A comprehensive outpatient weight reduction program: dietary patterns, psychological considerations, and treatment principles.

A comprehensive outpatient approach to weight reduction has the best chance of long-term success. This article outlines the dietitian's role and summarizes dietary patterns and psychological problems encountered in such a program at the University of Virginia Clinical Nutrition Center. Patients were assisted in making gradual changes in eating patterns through nutrition education and the use of behavior modification techniques. Initial food diaries often reflected a low intake of fruits, vegetables, whole grains, and legumes; increased consumption of these high-fiber foods is advocated as an aid to weight loss. Psychological support is an important component of the weight reduction process. The dietitian must be adequately prepared to provide this therapy but also must be able to recognize when patients should be referred for further psychological counseling. Two case studies are presented to illustrate the sabotage which must be dealt with by patients as they lose weight and struggle to maintain that weight loss.