Wellness Protocol: Weight Management

PHILOSOPHY:   For persons desiring to lose weight on their own, but still needing someone to interact with, while not being part of a structured program requiring attendance at set times.

FORMAT:   The Wellness Counselor will be available during posted office hours so the client can come in weekly if she/he feels it is necessary or with a scheduled a appointment. The first six sessions consist of weighing, counseling, and other feedback over a period of six months. The maintenance sessions can be monthly for another six-month period and then follow-up phone calls should be made for reinforcement. Clients are always encouraged to visit the wellness office for weight checks and feedback.

Session I. Initial Contact

1. Weigh the client.



2. Write down the client's goal weight.



3. Write down the client's ideal weight.



4. Negotiate a realistic weight loss for specific time period (two to five pounds at a time, etc.).



5. Examine the client's seating habits and point out where healthy changes can be made.



6. Inquire if the client would like a weight loss partner. If the client has no one in mind, suggest checking with other people (maybe someone with another CVD risk) for support.



7. Give a wallet card to the client and explain its use.



8. Make an appointment for the next visit.

• Wallet Card (developed by the University of Michigan Worker Health Program)
  
• Guide to Good Eating (National Dairy Council, 1998 or most recent)
  

Session II. One Week Later

1. Weigh the client and complete follow-up form.



2. Go over the previous week's diet and suggest changes, if necessary.



3. Assess how much dietary structure the client needs.



4. Adapt the program to the client's needs: i.e., vocabulary, ethnic or cultural background, etc.



5. Offer to talk to the client's spouse if she/he does the shopping or cooking.



6. Discuss managing eating while at work (buying and bringing in lunches).



7. Make an appointment for the next visit.

• Follow-up form (developed by the University of Michigan Worker Health Program).

1. Weigh the client.



2. Ask about the client's alcohol consumption. Explain that alcohol can be a source of many unnoticed calories in the diet. Note that the calories from alcohol provide little nutrition but instead add to weight gain.
   
   

   Alcohol type	Serving	Calories	Nutrition exchanges
   Regular Beer	12 oz.	151	1 starch, 2 fat
   Lite Beer	12 oz.	90	2 fat
   Table Wine	4 oz.	80	2 fat
   Distilled Spirits	1½ oz.	107	2 fat
   (86-proof gin, rum, vodka, whiskey, Scotch, etc.)

   
   Equivalents: 1.5 oz. distilled spirits = 4 oz. wine = 12 oz. reg. beer
   Source: American Dieticians Association



3. Explain to the client how exercise relates to weight reduction by burning calories. Exercise helps keep off the pounds that are lost through calorie restriction.
   
   Build exercise into the client's daily routine:



• Park further away at work, in the mall.
• Take stairs instead of escalator or elevator.
• Take walks at lunch or in evening.
4. Make an appointment for the next visit.

Session IV. One Week Later

1. Weigh the client.



2. Review the client's eating and drinking habits and discuss what changes have been made. If necessary, have the client commit to another date to implement any changes.



3. If the client reports drinking any alcohol, remind the client that alcohol can add to weight control problems because of the empty calories it puts in the diet. Ask if they remember how many calories there are in:



• a 12 oz. can of beer? (90-151 calories, 2 fat exchanges)
• a 4 oz. glass of wine? (90 calories, 2 fat exchanges)
• a 1½ oz. shot? (at least 107 calories, 2 fat exchanges)

(as proof goes up, so do the calories)

4. Teach the client how to control binges and urges for either food or drink.



5. Make an appointment for the next visit.

1. Weigh the client.



2. Help client learn how to eat in restaurants or fast food places, and stay on diet.



3. Help client learn how to survive the holidays and special occasions while dieting.

Session VI. and Future Sessions. Monthly

1. Weigh the client.



2. Maintenance:



• Go over the original goals for weight loss and help the client develop a long-term eating plan.



• Encourage the client to call the office if she/he needs reinforcement between visits.