A 43-year old woman with a long history of obesity and moderate hypertension and impaired glucose tolerance is referred to you by her primary care physician for nutritional counseling. The woman says she is not interested in following a diet and is not willing to commit to long-term counseling. What strategy would be most effective in working with her?
  1. Refer her to another RD.
  2. Discuss the value of small, manageable lifestyle modifications and encourage her to add one or two specific changes to her daily routine.
  3. Give her a written 1200-calorie diet plan and ask her to come back in 2 weeks.
  4. Lecture her about the risks to her health if she remains obese.
Explanation
Answer: B - The strategy that would be most effective in working with this woman would be to suggest a few small beneficial changes that she can make on her own without changing her entire diet. Having success with a few manageable suggestions may motivate her to begin making other small health-related changes to her diet and lifestyle. Since she is not interested in any type of formal diet instruction, providing a 1200-calorie written diet plan or lecturing her about her health risks will only reinforce her resistance to change.
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