Practical Strategies for Improving Diet Adherence

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Use self-monitoring (e.g., diet records, weighing)

Identify and employ alternatives to eating (e.g., exercise, hobbies)

Find a partner(s) to diet with you

Avoid triggers for eating (especially high-risk foods)

Keep acceptable foods accessible and unacceptable foods inaccessible

Keep a regular eating schedule and eat frequent small amounts rather than infrequent binges

Practice responses to hosts/acquaintances that urge you to indulge or eat more

Follow an eating schedule

Use a shopping list and stick to the list

Do not grocery shop when hungry

Be involved in food preparation

Eat slowly

Do not feel compelled to clean your plate Indulge infrequently in small amounts

After losing weight, give away or sell clothes that are too big Realize that lapses will occur and return to diet after lapses

In fact, better adherence to diet recommendations would greatly reduce the morbidity and mortality associated with obesity and diabetes. For a number of factors, adherence to diet can be difficult and restrictive. This results in both patients and practitioners frequently abandoning diet interventions in favor of medications and even surgery, despite the many adverse effects and complications, not to mention cost, inherent to these therapies. Predictors of poor outcome include prior attempts at weight loss, poor health, psychiatric illness, and multiple life stressors.49, 50 Patients with these factors should therefore be targeted for more aggressive and supportive interventions to improve their chances of success.

The future of obesity treatment involves a multidisciplinary approach that encompasses medical interventions, pharmaceutical developments, and surgical approaches in combination with broad societal changes (school-based programs, workplace programs, food industry and media involvement). Since sustained weight loss by lifestyle change is difficult to achieve, preventing weight gain should be the focus of these changes. Unfortunately, over the last three decades, childhood obesity has more than doubled for children aged 2-5 years and adolescents aged 12-19 years, and it has tripled for children 6-11 years.51 A substantial amount of research examining valid and sustainable treatment options is required.

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