Dieting As A Change Behaviour

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Dieting is part of a complex process of changing behaviour. Prochaska has described the various steps which a person takes in contemplating a possible change in behaviour before such change is actually implemented and hopefully also maintained during later phases (3). For such changes to take place, realistic goals must be available. Foster et al. have described that most patients joining an obesity clinic have goals which are clearly unrealistic and which may lead to frustration, early drop-out and relapse (4). For practical reasons, goals can be divided into an overall long-term goal (where a 10% maintained weight loss is realistic) and short-term goals (which are helpful to cope with everyday problems). These goals may be changed at short notice in relation to everyday life problems. The point is to make the obese patient in dietary

Table 30.1 Characteristics of macronutrients (modified after Blundell (5))

Fat

Protein

Carbohydrate

Alcohol

Low

High

Intermediate

Stimulates appetite

Low

High

High

Stimulates appetite

High

Low

High

Varies

High

Low

Low

High

High

None

Low

None

No

Yes

Yes

Yes

Poor

Good

Good

Poor

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