Nutrition Intervention
AWM: Utilize the Nutrition Care Process
It is reasonable for registered dietitian nutritionists or international equivalents to utilize the Nutrition Care Process to provide effective, client-centered interventions based on shared decision-making and clinical judgement and individualized to each client’s needs, circumstances, and goals.
AWM: Provide Medical Nutrition Therapy
Medical Nutrition Therapy provided by registered dietitian nutritionists or international equivalents is recommended for adults with overweight or obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, as appropriate for and desired by each client.
AWM: Adapt Goals and Interventions
It is reasonable for registered dietitian nutritionists or international equivalents to monitor and evaluate client outcomes and adapt goals and interventions, including those for weight maintenance, and provide resources as needed for each client.
AWM: Minimize Weight Bias and Stigma
It is reasonable for registered dietitian nutritionists or international equivalents to minimize the effects of weight bias and weight stigma and its consequences by targeting client-centered goals, individualizing interventions according to complex contributors of overweight and obesity, communicating using client-preferred terms, and providing an inclusive physical environment.
AWM: Collaborate with Interprofessional Healthcare Team
Registered dietitian nutritionists or international equivalents should collaborate with an interprofessional healthcare team to provide comprehensive, multi-component care for adults with overweight or obesity, as appropriate for and desired by each client.
AWM: Coordinate Care in a Variety of Settings
Registered dietitian nutritionists or international equivalents providing medical nutrition therapy interventions for adults with overweight and obesity should coordinate care in a variety of settings, including primary care/outpatient, community and workplace settings, to access and support each client with resources in the environment that best suits individualized needs.
AWM: Number and Frequency of Interactive Contacts
Registered dietitian nutritionists or international equivalents may provide at least five interactive sessions, when feasible and desired by each adult client with overweight or obesity, to achieve the greatest potential improvement in outcomes. Frequency of contacts should be tailored to each client’s preferences and needs.
AWM: Intervention Duration
Registered dietitian nutritionists or international equivalents should provide overweight and obesity management interventions for a duration of at least one year to improve and optimize cardiometabolic and weight outcomes, as appropriate for and desired by each client.
AWM: Follow-Up Contacts
Following completion of overweight and obesity management interventions, registered dietitian nutritionists or international equivalents should provide follow-up contacts at least every three months, for as long as desired by each client, to facilitate maintenance of weight loss and improved cardiometabolic outcomes.
AWM: Telehealth and In-Person Care
Registered dietitian nutritionists or international equivalents may use telehealth, in-person contacts, or a blend of these delivery methods when providing MNT interventions to adults with overweight or obesity. Outcomes may be optimized by including in-person contacts.
AWM: Group and Individual Contacts
Registered dietitian nutritionists or international equivalents may use both individual and group delivery methods when providing MNT interventions to adults with overweight or obesity, as feasible and appropriate for each client.
AWM: Payment for Services
It is reasonable and necessary for registered dietitian nutritionists or international equivalents to be aware of and utilize existing channels of payment for services for adults with overweight or obesity to improve client access to care.
AWM: Dietary Patterns
Registered dietitian nutritionists or international equivalents should advise adult clients with overweight or obesity that many different dietary patterns can be individualized to support client-centered goals. Prescribed dietary approaches should achieve and maintain nutrient adequacy and be realistic for client adherence. Prescribed calorie levels should be tailored based on estimated or measured needs and should be adjusted to improve weight outcomes, as appropriate for and desired by each client.
AWM: Components of a Comprehensive Intervention
Registered dietitian nutritionists or international equivalents should advise the following components as part of a comprehensive adult overweight and obesity management intervention to improve cardiometabolic outcomes, quality of life, and weight outcomes, as appropriate for and desired by each client:
- Nutritionally adequate diet with adjusted calories to improve weight outcomes and a nutritionally adequate, energy-balanced diet for weight maintenance;
- Behavioral strategies, including self-monitoring (diet, physical activity, weight);
- Appropriate physical activity to meet client goals (within the RDN’s scope of practice or referral to an exercise practitioner).
AWM: Co-Morbidities
Registered dietitian nutritionists or international equivalents should collaborate with clients and healthcare teams to manage co-morbidities such as type 2 diabetes mellitus, cardiovascular disease, dyslipidemia and other potential complications associated with overweight or obesity by tailoring MNT to each client’s specific health care needs, including medications, while supporting weight loss.
AWM: Pharmacotherapy and Metabolic and Bariatric Surgery
Adults with obesity who receive pharmacotherapy or metabolic and bariatric surgery should collaborate with registered dietitian nutritionists or international equivalents, as part of an interprofessional healthcare team, to improve and maintain a healthy diet that meets nutritional needs and advances weight-loss efforts to improve cardiometabolic outcomes.
AWM: Members of Groups Disproportionately Affected by Overweight or Obesity and Under-Resourced Communities
For adults who are members of groups disproportionately affected by overweight or obesity, or under-resourced communities (e.g., adults with low socioeconomic status, adults from racial or ethnic minority groups, older adults, adults with disabilities), registered dietitian nutritionists or international equivalents should provide culturally appropriate interventions that are tailored to each client’s values, beliefs and barriers regarding excess weight, and food and physical activity behaviors.
