is best to supporting a client in making changes that he or she not only
is ready to make but can feasibly sustain.

Therefore, when clients ask what you think about a
particular diet, ask if it would be okay if you posed a few questions to them first. Examples of questions are outlined below. These are the types of questions one might ask when using motivational interviewing as a communication technique, with the aim of providing two to three reflections for each open-ended question (this is demonstrated below with the first question). This approach is more likely to help a client gain insights into the change he or she is contemplating—insights that can then help you and your client work together to develop an adherence-enhancing action plan, should the client decide that now is a good time to make the change.

  • “What do you know about this diet already?” After the client answers this question, provide a couple of reflections of what you heard. For example, consider this hypothetical conversation:

    Client, who is considering starting a low-carbohydrate diet: “Well, I know that you pretty much eliminate carbohydrates. No more bread. No more pasta. No more rice. No more fruit, at least for a while. And then you lose a lot of weight.”

    Fitness professional: “So you know that if you make some of these changes to what you eat, you will lose weight.”

    Client: “Yes, I think so. I mean it would be hard to make all of those changes. But I know I need to lose weight. And I’ve heard the quickest way to lose weight is to follow a low-carb diet.”

    Fitness professional: “You want to go on a diet so you can lose weight, and you want to lose it quickly. But you know it won’t be easy.”

    Client: “Yes, right.”

  • “What is it about this diet that most appeals to you?”

  • “Based on your research, what changes do you think you’d need to make to follow this diet?”

  • “On a scale of 0–10, with 0 being not at all and 10 being absolutely, how ready are you to make those changes right now?”

  • “On the same 0–10 scale, how confident are you that you can sustain these changes for at least the next year?”

  • “So what do you think you’ll do?”

  • If during the questioning a client provides information that is factually incorrect or could potentially cause harm (for example, the client is considering taking a potentially dangerous weight loss supplement), refrain from overt correction; instead, ask the client’s permission to share the information. For example:

    “The eating plan you mention includes weight loss supplements. Would it be okay with you if I share with you a concern I have about weight loss supplements?”

    Overall, the client’s answers to these questions will help in assessing whether the client is ready to make a change, and if so, what changes he or she will be most likely to sustain. From there, if the client is ready, you can help him or her make plans to optimize adherence.

    To read more about eating plans your clients may be contemplating, 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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