Study results suggest that incorporating registered dieticians into the nutritional guidance of patients with obesity can favorably influence health outcomes.

Research has shown that diet therapy with weight loss can help decrease risks for obesity- and other lifestyle-related diseases and conditions, such as metabolic syndrome. Reducing the amount of visceral fat in the body can significantly reduce the number of metabolic risk factors patients may develop. Experts have defined severe obesity as a BMI above 35 kg/m², and some studies have suggested pathophysiological differences between patients with BMIs above 35 kg/m² and those with BMIs between 25 kg/m² and 35 kg/m². As such, people with BMIs higher than 35 kg/m² are often treated and cared for differently than other individuals with obesity or overweight.

Although registered dietitians are often present at hospitals and public health centers, there is currently no established guidance for measuring obesity. Initial nutritional guidance typically involves interviewing patients to evaluate their dietary habits. Upon completing these interviews, appropriate approaches to calorie intake can be recommended. However, it is unclear whether patients with obesity generally receive proper nutritional guidance and ongoing follow-up, especially among those who visit general hospitals for other diseases or health conditions.

For a study published in Frontiers in Nutrition, Takatoshi Anno, MD, PhD and colleagues investigated whether nutritional guidance interventions were appropriately provided to patients with moderate obesity, which was defined as a BMI above 30 kg/m². “Our study is particularly important because nutritional guidance interventions may prove to be more effective than current approaches for managing obesity,” Dr. Anno says. The study authors also evaluated the effectiveness of nutritional guidance interventions in improving obesity and metabolic parameters during a short period. Specifically, BMI and metabolic markers were compared between patients who received nutritional guidance from a registered dietitian with those who did not.

Few Patients With Moderate Obesity Receive Nutritional Guidance

Of the 636 patients with moderate obesity included in the study, only 164 received nutritional guidance from a registered dietitian at least once. Most interventions on nutritional guidance that were conducted by a registered dietitian were ordered from internal medicine. However, internal medicine was the most common department that did not perform these interventions.

A secondary analysis compared patients who underwent blood examinations and received nutritional guidance from a registered dietitian with those who did not receive such guidance. While there were no significant differences in body weight and BMI between these groups, the study team observed a noteworthy decrease in dyslipidemia-associated metabolic markers among patients who received nutritional guidance (Table). Other metabolic markers also tended to decrease for those receiving guidance, but they did not reach statistical significance.

Incorporate Registered Dieticians into Treatment Plans

Although physicians and surgeons rarely refer patients with obesity to registered dietitians for nutritional guidance, diet therapy has been shown to have beneficial effects in these types of cases. “By providing appropriate nutritional guidance, improvements in BMI and metabolic parameters can be expected,” says Dr. Anno. “It’s important to incorporate registered dieticians into the nutritional guidance of patients with obesity because it can favorably influence health outcomes.” The findings also highlight the lack of nutritional guidance and treatment during hospitalization. Patients should be encouraged to proactively seek and use nutritional guidance.

The study group noted that short-term nutritional guidance interventions might lead to favorable outcomes in patients with obesity, especially for those who do not exhibit symptoms and are admitted to the hospital. “It’s possible that effective short-term interventions might help patients better understand the importance of nutrition,” Dr. Anno says. Even small amounts of weight loss for these individuals can improve health outcomes. In fact, results from a recent intervention study confirmed that even a 3% weight loss can improve health problems.