Initial Review

After looking at baseline data, consider

  • Level of motivation & position on cycle of change
  • Integrated planning
  • Healthy eating dietary advice, preferably written. Encourage an energy deficit of approx 500 kcals/day
  • Physical activity programme
  • Behavioural counselling. Encourage self monitoring of goals using a food and activity diary
  • Local support network ( family, friends)
  • Community support network
  • Use of commercial enterprises
  • Need for pharmacotherapy
  • Offer detailed advice regarding risk factors and co-morbidity

Refer if special considerations

 Special considerations

 Refer to

 Diabetes

 Diabetes integrated 
 care service

 CHD

 Check if patient is
 under care of cardiac
 specialist nurse

 Poor mobility

 Refer to physiotherapy
 or rheumatology clinics

 Lack of exercise

 Give general advice but
 also use exercise
 referral schemes,
 walking for health,
 green gym etc

 Special dietary
 requirements/restrictions

 eg renal disease,
 allergies, coeliac
 disease. Enlist
 specialist dietetic
 support

 Psychological problems

 Refer for counselling

 Mental health problems

 Refer to psychiatric
 service

Review 2

  • Preferably within a month
  • Review food & activity diary
  • Discuss specific difficulties i.e. triggers etc
  • Weight, waist circumference, Blood Pressure
  • Use of patient held record cards
  • Motivation and positive encouragement
  • Behavioural and lifestyle changes
  • Treatment plan changes
  • Agree realistic goals for next visit