Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
Research Group Nutrition, Dietetics, and Lifestyle, HAN University of Applied Sciences, Nijmegen, the Netherlands.
J Hum Nutr Diet. 2025 Feb;38(1):e13387. doi: 10.1111/jhn.13387.
Dietetic treatment of adults with obesity can result in effective weight loss with health improvements. However, it remains unclear which components of dietetic consultation are key for successful treatment of individual patients. Therefore, the aim of this study is to explore dietitians' perceptions of key components relevant for successful dietetic treatment of adults with obesity in primary health care in the Netherlands.
In this phenomenological study, semistructured interviews were conducted with 18 dietitians who have experience in treating adults with obesity in primary care. Validation of interview data was performed through two focus group discussions with 14 dietitians. Thematic analysis was used to analyse the data.
Four main themes were identified: (i) building a good relationship; (ii) identifying patient needs; (iii) supporting behaviour change and (iv) providing advice. Dietitians highlighted the relevance of building a good relationship with their patients and emphasised adopting a counselling role alongside their role of educator. They also recommended the use of educational materials, counselling techniques and behaviour change strategies (e.g. goal setting, self-monitoring, addressing barriers) to address specific patient needs, such as health literacy, self-efficacy and motivation.
This study demonstrates that dietitians perceive the ability to build a trusted relationship, in which patient needs are properly explored and addressed, as the key to successful dietetic treatment of adults with obesity. Our findings emphasise the importance of the dietitian's approach in this process and show that patient factors influence the choice of appropriate treatment approaches.
对肥胖成年人进行饮食治疗可以有效减轻体重，改善健康状况。然而，目前尚不清楚饮食咨询的哪些组成部分是成功治疗个体患者的关键。因此，本研究旨在探讨荷兰初级保健中营养师对治疗肥胖成年人饮食治疗成功的关键因素的看法。
在这项现象学研究中，对 18 名有在初级保健中治疗肥胖成年人经验的营养师进行了半结构化访谈。通过与 14 名营养师进行的两次焦点小组讨论对访谈数据进行了验证。使用主题分析对数据进行分析。
确定了四个主要主题：（i）建立良好的关系；（ii）确定患者的需求；（iii）支持行为改变；（iv）提供建议。营养师强调与患者建立良好关系的相关性，并强调在教育者角色之外采用咨询角色。他们还建议使用教育材料、咨询技巧和行为改变策略（例如目标设定、自我监测、解决障碍）来满足特定患者的需求，例如健康素养、自我效能和动机。
本研究表明，营养师认为建立可信赖的关系的能力，在这种关系中适当探索和解决患者的需求，是成功治疗肥胖成年人饮食的关键。我们的研究结果强调了营养师在这一过程中的方法的重要性，并表明患者因素影响了治疗方法的选择。
