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British Columbian dietitians' perspectives on their experiences with weight loss counselling for children and adolescents Bouttell, Shelagh Ann

Abstract

The prevalence of childhood and adolescent obesity has been increasing rapidly over the past decade, yet at this time, there is a lack of evidence regarding effective treatment approaches on which to base practice. At the same time, confusion seems to exist among dietitians as to the meaning and integration of different treatment philosophies, approaches and appropriate outcome measurements, raising questions about how dietitians are managing cases involving pediatric obesity in their practice. This study was undertaken to develop an understanding of dietitians' experiences of providing services to obese youth in British Columbia's Lower Mainland. Between 2004 and 2006, 13 practicing dietitians participated in individual interviews where they discussed their experiences of weight loss counselling with obese children and adolescents. A qualitative research design informed by grounded theory methodology was used to analyze these interviews. Experiences shared by dietitian informants reflected their frustration, doubt and conflict regarding what they should and could be doing with their clients when it came to weight management. They attributed this distress to four primary issues: inadequate time and resources to do their work effectively, client's lack of readiness to make behavioural change, the lack of appropriate counselling skills to be helpful to their clients and finally, uncertainty about how to best deal with the complex problem of obesity. These experiences impacted informants in different ways, and each found ways of addressing these challenges while continuing to work in the area of childhood obesity. Informant dietitians felt unsupported in their work, inadequately trained to support their clients, and uncertain how their profession should proceed in the management of childhood and adolescent obesity. The findings have important practice, education and research implications for the dietetics profession.

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