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Keywords:

  • clinical nutrition and dietetics;
  • evidence-based practice;
  • overweight;
  • weight control;
  • workforce

Abstract

Aim:  There are currently no data on dietitians' consulting practices or client profiles relating to weight loss in New Zealand. The present study describes the approaches to adult weight loss treatment, the consultation characteristics and the overweight/obese adult client characteristics of private practice dietitians in New Zealand.

Methods:  Thirty-seven dietitians (70% response rate) underwent a 25-minute telephone interview in which they were asked structured questions relating to their consultancy practices with adult self-paying weight loss clients. They subsequently provided anonymous weight loss and demographic data for such clients (n = 1367) over a one-year period. Descriptive statistics were calculated and presented as frequency tables and figures.

Results:  A flexible, small-changes approach was favoured most frequently over structured calorie/portion-prescription for weight loss treatment. All dietitians promoted physical activity and the majority of them (87%) often or always integrated behaviour modification strategies into practice. Most of the dietitians offered services on a casual basis (89%); initial consultations were typically 60 minutes in duration, with follow-ups, 30 minutes. Dietitians' clients were mainly female (80%), middle-aged (45 years ± SD 7 years) and of New Zealand/European ethnicity (92%). Baseline client weight was 87 kg ± 8 kg for females and 107 kg ± 15 kg for males.

Conclusions:  Dietitians' practices aligned mostly with evidence-based guidelines; however, the lack of long-term client follow-up needs to be addressed if dietitians are to provide a lead role in supporting best-practice weight loss and maintenance treatment. The narrow client profile indicates that those with high health burden from poor lifestyle are less likely to engage private dietitian services.