A survey of dietetic practice in obesity management
Introduction: Little is known about how dietitians organize the management of overweight and obese clients. The aim of this survey was to identify current dietetic practice in the management of such clients. Methods: In preparation for the joint Association for the Study of Obesity/British Dietetic Association (BDA) symposium in November 1997, a questionnaire was sent to BDA members registered on two BDA databases in order to identify current practice in the dietetic management of obesity. A total of 347 BDA members were contacted; 252 dietetic heads of service (or equivalent) and 95 members on the BDA freelance register. Information relating to referral criteria, organizational details and key features of typical management programmes was collected. Results: A poor response rate of 40% was achieved, with a similar response rate from dietetic heads of service and freelance dietitians. Of those who did respond, 91% accepted referrals for overweight or obese clients. The majority of respondents allocated up to 30 min for a new client appointment, and offered at least one follow-up appointment, usually at 4-week intervals and lasting up to 20 min. Freelance respondents allocated longer times for new client and follow-up appointments, and also reviewed patients more frequently (but did not allocate more follow-up appointments), than dietetic heads of service. Most consultations were on an individual basis and were not guided by standardized protocols. Conclusion: There is clearly an opportunity for dietitians to move towards evidence-based treatment of obesity, without substantial resource implications, by offering longer-term treatment using group therapy. The use of clinical guidelines, and auditing future dietetic practice against these guidelines, should be considered.
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